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Published on: July 22, 2011
CD8+CD25+ Tregs as a predictor of glucocorticoid sensitivity in patients with immune thrombocytopenia
Sara El-Sayed Abd El-Ghani1, Lina Ayman Mahmoud Mohamed1, Mohamed Roshdi El-Masry1
1Department of Internal Medicine, Clinical Hematology Unit, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Background:
ITP is an immune-mediated disorder showing increased platelet destruction and reduced platelet production. Glucocorticoids are the first-line treatment, but 10-20% of patients are insensitive to them. We should avoid the irrational use of steroids for treating ITP. No markers exist to predict treatment responses in ITP. Recently, a few studies showed abnormal ratio and function of Tregs in ITP patients and that the levels of Tregs change after glucocorticoid treatment. We aimed to study the value of CD8+ CD25+ Tregs in predicting glucocorticoid sensitivity in newly diagnosed ITP patients.
Research Design And Methods:
This cohort (longitudinal) study included 60 ITP patients. The baseline platelet counts and levels of CD8+ CD25+ Tregs were measured at diagnosis. The response to steroids was evaluated after 2 weeks of treatment, then after 3 months and 6 months.
Results:
The ROC curve was plotted, and the p value was not significant; therefore, the optimal critical value, specificity and sensitivity could not be determined.
Conclusions:
This study couldn't confirm the value of CD8+CD25+ Tregs in predicting glucocorticoid sensitivity in ITP, but there was a significant positive correlation between the CD8+CD25+ Tregs percentage and the steroids' response after 2 weeks. Therefore, further studies are recommended.
