Journal of Blood Medicine (Mar 2021)
Possible Role of CD11a in Primary Immune Thrombocytopenia Patients on Immunosuppressive Therapy
Abstract
Muhamad R Abdel Hameed,1,2 Howiada A Nafady,1,2 Mona Ibrahim Mostafa,3 Douaa Sayed,4 Ahmad A Obiedallah5 1Hematology Unit, Department of Internal Medicine, Assiut University Hospitals, Assiut University, Assiut, Egypt; 2Bone Marrow Transplantation Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 3Department of Internal Medicine, Assiut General Hospital, Assiut, Egypt; 4Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 5Critical Care Unit, Department of Internal Medicine, Assiut University Hospitals, Assiut University, Assiut, EgyptCorrespondence: Muhamad R Abdel HameedHematology Unit, Department of Internal Medicine, Assiut University Hospitals, Assiut University, Assiut, 71515, EgyptTel +20 1097510010Email [email protected] and Objectives: Immune thrombocytopenia (ITP) is one of the autoimmune diseases that presented by thrombocytopenia and increased risk of bleeding. Etiology of immune thrombocytopenia (ITP) is very complex. Lymphocyte function associated antigen-1 (LFA-1) plays important role in ITP. The aim of this study was evaluation of expression of CD11a on lymphocytes to explore its possible role in primary ITP patients also, regarding severity and response to immunosuppressive treatment.Patients and Methods: This is a cross-sectional case-control study. Forty adult patients aged (18:58) years, 29 females and 11 males were enrolled as newly diagnosed primary ITP. Forty age and sex matched control subjects were randomly selected. The expression of CD11a on lymphocyte subpopulations (CD3+ T cells, CD3+CD4+ T cells and CD19+ B cells) was analyzed by flowcytometry at the start of the study and after 6 months of follow-up.Results: The mean fluorescence intensity (MFI) of CD11a on CD3+ T and CD19+ B lymphocytes was significantly highly increased in ITP patients compared to healthy controls while MFI of CD11a on CD3+ CD4+Tclls was non-significant. MFI of CD11a on CD3+ and CD19+ B lymphocytes showed non-significant elevation with platelet count or bleeding score. MFI of CD11a on CD3+ showed significant highly increased level in refractory ITP compared with responder cases.Conclusion: CD11a had possible role in the pathogenesis of ITP. Immunosuppressive therapy in ITP did not affect the level of CD11a expression on T and B lymphocytes. Levels of CD11a do not reflect the severity of ITP neither platelet count nor bleeding score. Increased MFI of CD11a in CD3+T lymphocytes of ITP patients may cause resistance to immunosuppressive therapy.Keywords: Primary immune thrombocytopenia, immunosuppressive therapy, LFA-1, CD11a, B cells, T cells
