Background: Immune thrombocytopenia (ITP) is an immune-mediated acquired autoimmune hemorrhagic disease. About one-third of patients are unresponsive to first-line therapies. Thalidomide (THD) as an immunomodulatory agent is now used to treat several autoimmune disorders. Therefore, we assessed the safety and efficacy of THD in corticosteroid-resistant or relapsed ITP patients, and preliminarily explore its mechanism.
Methods: 50 newly-diagnosed ITP patients and 47 healthy volunteers were enrolled in this study. Additionally, 17 corticosteroid-resistant or relapsed ITP patients were recruited, with 7 cases in the rhTPO + THD group and 10 cases in the THD monotherapy group. Overall response rate at 6, 12, and 24 months were assessed. Levels of Neuropilin-1(NRP-1), regulatory T cells (Tregs) and regulatory B cells (Bregs) were detected.
Results: Expression of NRP-1, Tregs and Bregs were reduced in newly-diagnosed ITP patients. In vitro, THD treatment upregulated expression of NRP-1and Tregs only in ITP patients. As for corticosteroid-resistant or relapsed ITP patients, overall response rate at 6, 12, and 24 months was 85.7%, 57.1% and 100% in the rhTPO + THD group and 60%, 75% and 83.3% in the THD group, respectively. Additionally, rhTPO plus THD or THD therapy significantly increased the levels of NRP-1, Tregs and Bregs in responders.
Conclusions: Our study shows for the first time that NRP-1 is involved in the pathogenesis of ITP, THD could induce response in ITP patients by upregulating NRP-1 expression and restoring the proportion of Tregs and Bregs. THD might be served as a novel therapeutic agent in corticosteroid-resistant or relapsed ITP patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.intimp.2019.04.041 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effects of orelabrutinib, a BTK inhibitor, on antibody-mediated platelet destruction in primary immune thrombocytopenia.
Br J Haematol
March 2025
Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China.
Primary immune thrombocytopenia (ITP) is a haemorrhagic disorder with a complex pathogenesis, wherein autoreactive B-cell-mediated platelet destruction plays a crucial role. Bruton's tyrosine kinase (BTK) is widely expressed and essential for immune cells. Several BTK inhibitors have been used clinically to treat haematological malignancies, while few studies are focusing on the regulatory role of BTK in ITP.
View Article and Find Full Text PDFYC-4-3, a Novel Glycogen Synthase Kinase 3β Inhibitor, Alleviates the Endoplasmic Reticulum Stress of Macrophages in Primary Immune Thrombocytopenia.
Adv Sci (Weinh)
March 2025
Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Primary immune thrombocytopenia (ITP) is a heterogeneous autoimmune disease, characterized by decreased platelet count and increased risk of hemorrhage, in which macrophages play an important role in the pathogenesis. This study aims to explore the effects of YC-4-3, the patented chemical synthesis of benzothiazepinone compounds (BTZs), a novel GSK-3β inhibitor (GSK-3βi), on macrophages in ITP. The expressions of GSK-3β in monocytes are tested.
View Article and Find Full Text PDFImpact of self-reported cannabis use on veterans' intensive PTSD treatment outcomes.
Psychol Trauma
March 2025
Department of Psychiatry and Behavioral Sciences, Rush University Medical Center.
Objective: The impact of cannabis use on evidence-based posttraumatic stress disorder (PTSD) treatment outcomes remains inconclusive. Further, few studies to date have examined these relationships in intensive PTSD treatment settings, with existing literature being similarly inconclusive. The present study assessed the role of cannabis use frequency prior to and concurrent with treatment on self-reported PTSD and depressive symptoms in two samples of veterans undergoing distinct (3-week and 2-week) Cognitive Processing Therapy-based intensive treatment programs (ITPs; = 488; = 253).
View Article and Find Full Text PDF[Combination therapy with efgartigimod, fostamatinib, eltrombopag and prednisolone for a patient with refractory immune thrombocytopenia].
Rinsho Ketsueki
March 2025
Department of hematology, Toyonaka Municipal Hospital.
A 50-year-old man with immune thrombocytopenic purpura (ITP) was initially treated with prednisolone after 10 years of observation, but did not respond. Treatment with the thrombopoietin receptor agonist (TPO-RA) eltrombopag failed as well. After a transient partial response with fostamatinib, platelet counts decreased again, and the patient showed a severe bleeding tendency.
View Article and Find Full Text PDFHetrombopag treatment for immune thrombocytopenia in pregnancy refractory to corticosteroids and intravenous immunoglobulin: a case report.
Front Med (Lausanne)
February 2025
Department of Hematology, Haikou Municipal Hospital and Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China.
Pregnancy can lead to the recurrence or exacerbation of immune thrombocytopenia (ITP). Currently, first-line treatments of low-dose corticosteroids or intravenous immunoglobulin are considered safe and effective for both pregnant women and fetuses. However, there is no well-established treatment option for patients who are refractory to these medications.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!