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Effect of eltrombopag olamine tablets on CD40/CD40L in children with ITP
Received date: 2024-05-31
Online published: 2024-11-05
Objective To explore the mechanism of the effect of itraconazole ethanolamine tablets on the CD40/CD40L axis in children with idiopathic thrombocytopenic purpura （ITP）. Methods 80 children with ITP were selected as the study subjects. They were divided into a control group （n = 40） and a study group （n = 40） using a digital random table method. The control group was treated with cyclosporine， while the study group was treated with itraconazole ethanolamine tablets. Both groups were treated continuously for 3 months. Compare the clinical efficacy of two groups of patients T lymphocyte subpopulation levels ［CD3+ CD4+ and CD4+/CD8+， as well as adverse reactions. Detect CD40 on the surface of lymphocyte membrane and platelet membrane in two groups of patients CD40L level， plasma sCD40 and sCD40L levels were detected using ELISA. Results The total effective rate of the study group （92.50%） was significantly higher than that of the control group （75.00%） （P < 0.05）. CD3+ CD4+，CD4+/CD8+， The expression levels of sCD40 in plasma were higher than before treatment， CD8+ and peripheral blood CD19+ CD40+ The expression levels of CD3+， CD40L+ cells， and plasma sCD40L were lower than before treatment； Research group CD3+ CD4+， CD4+/CD8+， The expression level of sCD40 in plasma was higher than that in the control group， CD8+， And peripheral blood CD19+ CD40+ The expression levels of CD3+ CD40L+ cells and plasma sCD40L were lower than those of the control group （P < 0.05）. The CD40L+ cells on the surface of peripheral blood platelet membranes after two treatment groups were lower than before treatment； The CD40+ on the surface of peripheral blood platelet membrane in the study group was higher than that in the control group， CD40L+ cells were lower than those in the control group （P < 0.05）. The total adverse rate of the study group （15.00%） was lower than that of the control group （22.50%）， but there was no significant difference between the two groups （P > 0.05）. Conclusion The treatment of ITP in children with eltrombopag olamine tablets has good clinical efficacy， regulates the level of T lymphocyte subsets， and is safe.
Xunqi JI , Jia LI , Ning ZHANG , Zefu CHEN , Jing. LIN . Effect of eltrombopag olamine tablets on CD40/CD40L in children with ITP[J]. The Journal of Practical Medicine, 2024 , 40(20) : 2918 -2922 . DOI: 10.3969/j.issn.1006-5725.2024.20.016
| 1 | 杨慕然，周泽平. 免疫性疾病继发性ITP临床特点及治疗研究进展［J］. 中国免疫学杂志，2021，37（3）：361-366. |
| 2 | 中国儿童原发性免疫性血小板减少症诊断与治疗改编指南（2021版）［J］. 中华儿科杂志，2021，5（10）：810-819. |
| 3 | PROVAN D， ARNOLD D M， BUSSEL J B， et al. Updated international consensus report on the investigation and management of primary immune thrombocytopenia ［J］. Blood Adv，2019， 3（22）： 3780-3817. doi:10.1182/bloodadvances.2019000812 |
| 4 | SUN M L， WANG X J， ZHANG N， et al. Imbalance of follicular regulatory T （Tfr） cells/follicular helper T（Tfh）cells in adult patients with primary immune Thrombocytopenia ［J］. Exp Biol Med（Maywood）， 2023，248（11）： 959-965. doi:10.1177/15353702231168142 |
| 5 | OU C， CHANG H， HUNG Y S， et al. Changing profile of platelet activity and turnover indices during treatment response of immune thrombocytopenia ［J］. Clin Exp Med， 2022， 22（4）： 595-603. doi:10.1007/s10238-022-00790-8 |
| 6 | 刘锋，房洪英，谢冉，等. 儿童原发性免疫性血小板减少症的二线治疗药物新选择：艾曲波帕与罗米司亭［J］. 儿科药学杂志，2023，29（11）：56-60. |
| 7 | 施亦凡，邢丰，冯国安. 艾曲波帕二线治疗用于ITP一线治疗失败患者中的疗效及安全性评价［J］. 系统医学，2023，8（21）：43-46. |
| 8 | 江载芳，申昆玲，沈颖. 诸福棠实用儿科学［M］. 8版. 北京：人民卫生出版社，2015：1896-1899. |
| 9 | ALANDRI F， ROSSI E， BARTOLETTI D， et al. Real-world use of thrombopoietin receptor agonists in older patients with primary immune thrombocytopenia［J］. Blood， 2021， 138（7）： 571-583. doi:10.1182/blood.2021010735 |
| 10 | 黄菊，卫仿仙，韩艳霞，等. 原发性免疫性血小板减少症患者骨髓TPO及c-mpl水平测定意义［J］. 实用医学杂志，2021，37（15）：1982-1987. |
| 11 | 张攀，石宇，徐颖. 儿童免疫性血小板减少症血清中抗核仁抗体纯化以及靶抗原的筛选［J］. 基因组学与应用生物学，2019，38（5）：2283-2288. |
| 12 | LIN X， XU A， ZHOU L， et al. Imbalance of T lymphocyte subsets in adult immune thrombocytopenia ［J］. Int J Gen Med， 2021， 14： 937-947. doi:10.2147/ijgm.s298888 |
| 13 | ROBINSON J W， LI J Y， WALKER L D， et al. T cell-expressed CD40L potentiates the bone anabolic activity of intermittent PTH treatment［J］. J Bone Miner Res， 2015， 30（4）： 695-705. doi:10.1002/jbmr.2394 |
| 14 | 王静茹，王少娜，李沐洲，等. 艾曲波帕乙醇胺片治疗特发性血小板减少性紫癜患儿的临床研究［J］. 中国临床药理学杂志，2023，39（10）：1393-1396. |
| 15 | YE X， ZHANG L， WANG H， et al. The role of IL-23 / Th17 pathway in patients with primary immune thrombocytopenia［J］．PLoS One， 2015， 10（1）： e0117704． doi:10.1371/journal.pone.0117704 |
| 16 | WEN R， WANG Y， HONMG Y， et al. Cellular immune dysregulation in the pathogenesis of immune thrombocytopenia ［J］. Blood Coagul Fibrinolysis，2020，31（2）：113-120. doi:10.1097/mbc.0000000000000891 |
| 17 | CHAND DAKAL T， DHABHAI B， AGARWAL D， et al. Mechanistic basis of costimulatory CD40-CD40L ligation mediated regulation of immune responses in cancer and autoimmune disorders ［J］. Immunobiology， 2020， 225（2）： 15189. doi:10.1016/j.imbio.2019.151899 |
| 18 | VIAL G， GENSOUS N， DUFFAU P. The CD40-CD40Laxis： current and future implications in clinical immunology ［J］. Rev Med Interne， 2021， 42（10）： 722-728. doi:10.1016/j.revmed.2021.02.005 |
| 19 | 贾瑞萍，赵雪芸. 自身免疫性血小板减少性紫癜患者外周血中 CD4+ CD25+ 调节性T细胞、sFas和sFasL的表达及临床意义［J］. 中国实验血液学杂志，2011，19（5）：1264-1267. |
| 20 | SARMIENTO L， SVENSSON J， BARCHETTA I， et al. Escape from X chromosome inactivation and female bias of autoimmune diseases［J］. Mol Med， 2020， 26（1）： 127. doi:10.1186/s10020-020-00256-1 |
| 21 | 朱世荣，谌海燕，王明镜，等. 免疫性血小板减少症患者调节性B细胞变化与临床意义［J］. 中国实验血液学杂志，2019，27（1）：175-179. |
| 22 | FRANCA T T， BARREIROS L A， SALGADO R C， et al. CD40 ligand deficiency in Ltin Americaa： clinical， immunological， and genetic characteristics［J］. J Clin Immunol， 2022， 42（3）： 514-526. |
| 23 | MULDER K， PATEL A A， KONG W T， et al. Cross-tissuesingle-cell landscape of human monocytes and macrophages in healthand disease［J］. Immunity， 2021， 54（8）： 1883-1900.e5. doi:10.1016/j.immuni.2021.07.007 |
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