Newly diagnosed patients with Immune Thrombocytopenia exhibit altered expressions of CD4 T cell activation markers

Research output: Chapter in Book/Report/Conference proceedingConference Contribution (Conference Proceeding)

Abstract

Background
Immune thrombocytopenia (ITP) is a rare autoimmune disease characterised by a low platelet count and bleeding risk. The pathogenesis is complex, involving both antibody and cell-mediated autoimmune attack of platelets and megakaryocytes. Currently, there is no diagnostic test for ITP and diagnosis relies on exclusion of many alternative causes of a low platelet count which can be challenging. Although previous studies have demonstrated T cell abnormalities in ITP patients, these findings are limited due to the use of heterogeneous chronic ITP patients on a variety of treatments.
The FLIGHT trial is a multicentre, NIHR funded, RCT for newly diagnosed ITP patients, comparing first line treatment pathways. Patients enrolled were invited to participate in the laboratory sub-study which included blood samples at baseline pre-randomisation. In this newly diagnosed ITP patient cohort, we compared a comprehensive panel of T cell activation markers to healthy controls.
Methods
Following consent, peripheral blood was drawn into TransFix® vacuum blood collection tubes, allowing the stabilisation of cell surface marker expression (n=75). Blood was drawn in the same way for healthy controls (n=20). Whole blood was stained with antibodies against CD3, CD4, CD25, CD40L, CD69, CD71, OX-40 and HLA-DR, and expression of these markers was determined by flow cytometry.
Results
Newly diagnosed ITP patients exhibit aberrant T cell activation marker expression when compared to healthy controls. ITP patients showed decreased expression of CD25, CD69, and CD40L, with an increase in the expression of HLA-DR. These results suggest that measurement of T cell activation markers may help differentiate ITP from other causes of thrombocytopenia to aid diagnosis.
Original languageEnglish
Title of host publicationBritish Society of Immunology Conference
Publication statusPublished - Nov 2019

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