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It is well known that idiopathic thrombocytopenic purpura (ITP) is an acquired organ-specific autoimmune hemorrhagic disease and dysfunctional cellular immunity is considered important in the pathophysiology of ITP, however, polarization and apoptosis profiles of T lymphocytes remain unclear completely. In this paper, we investigated the polarization of T cell subsets, the expressions of apoptotic proteins Fas/FasL on T cell subsets and the level of antiapoptotic gene bcl-2 and bax mRNA in the bcl-2 family, then discussed the role of them in ITP pathogenesis. We demonstrated that the ratios of Th1/Th2 and Tc1/Tc2 in ITP children increased obviously, the average percentages of Th1 and Th2 also increased clearly, but the average percentages of Tc1 and Tc2 did not changed. In ITP children, the expressions of Fas, FasL on Th, Th1, Th2, Tc, Tc1 and Tc2 increased significantly. The expressions of FasL on Th1 and Tc1 increased sharply vs. Fas, whereas the expressions of Fas on Th2 and Tc2 increased obviously vs. FasL. The expressions of bcl-2 mRNA in ITP children increased significantly, but the expressions of bax mRNA decreased, the ratios of bcl-2/bax mRNA were improved obviously and there were positive correlation between the ratios of Th1/Th2 (IFN- γ+T/IL-4+T) and the ratios of bcl-2/bax mRNA. Taken together, our findings indicate that ITP is Th1 type cell predominant disease although the precise mechanisms await further functional assay. This abnormal polarization of T cell subsets might be related to the high ratios of bcl-2/bax mRNA and the abnormal expressions of Fas, FasL on T cell subsets, as can involve in ITP immunopathogenesis. [ABSTRACT FROM AUTHOR]

In this study, we evaluated the response to treatment of 409 idiopathic thrombocytopenic purpura (ITP) patients who were tested for the presence of platelet-associated autoantibodies by direct-platelet immunofluorescence test (PIFT) and for the presence of plasma antibodies directed against the GPIIb/IIIa, GPIb and GPIa/IIa by monoclonal antibody immobilization of platelet antigens (MAIPA). In patients with platelet autoantibodies in comparison with patients without antibodies more frequently were observed the chronic form of disease (83.5% vs. 68.5%) and severe symptoms of haemorrhage diathesis (17.3% vs. 6.9%). Evaluation of the treatment response (to corticosteroids, immunosuppressive drugs and splenectomy) referred to patients with complete response, e.g. complete remission defined as platelet count of >100 × 109/l for at least 2 years. The percentage of complete response in the whole population of ITP patients, both with and without autoantibodies regardless of the method of treatment, was similar (about 54%). However, the presence of platelet autoantibodies had effect on patients treated with corticosteroids: complete response approximately 71% (36/51) of patients with autoantibodies and in 60% (72/120) of patients without antibodies, as well as in patients treated with immunosuppressive drugs (cyclophosphamide, azathioprine, vincristin and vinblastin); complete response approximately 51% (11/21) of patients with autoantibodies and in 34.8% (6/17) of patients without autoantibodies. The presence of autoantibodies had no effect on the response of splenectomy patients. [ABSTRACT FROM AUTHOR]