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IJHSR. 2016; 6(10): 68-75


Interleukin 7 in Primary Immune Thrombocytopenia: A Case Control Study.

Nahela Ahmed Shalaby, Shaimaa Abdelmalik Pessar, Radwa Mohamed Salah.

Abstract
Introduction: Primary immune thrombocytopenia (ITP) is an acquired immune-mediated disorder characterized by isolated thrombocytopenia without any underlying cause. Until recently, the abbreviation ITP stood for idiopathic thrombocytopenic purpura, but current awareness for the immune-mediated nature of the disease, and the absence or minimal signs of bleeding have led to a revision of the terminology. Concepts surrounding the mechanisms of thrombocytopenia in ITP have shifted from the traditional view of increased platelet destruction mediated by auto antibodies to more complex mechanisms in which both impaired platelet production and T cell-mediated effects play a role. Interleukin-7 (IL-7) is a key factor for thymocyte survival and lymph node maturation. Recent studies indicate its important role in autoimmunity; polymorphisms in the IL-7 receptor (IL-7Rα) have been associated with increased risk for autoimmune disease and blocking IL-7Rα antibodies showed therapeutic efficacy in several autoimmune mouse models.
Aim: To evaluate the level of IL-7 in primary immune thrombocytopenia for possibility of being adopted as a reliable marker for ITP.
Materials and Methods: A total of 65 children were enrolled in the study; 45 ITP patients (35 active and 15 in remissions) diagnosed according to recent IWG criteria in The Pediatric Clinic of ASUH and 15 healthy subjects were taken as control group. All were assessed for plasma and BM levels of IL-7 by ELISA.
Results: Our study revealed a significant decrease in plasma IL7 level in both whole ITP patients and active ITP groups than control group, but IL7 level in BM of all patient groups show no significant difference over control. Plasma IL7 has a diagnostic utility in ITP at certain cut-offs.
Conclusion: IL7 can be relied upon as a diagnostic marker for ITP at cut-off (15 pg/ mL). However, its role in prognosis needs further investigations.

Key words: ITP, IL-7, primary immune thrombocytopenia.



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