Role of Circulating Myeloid-Derived Suppressor Cells in Pathogenesis of Immune Thrombocytopenia in Children and Adolescents

Abstract

mmune thrombocytopenia (ITP) is an acquired autoimmune bleeding disease characterized by mutually increased platelet I destruction and decreased platelet production. ITP involves complicated upstream immune dysregulations in which T-cell subsets are supposed to take the center stage. MDSCs (myeloid-derived suppressor cells) are a heterogeneous group of immune cells from the myeloid lineage. MDSCs strongly expand in pathological situations such as chronic infections and cancer. MDSCs interact with other immune cell types including T cells, dendritic cells, macrophages and natural killer cells to regulate their functions. Decreased number and defective function of MDSCs may have a contributing role in the hematologic diseases other than malignancies such as immune-mediated cytopenias or including ITP or Chronic idiopathic neutropenia (CIN) by augmenting the T-cell mediated platelet or neutrophil destruction respectively. Apparently, MDSCs represent regulatory components of the immune system with critical role in immune disorders of hemopoiesis. A Cross-sectional observational study was conducted in Ain Shams University Children's hospital in the period from November 2019 to March 2020, it included 41 children and