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Abstact: thrombopotin and immune response

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14 years 8 months ago #11714 by lucidawn
Did anyone read this? I found it pretty interesting, considering the topic of platelet production and thrombopoietic agents, Promacta and NPlate. Apparently there is some positive immune responses.

www.ncbi.nlm.nih.gov/pubmed/20688957

Most of you have probably already read it, but for those who haven't:

Abstract
Immune thrombocytopenia (ITP) is an autoantibody-mediated bleeding disorder with both accelerated platelet destruction and impaired platelet production. We and others have described impaired regulatory CD4(+)CD25(hi) T cells (Treg) numbers and/or suppressive function in ITP patients. Clinical trials using thrombopoietic agents to stimulate platelet production have shown favorable outcomes in ITP patients, but information on the immunologic responses of treated patients are lacking. We studied the immunologic profile of chronic ITP patients before (n = 10) and during treatment with thrombopoietin receptor (TPO-R) agonists (n = 9). Treg activity, as measured by suppression of proliferation of autologous CD4(+) CD25(-) cells, was improved in patients on treatment (P < .05), and the improvement correlated with reduction in interleukin-2-producing CD4(+) cells, consistent with dampening of immune responses. There was a concomitant increase in total circulating transforming growth factor-β1 (TGF-β1) levels (P = .002) in patients on treatment, and the levels of TGF-β1 correlated with the degree of improvement in platelet counts (r = .8, P = .0002). This suggests that platelets in patients on TPO-R treatment may play a role in improving Treg function, either directly or indirectly by enhanced release of TGF-β1 as a result of greater platelet turnover. In conclusion, our findings suggest that thrombopoietic agents in patients with ITP have profound effects to restore immune tolerance.

PMID: 20688957 [PubMed - indexed for MEDLINE]PMCID: PMC2996119 [Available on 2011/11/25]

Donna Ingold
Mom to Kelly 22, Karen 21, Josiah 19 (Congenital Heart Defect, MS), Timothy 17 (Chronic Refractory ITP-dx 5/03, Asthma), Isaac 15(blind left eye).

Allergic and Refractive to WinRho
Shortlived small response to IVIg(a few days of 30k or less).
0-1k since September 2010
No response to...
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14 years 8 months ago #11721 by tacmom
Thanks Donna, for posting this! I got the email, but I couldn't open it. This is a very interesting article! In the beginning, we noticed that Nplate was helping with Caitlin's wbc counts, but now it doesn't seem to have any effect. I can't say her pattern of getting sick is less/more. She was feeling flu-like earlier this week but only had a low grade fever. (And tested negative for strep/flu)

Pauline-mom of Tiffany (age 14) and Caitlin (Chronic ITP, UCTD -age 13)

Diagnosed: 03/02/07
Current count (Feb 2011): 138
Current dose: 1 mcg/kg

Treatments tried: IVIG (doesnt work), Prednisone (sometimes works with high doses), Nplate (2 years on it-worked, but had to be taken off due to...
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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14 years 8 months ago #11737 by Sandi
Yeah, I saw that last night. I'm not quite sure what to think.
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