Significance Of Leptin And Leptin Receptor In Primary Immune Thrombocytopenia

Objective: To detect the leptin and its receptor in patient with PrimaryImmune Thrombocytopenia, exploring the role played in pathogenesis ofprimary ITP and the correlation between clinical characteristic andtherapeutic effect.Methods: Enzyme-linked immunosorbent assay (ELISA) was used todetect the plasma leptin and soluble leptin receptor (sLR) in 34 healthycontrol and 32 Primary ITP patients. By reverse transcription-polymerasechain reaction (RT-PCR), the mRNA of long obese receptor (Ob-RL) andshort obese receptor (Ob-RS) in peripheral blood mononuclear cells (PBMC)were assayed. Patients’clinical characteristics and therapeutic effect werealso evaluated so as to investigate the pathogenesis of primary ITP and thecorrelation between clinical characteristic and therapeutic effect.Results:1. The mean level of plasma leptin in patients with primaryITP(337.54±181.75 pg/ml)was significantly higher than that of the healthycontrols (255.75±143.87 pg/ml)( P＜0.05).2. The mean level of plasma sLR in patients with primary ITP(15.13± 4.65 ng/ml)was obviously lower than the healthy controls(17.94±5.96 ng/ml)(P＜0.05).3. Only a part of primary ITP patients and healthy controls expressedOb-RLmRNA in PBMCs and the positive rate in ITP patients(62.5%)washigher than that of the healthy controls(35.3%)(P＜0.05).All the ITP patientsand healthy controls expressed Ob-RSmRNA in PBMCs and the meanoptical density value in ITP patients(0.47±0.32)was lower than that of thehealthy controls (0.97±0.84)( P＜0.05).4. The expression level of leptin and its receptor in patients with ITPwas not relevant to the patients’age, the count of PLT, the BMI as well as thetherapy frequency, but the expression of plasma sLR and Ob-RLmRNA wasgender related. The positive expression rate of Ob-RLmRNA in malepatients(100%)was higher than that of the female(52.00%)(P＜0.05).Themean level of plasma sLR in male patients(11.54±3.03 ng/ml)wasstatistically lower than that of the female (16.13±4.60 ng/ml)(P＜0.05).5. There was no significant correlation between the therapeutic effectand the expression of sLR, Ob-RSmRNA in ITP patients. There were acorrelation between the plasma leptin and Ob-RLmRNA expression levelabout gender. The mean level of plasma leptin in patients sensitive to therapy(294.32±146.12 pg/ml)was distinctly lower than that of those with no response(467.17±224.79 pg/ml)(P＜0.05). The positive rate of Ob-RLinpatient with response(75%) was distinctly higher than that of those with noresponse(25%)(P＜0.05).Conclusion:1. The alteration in the expression of leptin and its receptor waspossibly one of the pathogenesis for primary ITP.2. Leptin and its receptors were not the preferred indicators for theassessment of clinical conditions in patients with primary ITP.3. There was a correlation between the therapeutic effect and theexpression level of leptin as well as Ob-RLmRNA. The mean level ofplasma leptin in patients with no response to therapy was higher than that ofthe sensitive ones. The positive rate of Ob-RLwas lower than that of thesensitive ones. The expression level of leptin and Ob-RLmRNA were maybethe proper indicators to judge the therapeutic effect in ITP patients.