OBJECTIVE: To compare the effect of Sheng-Xue-Xiao-Ban Capsule (SXXBC) and indirubin to the peripheral platelets of the Idiopathic thrombocytopenic purpura (ITP) model mouse. METHODS: The ITP mouse model was established by the method of passive immunization. SXXBC and indirubin were used for intervention treatment. Then the hemorrhagic phenomena of ITP mice were observed and the numbers of peripheral platelets, hemoglobin and white blood cells, bone marrow megakaryocytes and their classification and coagulation function were detected and compared. RESULTS: The improvement rate of hemorrhage in SXXBC group was 40% for small dose, 60% for medium dose and 80% for high dose, while the improvement rate of hemorrhage in indirubin group was 30% for small dose, 50% for medium dose and 60% for high dose. There was no statistically significant difference in the improvement rate of hemorrhage between the two groups (P＞0.05). Compared with the model control group, PLT and Hb increased in different doses of SXXBC and indirubin group 4th-8th day after drug intervention (P＜0.05, 0.01). However, there was no significant difference between the different doses of SXXBC group and indirubin group (P＞0.05). Compared with the model control group, the WBC in each group was significantly lower (P＜0.05, 0.01) on the 4th-8th day after drug intervention; However, there was no statistical significance between the two groups of SXXBC and indirubin (P＞0.05). Compared with the model control group, the total number of megakaryocytes in each treatment group were decreased (P＜0.05, P＜0.01), in which the number of primary megakaryocytes in the large and medium dose groups of SXXBC and indirubin were decreased (P＜0.05, 0.01), and the number of juvenile megakaryocytes in the large dose group of SXXBC and indirubin were also decreased (P＜0.05). The number of granular megakaryocytes were decreased in each intervention groups (P＜0.05, 0.01), and the number of thromocytogenic megakaryocyte was increased in the high and medium dose groups of SXXBC and indirubin (P＜0.01). The time of prothrombin was shortened in the high and medium dose groups of SXXBC and indirubin (P＜0.05), and the fibrinogen (FIB) content in the high and medium dose groups of SXXBC was close to that of the normal control group. CONCLUSION Both of the SXXBC and the indirubin standard all show good hemostatic effects. Indirubin shows a positive effect on increasing the peripheral platelet and hemoglobin in ITP model mice, regulating the immune response, reducing the total number of bone marrow megakaryocytes, increasing the thromocytogenic megakaryocyte, and increasing coagulation function.
Animals ; Blood Platelets ; Capsules ; Indoles ; Megakaryocytes ; Mice ; Purpura, Thrombocytopenic, Idiopathic/drug therapy*

To investigate contribution of soluble interleukin-2 receptor (SIL-2R) to the clinical progress of idiopathic thrombocytopenic purpura (ITP), SIL-2R levels were measured in the plasma of 34 patients and 34 normal controls with double antibody sandwich ELISA. The cohort consisted of 12 patients with chronic ITP, 15 with acute ITP and 7 with ITP in remission. The results showed that the mean SIL-2R level of chronic ITP group was significantly higher than those of both the control and acute ITP group (P < 0.001 and P < 0.01, respectively). The SIL-2R level of 7 cases in remission, however, was not significantly different from that of normal controls. Furthermore, the plasma levels were dramatically lowered in patients responsive to VLAP regimen (vincristine, L-imidazole, antaisu and prednisone), and those were not evidently decreased in unresponsive patients. It was concluded that T cell activation may play a role in the development of ITP, and further, the level of plasma SIL-2R might predict the prognosis of ITP.
Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; immunology ; Receptors, Interleukin-2 ; blood

OBJECTIVETo identify the relationship between the expression of alpha and beta-isoforms of glucocorticoid receptors (GR) in peripheral blood mononuclear cells (PBMC) and glucocorticoid resistance in children with idiopathic thrombocytopenia purpura (ITP).

METHODSReal-time PCR was used to detect the expression of GR alpha and GR beta mRNA in PBMC from 30 children with ITP (glucocorticoid-sensitive, n=18; glucocorticoid-resistant, n=12) and 10 healthy children (control group). Enzyme immunoassay was used to measure plasma levels of total glucocorticoids.

RESULTSThere were no significant differences in PBMC GR alpha mRNA levels among the glucocorticoid sensitive, the glucocorticoid-resistant and the control groups. Compared with the glucocorticoid-sensitive and the control groups, the expression of GR beta mRNA in the glucocorticoid-resistant group was significantly up-regulated (p<0.01). Plasma total glucocorticoids level in the glucocorticoid-resistant group was found to be much higher than that in the glucocorticoid-sensitive and the control groups (p<0.01).

CONCLUSIONSThe up-regulated expression of GR beta mRNA may associated with glucocorticoid resistance in children with ITP.

Child ; Child, Preschool ; Drug Resistance ; Female ; Glucocorticoids ; pharmacology ; Humans ; Male ; Purpura, Thrombocytopenic, Idiopathic ; blood ; drug therapy ; RNA, Messenger ; analysis ; Receptors, Glucocorticoid ; blood ; genetics

No abstract available.
Carcinoma, Renal Cell/*complications/pathology/surgery ; Danazol/therapeutic use ; Humans ; Kidney Neoplasms/*complications/pathology/surgery ; Male ; Middle Aged ; Nephrectomy ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic/blood/drug therapy/*etiology

OBJECTIVETo investigate the clinical effect and safety of anti-D immunoglobulin (anti-D) in the treatment of children with newly diagnosed acute immune thrombocytopenia (ITP) through a Meta analysis.

METHODSPubMed, EMBASE, Cohrane Library, Ovid, CNKI, and Wanfang Data were searched for randomized controlled trials (RCTs) published up to April 2017. Review Manager 5.3 was used for the Meta analysis.

RESULTSSeven RCTs were included. The Meta analysis showed that after 72 hours and 7 days of treatment, the intravenous immunoglobulin (IVIG) group had a significantly higher percentage of children who achieved platelet count >20×10/L than the anti-D group (P<0.05). There were no significant differences in platelet count after 24 hours, 72 hours, and 7 days of treatment between the anti-D (50 μg/kg) group and the IVIG group (P>0.05), and there were also no significant differences in platelet count after 24 hours and 7 days of treatment between the 50 μg/kg and 75 μg/kg anti-D groups (P>0.05). The anti-D group had a significantly greater reduction in the hemoglobin level than the IVIG group after treatment, but did not need transfusion. No children in the anti-D group or the IVIG group experienced serious adverse reactions.

CONCLUSIONSIntravenous injection of anti-D may have a similar effect as IVIG in improving platelet count in children with acute ITP, but it may be slightly inferior to IVIG in the rate of platelet increase after treatment. The anti-D dose of 50 μg/kg may have a similar effect as 75 μg/kg. The recommended dose of anti-D for treatment of ITP is safe.

Humans ; Immunoglobulins, Intravenous ; adverse effects ; therapeutic use ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; blood ; drug therapy ; Rho(D) Immune Globulin ; adverse effects ; therapeutic use

The aim of this study was to investigate the circulating levels of IL-11 in the patients with chronic idiopathic thrombocytopenic purpura (CITP), and its significance, and to evaluate the curative effect of rhIL-11 on CITP. The level of IL-11 in patients with CITP was determined by ELISA before and after treatment, respectively. 1.5 mg of rhIL-11 were injected subcutaneously, once a day, continuously for 14 days as one course, treatment time 1 - 2 courses as total. The results showed that the higher blood IL-11 level was found in CITP patients than that in controls (P < 0.01) and during the course of treatment the number of platelets in peripheral blood of patients with CITP parallelled to the level of IL-11. The platelet counts were obviously increased in all CITP patients after rhIL-11 treatment. It is concluded that the serum level of IL-11 in patients is correlated to the number of platelets in patients. rhIL-11 can be used as an effective treatment for CITP.
Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Humans ; Interleukin-11 ; blood ; therapeutic use ; Male ; Middle Aged ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Recombinant Proteins ; therapeutic use ; Treatment Outcome

In order to determine the curative effect of multiglycosidorum Tripterygii and prednisone for treatment of children with chronic refractory idiopathic thrombocytopenic purpura (ITP), a total of 28 patients had been treated with multiglycosidorum Tripterygii and prednisone. Multiglycosidorum Tripterygii was given at a dose of 1 mg/kg body weight per day and the prednisone was given at a dose of 0.5 mg/kg body weight per day for two consecutive months. Bone marrow examination and blood platelet associated immunoglobin G (PAIgG) measurement were performed during the treatment. The results showed that in 21 patients acquired effectiveness, of whom, according the common criteria, 9 patients achieved curative effective, 7 achieved significant effectiveness and 5 effective. 7 patients did not achieve effectiveness. There were no serious side effects associated with therapy. The number of proplatelets on bone marrow smears was increased and the titers of IgG to platelet were restored to normal range in patients achieving remission. In conclusion, combination of multiglycosidorum triptergii with prednisone is effective and safe for treatment of chronic refractory idiopathic thrombocytopenic purpura in children.
Adolescent ; Child ; Child, Preschool ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Immunoglobulin G ; blood ; Immunosuppressive Agents ; administration & dosage ; Infant ; Male ; Platelet Count ; Prednisone ; administration & dosage ; Purpura, Thrombocytopenic, Idiopathic ; blood ; drug therapy ; Tripterygium

In order to determine the curative effect of small dose heparin for treatment of chronic idiopathic thrombocytopenic purpura (CITP), a total of 12 CITP patients, who were failed with prednisone and immunosuppressants over 6 months, had been treated with subcutaneous injection of small dose heparin. The curative effects were seen in 8 patients and there were no exacerbation of hemorrhage during the therapy. The results showed that it is effective and safe to use this treatment for CITP.
Adolescent ; Adult ; Anticoagulants ; therapeutic use ; Child ; Chronic Disease ; Dose-Response Relationship, Drug ; Female ; Heparin ; therapeutic use ; Humans ; Male ; Middle Aged ; Partial Thromboplastin Time ; Prothrombin Time ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Thrombin Time ; Treatment Outcome ; Whole Blood Coagulation Time

PURPOSE: Thrombocytopenia is a serious life threatening consequence in patients with bone marrow failure syndrome. Thrombopoietin (TPO), recently cloned by several groups has been shown to be a key regulation of megakaryopoiesis and thrombopoiesis. Recent studies have demonstrated a positive or negative relationship between TPO levels and platelet counts due to underlying disease states. To clarify the role of TPO in thrombocytopenic condition we determined plasma TPO levels and megakaryocyte colony assay. METHPDS: TPO levels were measured in thrombocytopenic patient with aplastic anemia, chemotherapy induced bone marrow failure, idiopathic thrombocytopenic purpura (ITP) and in newborn by ELISA (QuantikineTM, R&D System, USA). Controls were short statured normal children with normal platelet counts. Plasma was preserved in 20oC until test. CFU-mega was determined by MegaCultTM (Stem Cell Tech. Inc., Canada). Ficoll separated mononuclear cells were cultured for 10~12 days with TPO or stem cell factor (SCF) in 37degrees C 5% CO2 atmosphere, colonies were fixed, stained and examined with inverted microscope. Results were analysed by Student-t test. RESULTS: TPO levels were markedly increased in aplastic anemia and chemotherapy induced thrombocytopenia compared to those of normal controls. Patients with ITP had decreased level of plasma TPO. There was inverse relationship between platelet count and TPO levels for patients with aplastic anemia and chemotherapy induced thrombocytopenia. There was no definite relationship between platelet counts and TPO levels but inverse relationship between platelet counts and PDW levels in neonates was noted. The levels of TPO were increased after improvement of platelet in thrombocytopenic neonate. Megakaryocyte colonies were increased in the mononuclear cells of the patients with ITP and chemotherapy induced thrombocytopenia. There was little colony formation in aplastic anemia. TPO had no definite effect in megakaryocyte colony formation but SCF increased colony formation. CONCLUSION: TPO levels were increased in aplastic anemia and chemotherapy induced thrombocytopenia but decreased in ITP. There was inverse relationship between platelet count and TPO levels in aplastic anemia and chemotherapy induced thrombocytopenia. Thus TPO could be useful for differentiate the etiology of thrombocytopenia. Megakaryocyte colony was increased in ITP and chemotherapy induced thrombocytopenia, but decreased in aplastic anemia. SCF was effective in megakaryocyte colony formation. TPO and SCF will be helpful to increase platelet in thrombocytopenic patients. However, further study will be needed.
Anemia, Aplastic ; Atmosphere ; Blood Platelets ; Bone Marrow* ; Child ; Clone Cells ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Ficoll ; Humans ; Infant, Newborn ; Megakaryocytes* ; Plasma ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Stem Cell Factor ; Thrombocytopenia* ; Thrombopoiesis ; Thrombopoietin*

OBJECTIVETo evaluate the efficacy and safety of high dose dexamethasone combined with recombinant human thrombopoietin (rhTPO) in adults with severe newly diagnosed immune thrombocytopenia (ITP).

METHODSForty-eight adult patients with severe ITP were randomized into two groups, experimental group and control group. The patients in experimental group were given high-dose dexamethasone combined with rhTPO treatment, the patients in control group were given single high-dose dexamethasone treatment. Platelet count, platelet increase, as well as the overall response rate were strictly observed in the process. At the same time, the patient's drug tolerance and any adverse drug reactions were observed.

RESULTSThe platelet counts and platelet increase of the patients in experimental group were significantly higher than that in control group (P<0.05) at day 3, 7, 14, 30. There was no significant difference in overall response rates between the two groups (34.8% vs 36.0%, 56.5% vs 48.0%, P>0.05) at day 3, 7. The overall response rates of experimental group at day 14, 30 were significantly higher than that of control group (91.3% vs 68.0%, 82.6% vs 52.0%, P<0.05). The muscle aches occurred in one patient in experimental group which was self-recovery without special treatment.

CONCLUSIONrhTPO combined with high-dose dexamethasone could rapidly increase the platelet count, reduce the risk of bleeding, and prolonge the effect with a low incidence of tolerable adverse events compared to single high-dose dexamethasone. rhTPO combined with high-dose dexamethasone could be a new therapeutic choice for severe primary ITP.

Adult ; Blood Platelets ; Dexamethasone ; administration & dosage ; therapeutic use ; Humans ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Thrombopoietin ; administration & dosage ; therapeutic use ; Treatment Outcome