INFLUENCE OF INTRAVENOUS IMMUNOGLOBULIN AND METHYLPREDNISOLONE ON CYTOKINES SECRETED BY T LYMPHOCYTE IN CHILDREN PRIMARY IMMUNE THROMBOCYTOPENIA

Objectives: Our study was designed to explore the Influence of Intravenous Immunoglobulin (IVIG) and Methylprednisolone (MP) on cytokines secreted by T lymphocyte in children Primary Immune Thrombocytopenia (ITP). Materials and Methods: We enrolled children ITP at the onset of their disease from our department between December 2011 and March 2013. We followed them until 12months of their whole duration, choosing the patients whose ultimate duration less than 3 months and no recurrence. Cytokines measurement by cytometric bead array included IL-2, IL-4, IL-6, IL-10, TNF, IFN and IL-17. We divided patients into 3 groups according to the treatment they received before testing cytokines level, then we compared T cell cytokines level among these groups. Results: We enrolled 62 patients with first diagnosed ITP and ultimate duration wasless than 3 months without recurrence (38 boys and 24 girls, age range 2-178 months, median 33 months). We found IL-2 level decreased in both groups treated with MP for 1 day (N = 29, P = 0.042) and group in which patients treated with IVIG for 1 day (N = 18, P = 0.048) compared with group without any treatment (N = 15). Conclusion: As for children ITP, although pathways of MP and IVIG in treating thrombocytopenia were different, they both could decrease IL-2 in children ITP ultimately. As a representative cytokine of TH1 cell, IL-2 has been demonstrated to be important in lymphocyte activation and mobilization. So we considered that MP and IVIG can reduce the T cell activation and production of auto-antibodies by decrease IL-2.