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Changing profile of platelet activity and turnover indices during treatment response of immune thrombocytopenia

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Abstract

Both platelet count and function change after treatment of immune thrombocytopenia. Platelet function can be measured by plasma markers, including platelet activity [e.g., soluble P-selectin (sP-selectin) and soluble CD40 ligand (sCD40L)] and platelet turnover markers [e.g., glycocalicin (GC)]. Patients were classified into no response (NR, including new diagnosis), partial response (PR) and complete response (CR). One hundred and sixteen samples (29 CR, 32 PR, 55 NR) from 79 patients were collected. Plasma markers (sP-selectin, sCD40L and GC) were measured by ELISA. Platelet counts and mean platelet volume (MPV) were obtained in the clinical laboratory using GenS System-2. The results showed that responsive patients (PR + CR) had higher levels of sP-selectin (P = 0.026) and sCD40L (P = 0.001). Although there was no difference in MPV (P = 0.077) or GC (P = 0.078), there was a marked decrease of GC index (P < 0.001) in responsive patients. Paired sample analysis showed no difference in sP-selectin, sCD40L, MPV or GC but significant difference in GC index (P = 0.017) between NR and PR. Another paired sample analysis showed no difference in sP-selectin, sCD40L, MPV or GC but significant difference in GC index (P = 0.029) between PR and CR. Patients with refractory and newly diagnosed disease had a significant difference in GC (P = 0.020) and sCD40L (P = 0.001), despite similarly low platelet counts. In conclusion, platelet activity markers (sP-selectin and sCD40L) and GC indices change in parallel with treatment response. Plasma levels of GC and sCD40L may be predictors of treatment response.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by grant NMRPG3F0521 awarded by Ministry of Science and Technology, Taiwan.

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Authors and Affiliations

  1. School of Medicine, Chang Gung University, Taoyuan, Taiwan

    Hung Chang, Yu-Shin Hung, Ming-Chung Kuo, Pei-Ling Li & Tung-Liang Lin

  2. Division of Hematology-Oncology, Chang Gung Memorial Hospital, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan

    Chewei Ou, Hung Chang, Yu-Shin Hung, Ming-Chung Kuo & Tung-Liang Lin

  3. Center of Hemophilia and Coagulation Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan

    Hung Chang & Yu-Shin Hung

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  1. Chewei Ou
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Contributions

CO and HC designed the study and wrote this manuscript. Y-SH, M-CK and T-LL collected patient information and revised the manuscript. P-LL conducted the experiment and analyzed the data. All authors reviewed and approved the contents of the manuscript.

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Correspondence to Hung Chang.

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Informed consent was obtained from all individual participants included in the study.

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This study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board of Chang Gung Memorial Hospital.

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Ou, C., Chang, H., Hung, YS. et al. Changing profile of platelet activity and turnover indices during treatment response of immune thrombocytopenia. Clin Exp Med 22, 595–603 (2022). https://doi.org/10.1007/s10238-022-00790-8

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  • DOI: https://doi.org/10.1007/s10238-022-00790-8

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