Efficacy of immunomodulatory therapy with all-trans retinoid acid in adult patients with chronic immune thrombocytopenia
Efficacy of immunomodulatory therapy with all-trans retinoid acid in adult patients with chronic immune thrombocytopenia
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DOI：
10.1016/j.thromres.2016.02.013
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发表时间：
2016-04-01
影响因子：
7.5
通讯作者：
Ruan, Chang-geng
中科院分区：
文献类型：
--
作者：
Dai, Lan;Zhang, Ri;Ruan, Chang-geng
简介：免疫性血小板减少症（ITP）是一种常见的血液系统疾病的特点是孤立的血小板减少症。在成人中，ITP更可能是慢性的，需要个性化的治疗和管理。糖皮质激素和脾切除术是ITP最常用的治疗方法。然而，这些常规方法在这些慢性ITP患者中失败。本研究的目的是评估免疫调节治疗与全反式维甲酸（ATRA）在成人慢性ITP.Materials和方法患者的疗效：ATRA治疗共35例慢性ITP谁与标准剂量的糖皮质激素和/或脾切除术失败。结果：完全缓解10例（28.6%），总缓解19例（54.3%）。与对照组相比，ITP患者外周血Treg细胞、IL-10和Foxp 3表达水平均明显降低。结论：ATRA治疗可诱导慢性ITP患者Treg细胞发生明显变化，从而诱导ITP的免疫应答。(C)2016爱思唯尔有限公司版权所有。
Introduction: Immune thrombocytopenia (ITP) is a common hematologic disorder characterized by isolated thrombocytopenia. In adults, ITP is more likely to be chronic, requiring individualised treatment and management. Corticosteroids and splenectomy are the most common therapy for ITP. However, these routine approaches failed in these patients with chronic ITP. The aim of this study was to evaluate the efficacy of immunomodulatory therapy with all-trans retinoid acid (ATRA) in adult patients with chronic ITP.Materials and methods: ATRA therapy was applied in a total of 35 patients with chronic ITP who failed with standard dose corticosteroids and/or splenectomy. The response ratio and the change of the T cell subsets including Th1, Th2, Th17 and Treg, were evaluated.Results: Complete response and overall response were observed in 10 (28.6%) and 19 patients (54.3%), respectively. Compared with the control group, a significant decreased level of Treg cells, IL-10 and Foxp3 expression were found in ITP patients. ATRA therapy could significantly increase the percentage of Treg cell, IL-10 level and Foxp3 expression.Conclusions: Our findings indicate that ATRA therapy could induce significant changes of Treg cells to induce response in patients with chronic ITP. (C) 2016 Elsevier Ltd. All rights reserved.