Platelet Disorders |
1 Haematology Oncology Centre, Qilu Hospital, Shandong University, Jinan
2 Department of Clinical Laboratory, Qilu Hospital, Shandong University, Jinan
3 The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, China
Correspondence: Ming Hou, M.D., Ph.D. Haematology Oncology Centre, Qilu Hospital, Shandong University, 107 West Wenhuaxi Rd, Jinan, Shandong 250012. E-mail:houming{at}medmail.com.cn
To evaluate the effects of high-dose dexamethasone (HD-DXM) on the balance of interleukin-18 (IL-18) and its endogenous antagonist IL-18 binding protein (IL-18BP) in ITP patients, IL-18, IL-18BP as well as IFN-
, IL-4 plasma levels and platelet counts were determined in 17 ITP patients receiving DXM 40 mg/day for four consecutive days and in 24 healthy subjects. Using RT-PCR, the mRNA expression of IL-18, IL-18BP, IFN-
, IL-4, T-box (T-bet) and GATA-binding protein 3(GATA-3) were studied in all subjects. The in vitro effects of DXM on IL-18BP and IL-18 of peripheral blood mononuclear cells (PBMCs) were studied by ELISA. HD-DXM administration increased IL-18BP and reduced IL-18 expression significantly (p<0.05), which resulted in a downregulation of IL-18/IL-18BP ratio p<0.05). In vitro, DXM had a significant effect on secretion of IL-18BP while diminishing IL-18 release from cultures of PBMCs. These results suggest that downregulation of IL-18/IL-18BP might account for its clinical efficacy of HD-DXM in active ITP.
Key words: interleukin-18, interleukin-18 binding protein, high-dose dexamethasone, idiopathic thrombocytopenic purpura.