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Clonally Expanded T-Cells in the Peripheral Blood of Patients with Idiopathic Thrombocytopenic Purpura and Helicobacter pylori Infection

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Abstract

Eradication of Helicobacter pylori leads to platelet recovery in some patients with idiopathic thrombocytopenic purpura (ITP).Therefore, the pathogenesis of a subgroup of ITP is probably associated with H pylori infection (H pylori-related ITP). If H pylori-related ITP is a definite subgroup of ITP, specific oligoclonal T-cells might accumulate in the peripheral blood (PB). To address this issue, we performed single-strand conformation polymorphism analysis of complementarity-determining region 3 (CDR3) of the T-cell receptor β chain genes of PB T-cells. Fourteen ITP patients with H pylori infection and 12 ageadjusted healthy volunteers were studied. Of the 14 patients, 8 patients (responders) exhibited a platelet response after successful H pylori eradication therapy, but 6 patients (nonresponders) did not. V±5.2, V±15, and V±19 gene usage by clonally expanded T-cells in PB obtained before H pylori eradication therapy was significantly higher in responders than in nonresponders or healthy volunteers (V±5.2, P = .023; V±15, P = .004; V±19, P = .036). Furthermore, an abrogation of clonally expanded T-cells was observed after therapy in some responders.These findings suggest that specific T-cell clones accumulate in H pylori-related ITP and that such clones may be associated with immune-mediated destruction of platelets.

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References

  1. Gasbarrini A, Franceschi F, Tartaglione R, Landolfi R, Pola P, Gasbarrini G. Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori. Lancet. 1998;352:878.

    Article  CAS  PubMed  Google Scholar 

  2. Emilia G, Longo G, Luppi M, et al. Helicobacter pylori eradication can induce platelet recovery in idiopathic thrombocytopenic purpura. Blood. 2001;97:812–814.

    Article  CAS  PubMed  Google Scholar 

  3. Kohda K, Kuga T, Kogawa K, et al. Effect of Helicobacter pylori eradication on platelet recovery in Japanese patients with chronic idiopathic thrombocytopenic purpura and secondary autoimmune thrombocytopenic purpura. Br J Haematol. 2002;118:584–588.

    Article  PubMed  Google Scholar 

  4. Veneri D, Franchini M, Gottardi M, et al. Efficacy of Helicobacter pylori eradication in raising platelet count in adult patients with idiopathic thrombocytopenic purpura. Haematologica. 2002;87:1177–1179.

    PubMed  Google Scholar 

  5. Hino M, Yamane T, Park K, et al. Platelet recovery after eradication of Helicobacter pylori in patients with idiopathic thrombocytopenic purpura. Ann Hematol. 2003;82:30–32.

    CAS  PubMed  Google Scholar 

  6. Hashino S, Mori A, Suzuki S, et al. Platelet recovery in patients with idiopathic thrombocytopenic purpura after eradication of Helicobacter pylori. Int J Hematol. 2003;77:188–191.

    Article  CAS  PubMed  Google Scholar 

  7. Ando T, Tsuzuki T, Mizuno T, et al. Characteristics of Helicobacter pylori-induced gastritis and the effect of H. pylori eradication in patients with chronic idiopathic thrombocytopenic purpura. Helicobacter. 2004;9:443–452.

    Article  PubMed  Google Scholar 

  8. Sato R, Murakami K, Watanabe K, et al. Effect of Helicobacter pylori eradication on platelet recovery in patients with chronic idiopathic thrombocytopenic purpura. Arch Intern Med. 2004;164:1904–1907.

    Article  PubMed  Google Scholar 

  9. Fujimura K, Kuwana M, Kurata Y, et al. Is eradication therapy useful as the first line of treatment in Helicobacter pylori-positive idiopathic thrombocytopenic purpura? Analysis of 207 eradicated chronic ITP cases in Japan. Int J Hematol. 2005;81:162–168.

    Article  PubMed  Google Scholar 

  10. Inaba T, Mizuno M, Take S, et al. Eradication of Helicobacter pylori increases platelet count in patients with idiopathic thrombocytopenic purpura in Japan. Eur J Clin Invest. 2005;35:214–219.

    Article  CAS  PubMed  Google Scholar 

  11. Stasi R, Rossi Z, Stipa E, Amadori S, Newland AC, Provan D. Helicobacter pylori eradication in the management of patients with idiopathic thrombocytopenic purpura. Am J Med. 2005;118:414–419.

    Article  PubMed  Google Scholar 

  12. Jarque I, Andrew R, Llopis I, et al. Absence of platelet response after eradication of Helicobacter pylori infection in patients with chronic idiopathic thrombocytopenic purpura. Br J Haematol. 2001;115:1002–1003.

    Article  CAS  PubMed  Google Scholar 

  13. Michel M, Khellaf M, Desforges L, et al. Autoimmune thrombocytopenic purpura and Helicobacter pylori infection. Arch Intern Med. 2002;162:1033–1036.

    Article  PubMed  Google Scholar 

  14. Michel M, Cooper N, Jean C, Frissora C, Bussel JB. Does Helicobater pylori initiate or perpetuate immune thrombocytopenic purpura? Blood. 2004;103:890–896.

    Article  CAS  PubMed  Google Scholar 

  15. Shimomura T, Fujimura K, Takafuta T, et al. Oligoclonal accumulation of T cells in peripheral blood from patients with idiopathic thrombocytopenic purpura. Br J Haematol. 1996;95:732–737.

    Article  CAS  PubMed  Google Scholar 

  16. Asaka M, Kimura T, Kudo M, et al. Relationship of Helicobacter pylori to serum pepsinogen in an asymptomatic Japanese population. Gastroenterology. 1992;102:760–766.

    Article  CAS  PubMed  Google Scholar 

  17. Ohara S, Kato M, Asaka M, Toyota T. Studies of 13C-urea breath test for diagnosis of Helicobacter pylori infection in Japan. J Gastroenterol. 1998;33:6–13.

    Article  CAS  PubMed  Google Scholar 

  18. Vianelli N, Valdre L, Fiacchini M, et al. Long-term follow-up of idiopathic thrombocytopenic purpura in 310 patients. Haematologica. 2001;86:504–509.

    CAS  PubMed  Google Scholar 

  19. Yamamoto K, Sakoda H, Nakajima T, et al. Accumulation of multiple T cell clonotypes in the synovial lesions of patients with rheumatoid arthritis revealed by a novel clonality analysis. Int Immunol. 1992;4:1219–1223.

    Article  CAS  PubMed  Google Scholar 

  20. Chomczynski P, Sacchi N. Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem. 1987;162:156–159.

    Article  CAS  PubMed  Google Scholar 

  21. Choi YW, Kotzin B, Herron L, Callahan J, Marrack P, Kappler J. Interaction of Staphylococcus aureus toxin “superantigens” with human T cells. Proc Natl Acad Sci U S A. 1989;86:8941–8945.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Gasbarrini A, Franceschi F. Autoimmune disease and Helicobacter pylori infection. Biomed Pharmacother. 1999;53:223–226.

    Article  CAS  PubMed  Google Scholar 

  23. Zentilin P, Seriolo B, Dulbecco P, et al. Eradication of Helicobacter pylori may reduce disease severity in rheumatoid arthritis. Aliment Pharmacol Ther. 2002;16:1291–1299.

    Article  CAS  PubMed  Google Scholar 

  24. Figura N, Giordano N, Burroni D, et al. Sjögren’s syndrome and Helicobacter pylori infection. Eur J Gastroenterol Hepatol. 1994;6:321–322.

    Google Scholar 

  25. de Luis DA, Varela C, de La Calle H, et al. Helicobacter pylori infection is markedly increased in patients with autoimmune atrophic thyroiditis. J Clin Gastroenterol. 1998;26:259–263.

    Article  PubMed  Google Scholar 

  26. Takahashi T, Yujiri T, Shinohara K, et al. Molecular mimicry by Helicobacter pylori CagA protein may be involved in the pathogenesis of H. pylori-associated chronic idiopathic thrombocytopenic purpura. Br J Haematol. 2004;124:91–96.

    Article  CAS  PubMed  Google Scholar 

  27. Olsson B, Andersson PO, Jernas M, et al. T-cell-mediated cytotoxicity toward platelets in chronic idiopathic thrombocytopenic purpura. Nat Med. 2003;9:1123–1124.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Haematology, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, 162-8666, Tokyo, Japan

    Midori Ishiyama, Masanao Teramura, Koji Iwabe & Toshiko Motoji

  2. Rheumatology, Immunology and Genetics Program, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan

    Tomohiro Kato

Authors
  1. Midori Ishiyama
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  2. Masanao Teramura
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  3. Koji Iwabe
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  4. Tomohiro Kato
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  5. Toshiko Motoji
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Correspondence to Masanao Teramura.

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Ishiyama, M., Teramura, M., Iwabe, K. et al. Clonally Expanded T-Cells in the Peripheral Blood of Patients with Idiopathic Thrombocytopenic Purpura and Helicobacter pylori Infection. Int J Hematol 83, 147–151 (2006). https://doi.org/10.1532/IJH97.05119

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  • DOI: https://doi.org/10.1532/IJH97.05119

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