Alteration And Significance Of Serum TPO, IL-11and TNF-αof ITP Patients

Objective Primary immune thrombocytopenia (ITP), previously called idiopathicthrombocytopenic purpura, is an autoimmune bleeding disorder that affects bothchildren and adults. Until fairly recently, it was considered an autoantibody disorder inplatelets. More recently, studies have shown that in many patients there is a relativeplatelet underproduction that contributes to the thrombocytopenia seen in this disease.The objective of our research is to explore the significant of serum thrombopoietin(TPO), interleukin-11(IL-11) and tumor necrosis factor-α (TNF-α) before and aftertreatment in immune thrombocytopenic purpura (ITP) and the quantity relationshipwith platelet (PLT) and megakaryocytes (MK).Methods Double antibody sandwich enzyme-linked immunosorbent assay (ELISA)was applied to detect the levels of serum TPO, IL-11and TNF-α in30cases of ITPpatients before treatment, twenty cases of ITP patients after treatment and30normalsubjects, PLT and megakaryocytes on bone marrow smears were counted.Results Serum TPO (542.32±97.37pg/ml) and TNF-α (278.15±68.02pg/ml) of ITPpatients before treatment were significantly increased than the normal group (60.40±5.07pg/ml，66.95±10.57pg/ml)(P<0.01), and these of patients after treatment (356.06±33.64pg/ml，88.51±25.36pg/ml) were decreased significantly (P<0.01).The level ofTPO after treatment is still higher than those in normal controls，the levels of TNF-αafter treatment and normal control is no significant different. The level of serum IL-11before treatment (343.33±81.63pg/ml) was significantly higher than the normal level(83.05±7.21pg/ml)(P<0.01), but lower than the level after treatment (653.84±86.88pg/ml)(P<0.05). Marrow MK number of ITP patients (262.20±86.37/piece) wassignificantly higher than that of iron deficiency anemia (28.40±8.23/piece). The levelof the above cytokines before treatment had no significant correlation with PLT andMK, and the level of IL-11before treatment was positively correlated with the level ofTNF-α (r=0.711, P<0.01).Conclusion The levels of TPO, IL-11and TNF-α in peripheral blood of ITP patientsbefore treatment were significantly higher than the normal levels, and the levels ofIL-11and TNF-α were positively correlated; TPO and TNF-α decreased after treatment, while IL-11continued to rise. Our date hinted that increased TPO, IL-11and TNF-αmight contribute to the pathogenesis of ITP, which might be helpful for the diagnosisand prognosis of ITP.