Assessment of Interleukin-27 in Patients with Primary Immune Thrombocytopenia

Abstract

SUMMARY AND CONCLUSION I mmune thrombocytopenic purpura (ITP) is a disorder mediated by antiplatelet antibodies and characterized by accelerated destruction of platelets and impaired platelet production. The result is thrombocytopenia of varying degrees. Clinically recognized cases are typically associated with marked, isolated thrombocytopenia, mucocutaneous bleeding, and, rarely, more severe hemorrhage (ie, intracranial hemorrhage). Recent advances in our understanding of the specific pathways involved in immune-mediated platelet destruction, the significance of cytokine profiles in the pathogenesis of ITP and the newly discovered heterodimeric IL 27 by Pflanz et al. (2002) and its pleotropic proinflammatory and anti-inflammatory effects have led to the development of new insights regarding its role in the pathogenesis of ITP and whether manipulation of IL-27 could be used therapeutically to modulate inflammation in ITP or other autoimmune diseases. In this study serum level of IL 27 was measured in 30 ITP patients subgrouped to denovo, chronic on treatment and remitted ITP patients in comparison to 30 healthy adults (control group). In general, significantly higher IL 27 levels were observed in ITP patients than in controls with a sensitivity of 100%, and a specificity 80% at cut of level of 20 assessed by ROC curve. And when comparing IL 27 level in different groups of ITP patients there was a higher level of IL 27 in de novo ITP patients than those patients on treatment. However there were rising s.levels in those remitted ITP patients stopped their medications. These findings promote the previous suggestions about the role of IL 27 in the pathogenesis of ITP, indicating that IL 27 is an important target for further investigations. And raise the possibility for using IL 27 as an indicator of disease activity and the possibility of relapse.