Immune cell subset variations in immune thrombocytopenia: a prospective observational study

This study evaluated immune cell subset variations in immune thrombocytopenia (ITP) by comparing frequencies at diagnosis with controls and assessing changes post-therapy. A single-center prospective observational study enrolled 25 untreated acute and chronic ITP patients and 20 matched controls from January 2018 to January 2019. Immune cell subsets, including CD4+, CD8+, NK cells, NK-T cells, and T regulatory cells (Tregs), were analyzed using flow cytometric immunophenotyping. Patients received standard therapy, with responses assessed after 1 month using international criteria. The median age of patients was 43 years, with 52% female. At diagnosis, patients exhibited significantly lower Tregs (p = 0.001) and NK-T cells (p = 0.017), higher CD8+ cytotoxic T-cells, and a reduced CD4/CD8 ratio (p = 0.001) compared to controls. Following therapy, 85% of patients responded: 45% achieved complete response, and 40% partial response. However, post-treatment immune cell subsets did not differ significantly from baseline, nor could they predict response. ITP patients display notable immune cell abnormalities compared to controls, though these differences do not serve as reliable predictors of treatment outcomes. Further large-scale studies with functional analyses are essential to elucidate ITP pathogenesis and identify therapeutic targets.