A study on the influence of different distribution of platelet membrane glycoprotein antibodies on the clinical efficacy of ITP in children and literature review.

DOI: 10.12201/bmr.202407.00049

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  Abstract: Objective To investigate the effect of the differential distribution of three platelet membrane glycoprotein-specific antibodies (anti-GP-I b/Ⅸ, GP-II b/ IIIA and GP-II a/ IIIA) on the curative effect of first-line treatment in children with ITP. Methods From December 2019 to December 2023, 55 children with ITP were included in the study, and were divided into: anti-GPⅠb /Ⅸ antibody positive group (18 cases) and negative group (37 cases), anti-GPⅡb /Ⅲa antibody positive group (30 cases) and negative group (24 cases), anti-GPⅠa /IIa antibody positive group (16 cases) and negative group (38 cases). Platelet membrane glycoprotein specific antibodies in circulating plasma and platelet membrane release fluid were detected by enzyme-linked immunosorbent assay. All patients were treated with standard first-line regiments. The relationship between antibody distribution and platelet count after treatment was analyzed. Results Platelet count at 24h, 72h and 7 days after treatment was higher than before treatment in all groups (all P<0.05). However, when comparing the anti‐GPⅠb/Ⅸ antibody‐positive group with the negative group at 24 hours positive group (37.69±23.22), negative group (62.78±31.27), 72 hours positive group (99.38±115.32), negative group (229.43±167.70), and 7 days positive group (150.56±124.89), negative group (384.80±234.09), the platelet counts of the positive group were all significantly lower than the negative group (all P < 0.05); There were no significant differences in the levels of treated platelets between anti-GPⅡb/Ⅲa-antibody positive group and negative group at each time point (all P > 0.05); There was no difference in platelet count between the positive and negative group of anti-GPⅠa/Ⅱa antibodies at 24 hours and 72 hours after treatment (all P > 0.05), while the platelet count at 7 days after treatment was significantly lower in the positive group (213.53±192.20) compared with the negative group (356.90±253.16) (P < 0.05). Conclusion Pediatric ITP patients with different platelet antibody profiles showed differences in their efficacy after treatment with first-line regimens, patients with positive anti-GPⅠb/Ⅸ antibody had worse outcomes than negative patients, patients with positive and negative anti-GPⅡb/Ⅲa antibody did not differ, and patients with positive anti-GPⅠa/Ⅱa antibody had worse outcomes after 7 days compared with negative patients.

  Key words: Primary immune thrombocytopenia; platelet membrane glycoprotein specific antibody; child; platelet count

  Submit time: 20 July 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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