Gene Expression Of CD72 In Immune Thrombocytopenia

Objectives:To explore the role of CD72 in the pathogenesis of immune thrombocytopenia (ITP), we detected CD72, Sema4D, IL-4 and IFN-?mRNA expression and the levels of plasma Sema4D, IL-2, IL-4, IL-6 and INF-?in ITP patients(n=39) and controls (n=23).Methods:The levels of plasma IL-2, IL-4 and IL-6 were assayed by radioimmunoassay (RIA), The levels of plasma INF-?and sSema4D were analyzed by enzyme-linked immunosorbent assay(ELISA). Sema4D, CD72, IFN-?and IL-4MRNA expression by real-time quantitative reverse-transcription polymerase chain reaction (RT-PCR).Results:The expression of CD72 mRNA in ITP patients (n=23) with active disease was significantly lower than that in patients in remission (P<0.05) (n=16) and controls (P<0.05) (n=23). The IFN-?/IL-4 mRNA (Th1/Th2) expression in ITP patients with active disease and in remission was significantly higher than that in controls (P<0.01, P<0.05). The level of plasma IL-2 in ITP patients with active disease was significantly lower than that in patients in remission (P<0.05) and controls (P<0.05). The levels of plasma IL-4 in ITP patients with active disease and in remission were significantly higher than that of controls (P<0.01). The CD72 mRNA expression level correlated with Sema4DmRNA expression in peripheral blood mononuclear cells and level of plasma IL-2 in active ITP patients (P=0.024 and P=0.036).Conclusions:Our findings suggest that CD72 plays a negative role and correlate with Sema4D mRNA expression in peripheral blood mononuclear cells and level of plasma IL-2 in the active ITP patients. In this retrospective study, we evaluated the clinical features and the effects of various treatment modalities on the clinical course in elderly patients (i. e., age?60 yr) diagnosed with immune thrombocytopenia (ITP) at our center from 1980 to 2009. We retrospectively examined the medical records of 525 (325 females,200 males) ITP patients. The median age of the patients at presentation was 66 years (range:60-91yr). At initial diagnosis,461 (87.8%) patients had signs of bleeding, we find 62.5% patients had co-existing diseases, the most prevalent of which were hypertension (n=112,22.1%) and coronary heart disease (n=77,14.7%). One hundred-and-Forty-four patients (27.4%) received no treatment, and 299 (57%) received first line treatment only. Fourteen patients (2.7%) underwent splenectomy. Ninety patients who have follow-up?12months, (median51months, range,12-128months) the total rate of response was 68.8%(CR+PR).31.2%patients had not achieved CR or R, but the median platelets was 48.5�109/L (range,5-95�109/L). The death rate from causes directly related to ITP or its treatment was 8.0%with at last follow up in 113patients. In conclusion, there are more female aged patients during 60-69 years old. The splenectomy was rarely performed in patients more than 60 years old because of a good reponse to therapy. Even though the mortality was higher attributed to ITP or complications, this incidence was not significantly different from other death cause (p>0.05). This retrospective review represents the largest collection of elderly patients with ITP in China in a single center.