Study Of The Related Factors On Idiopathic Thrombocytopenic Purpura In Children

Partâ… Clinic Study on Cell Immune Conditions and Curative Turnover of Idiopathic Thrombocytopenic Purpura with Human Cyto-megalovirus Infection in ChildrenObjective Exploring the correlation between HCMV infection and the onset, therapeutic effect and prognosis in children with idiopathic thrombocytopenic purpura(ITP), in order to give some reference for more effective treatment of this disease.Methods Comparing the HCMV infection rate and cell immune conditions between 230 children with ITP and the control group of 200 children with acute upper respiratory infection(AURI) treated in our department between January,2002 to December,2006,by testing the serum HCMV antibodies with ELISA method and detecting the peripheral blood lymohocyte subsets with flow cytometry individually.Further,ITP patients were divided into two groups based on whether they were infected with HCMV or not..The two groups were compared with regard to the cell immune conditions,short-term effectiveness of treatment(two weeks) and long-term results(over six months).Results 88 out of 230(38.26%) ITP children were found with HCMV infection,and 165 cases(71.74%) with abnormal peripheral blood lymphocyte subgroup.22 out of 200 (11.0%)AURI patients were found with HCMV infection,and 36 cases(18.0%) with abnormal lymphocyte subgroup.There was a significant difference between these two groups(P＜0.01).At the first visit,74(84.09%) were found with abnormal cell immune condition in the HCMV group,and 91(64.08%) in non-infected group;after 6 months, 24(27.27%) were found abnormal in the HCMV group,and 5(3.52%) in non-infected ones. There was a remarkable difference between these two groups(P＜0.01).No significant difference existed in the short-term effectiveness of treatment between the group with HCMV infection and the group without that(P＞0.05).35 cases(39.78%) in the HCMV group had a course over 6 months,whereas 24(16.90%) in non-infected group.The difference is significant(P＜0.01).20 out of 34(58.82%) had a course over 6 months in the regular therapy group,and 15 out of 54(27.78%) did in the antivirus therapy group.The difference is also significant(P＜0.01).Conclusion Abnormal cell immune conditions induced by HCMV infection is probably one of the important factors that make a prolonged course of ITP in children. Further more,our study showed that anti-HCMV therapy resulted in good recovery of children from ITP with little side effect and that most children tolerated well to the therapy. Partâ…¡The change of CD4+CD25HighFoxp3+Treg cell and the Foxp3 gene expression in childhood acute idiopathic thrombocytopenic purpura before and after treatmentObjective Exploring the CD4⁺CD25^HighFoxp3⁺Treg cell function in the mechanism of acute idiopathic thrombocytopenic purpura and the role in therapy with gamma globulin and adrenal corticoid by studying the change of CD4⁺CD25^HighFoxp3⁺Treg cell percentage and the Foxp3 gene expression before and after treatment of acute idiopathic thrombocytopenic purpura.Method The change of CD4⁺CD25^HighFoxp3⁺Treg cell percentage was detected by flow cytometry,while the expression of Foxp3 gene was tested by RT-PCR.Results The CD4⁺CD25^HighFoxp3⁺Treg cell percentage and the Foxp3 gene expression in acute idiopathic thrombocytopenic purpura group before treatment were significantly lower than those of the normal control group(P＜0.01),but after treatment with adrenal corticoid alone or plus gamma globulin,the CD4⁺CD25^HighFoxp3⁺Treg cell percentage and the Foxp3 gene expression in acute idiopathic thrombocytopenic purpura group rose obviously higher than those of the normal control group(P＜0.01).Compared with group treated with adrenal corticoid alone,the group treated with corticoid plus gamma globulin was remarkly higher in CD4⁺CD25^HighFoxp3⁺Treg cell percentage and the expression of Foxp3 gene.Meanwhile,the recovery time of platelet number in group treated with corticoid plus gamma globulin was significantly shorter than that of using corticoid only(P＜0.05).Conclusion The decreasing of CD4⁺CD25^HighFoxp3⁺Treg cell and the Foxp3 gene expression play a role in the mechanism of children acute idiopathic thrombocytopenic purpura.Furthermore,adrenal corticoid and gamma globulin have a therapeutic effect on acute idiopathic thrombocytopenic purpura by inducing the expansion and activation of CD4⁺CD25^HighFoxp3⁺Treg cell. Partâ…¢Analysis of lymphotoxin gene polymorphism in children with idiopathic thrombocytopenic purpuraObjective To study on the gene polymorphism of LTα+252 distribution in children with ITP in Hubei,China,and explore the association of genotype frequency of LTαgene with the susceptivity of ITP.Method Eighty- eight ITP children and one hundred health controls were genotyped by the PCR-RFLP method for gene polymorphism of LTα+252,then compared the genotypes frequency between these two groups.Result The genotypes frequency of LTα+252G/G,G/A,A/A in ITP children were 27.27%,50.00%,22.72%individually,and there were no statistic difference compared with the control group.Conclusion No association was detected between the heterozygous genotype of LTα+252 and ITP in children of Hubei,China.