Advertisement

International Journal of Hematology

, Volume 83, Issue 2, pp 147–151 | Cite as

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

  • Midori Ishiyama
  • Masanao Teramura
  • Koji Iwabe
  • Tomohiro Kato
  • Toshiko Motoji
Article

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.

Key words

Idiopathic thrombocytopenic purpura (ITP) Helicobacter pylori T-cell clonality T-cell receptor Single-strand conformation polymorphism (SSCP) 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 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.CrossRefGoogle Scholar
  2. 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.CrossRefGoogle Scholar
  3. 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.CrossRefGoogle Scholar
  4. 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.Google Scholar
  5. 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.Google Scholar
  6. 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.CrossRefGoogle Scholar
  7. 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.CrossRefGoogle Scholar
  8. 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.CrossRefGoogle Scholar
  9. 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.CrossRefGoogle Scholar
  10. 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.CrossRefGoogle Scholar
  11. 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.CrossRefGoogle Scholar
  12. 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.CrossRefGoogle Scholar
  13. 13.
    Michel M, Khellaf M, Desforges L, et al. Autoimmune thrombocytopenic purpura and Helicobacter pylori infection. Arch Intern Med. 2002;162:1033–1036.CrossRefGoogle Scholar
  14. 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.CrossRefGoogle Scholar
  15. 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.CrossRefGoogle Scholar
  16. 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.CrossRefGoogle Scholar
  17. 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.CrossRefGoogle Scholar
  18. 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.Google Scholar
  19. 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.CrossRefGoogle Scholar
  20. 20.
    Chomczynski P, Sacchi N. Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem. 1987;162:156–159.CrossRefGoogle Scholar
  21. 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.CrossRefGoogle Scholar
  22. 22.
    Gasbarrini A, Franceschi F. Autoimmune disease and Helicobacter pylori infection. Biomed Pharmacother. 1999;53:223–226.CrossRefGoogle Scholar
  23. 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.CrossRefGoogle Scholar
  24. 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. 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.CrossRefGoogle Scholar
  26. 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.CrossRefGoogle Scholar
  27. 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.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2006

Authors and Affiliations

  • Midori Ishiyama
    • 1
  • Masanao Teramura
    • 1
  • Koji Iwabe
    • 1
  • Tomohiro Kato
    • 2
  • Toshiko Motoji
    • 1
  1. 1.Department of HaematologyTokyo Women’s Medical UniversityTokyoJapan
  2. 2.Rheumatology, Immunology and Genetics ProgramInstitute of Medical Science, St. Marianna University School of MedicineKanagawaJapan

Personalised recommendations