Evaluation of ADH4 gene expression and hematological parameters as biomarkers for the pathogenesis of ITP in the pediatric
DOI:
https://doi.org/10.31185/wjps.756Abstract
This study investigates the role of the ADH4 gene expression and hematological biomarkers in the pathogenesis of Immune Thrombocytopenic Purpura (ITP) in pediatric patients. The study involved 100 children, 50 with ITP and 50 healthy controls, to evaluate blood parameters and ADH4 gene expression. Results showed the mean white blood cell (WBC) count was significantly lower in ITP patients (8.11 ± 0.73) compared to controls (11.94 ± 0.69), Similarly, lymphocyte counts were significantly reduced in ITP patients (3.29 ± 0.43) versus controls (5.65 ± 0.42), The platelet count was markedly lower in ITP patients (26.18 ± 2.77) compared to controls (277.40 ± 10.74), On the contrary, The results show there was a non-significant difference between ITP patients and healthy individuals according to both neutrophil count and hemoglobin (Hb) levels (P < 0.05), while, ADH4 gene expression was significantly higher in ITP patients shown The mean 13.29, 1.00 between the ITP patients and Control respectively, suggesting its involvement in immune dysregulation. These findings highlight the potential of the ADH4 gene and some hematological parameter as a biomarker and therapeutic target in ITP, emphasizing the need for personalized treatment approaches
References
Demirci U, Umit EG, Baysal M, Demir AM. Morphologic evaluation of megakaryocytes in immune thrombocytopenia patients older than 80 years. Northern Clinics of Istanbul. 2023 Jul 1;10(4).
Martinez A, Martinez-Ramirez M, Martinez-Caballero D, Beneit P, Clavel J, Figueroa G, Verdu J. Radioimmunotherapy for non-Hodgkin's lymphoma: positioning, safety, and efficacy of 90Y-ibritumomab. 10 years of experience and follow-up. Revista Española de Medicina Nuclear e Imagen Molecular (English Edition). 2017 Jan 1;36(1):13-9.
Li Q, Liu Y, Wang X, Sun M, Wang L, Wang X, Liu Y, Fan W, Zhang K, Sui X, Guo X. Regulation of Th1/Th2 and Th17/Treg by pDC/mDC imbalance in primary immune thrombocytopenia. Experimental Biology and Medicine. 2021 Aug;246(15):1688-97.
Negash M, Tsegaye A, G/Medhin A. Diagnostic predictive value of platelet indices for discriminating hypo productive versus immune thrombocytopenia purpura in patients attending a tertiary care teaching hospital in Addis Ababa, Ethiopia. BMC hematology. 2016 Dec;16:1-8
[Neunert CE, Arnold DM, Grace RF, Kuhne T, McCrae KR, Terrell DR. The 2022 review of the 2019 American Society of Hematology guidelines on immune thrombocytopenia. Blood Advances. 2024 Jul 9;8(13):3578-82.
Zhang Q, Sun S, Zhu C, Zheng Y, Cai Q, Liang X, Xie H, Zhou J. Prediction and analysis of weighted genes in hepatocellular carcinoma using bioinformatics analysis. Molecular medicine reports. 2019 Apr 1;19(4):2479-88.
Hall JA, Grainger JR, Spencer SP, Belkaid Y. The role of retinoic acid in tolerance and immunity. Immunity. 2011 Jul 22;35(1):13-22.
Al Rasheed M, Alsayegh F, Al Mohareb F, Aljatham AA, Alqahtani FH, Malhan H, Osman HY, Aal-Yaseen H, Salama H, Al Saeed HH, Al-Tourah L. Immune-mediated thrombotic thrombocytopenic purpura landscaping in Gulf countries: a real-world evidence study (ATHENA Study). Annals of Blood. 2024 Mar 30;9.
Ozygała A, Rokosz-Mierzwa J, Widz P, Skowera P, Wiliński M, Styka B, Lejman M. Biological Markers of Myeloproliferative Neoplasms in Children, Adolescents and Young Adults. Cancers. 2024 Dec 8;16(23):4114.
Xu X, Zhang J, Xing H, Han L, Li X, Wu P, Tang J, Jing L, Luo J, Luo J, Liu L. Identification of metabolism-related key genes as potential biomarkers for pathogenesis of immune thrombocytopenia. Scientific Reports. 2024 Apr 19;14(1):9040.
Schmittgen TD, Livak KJ. Analyzing real-time PCR data by the comparative CT method. Nature protocols. 2008 Jun;3(6):1101-8.
Daniel WW, Cross CL. Biostatistics: a foundation for analysis in the health sciences. John Wiley & Sons; 2018 Nov 13.
Pietras NM, Gupta N, Vaillant AA, Pearson-Shaver AL. Immune thrombocytopenia. InStatPearls [Internet] 2024 May 5. StatPearls Publishing.
Kochhar M, Neunert C. Immune thrombocytopenia: a review of upfront treatment strategies. Blood Reviews. 2021 Sep 1;49:100822.
Ibrahim L, Dong SX, O'Hearn K, Grimes AB, Kaicker S, FritchLilla S, Breakey VR, Grace RF, Lebensburger JD, Klaassen RJ, Lambert M. Pediatric refractory immune thrombocytopenia: A systematic review. Pediatric Blood & Cancer. 2023 Mar;70(3): e30173..
Dou X, Yang R. Current and emerging treatments for immune thrombocytopenia. Expert Review of Hematology. 2019 Sep 2;12(9):723-32.
Alwadi KW, Alomari A, Alrugaib AK, Alrubayea A, Alzoman M, Alkahtani F. Clinical characteristics and outcomes of pediatric patients with immune thrombocytopenic purpura in King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital: A 10-year study. Cureus. 2020 Nov 6;12(11).
Singh G, Bansal D, Wright NA. Immune thrombocytopenia in children: consensus and controversies. The Indian Journal of Pediatrics. 2020 Feb;87:150-7.
Zafar H, Anwar S, Faizan M, Riaz S. Clinical features and outcome in paediatric newly diagnosed immune thrombocytopenic purpura in a tertiary care centre. Pakistan journal of medical sciences. 2018 Sep;34(5):1195.
Nagrebetsky A, Al-Samkari H, Davis NM, Kuter DJ, Wiener-Kronish JP. Perioperative thrombocytopenia: evidence, evaluation, and emerging therapies. British journal of anaesthesia. 2019 Jan 1;122(1):19-31.
Kuter DJ. The treatment of immune thrombocytopenia (ITP)—focus on thrombopoietin receptor agonists. Annals of Blood. 2021 Mar 31;6.
AlGahtani FH, Alshaman L, ElGohary G, Aleem A, AlQahtany FS, AlQahtany F. Bleeding diathesis as the initial presentation of chronic myeloid leukemia: a case series. Cureus. 2023 Apr 6;15(4).
Sezgin ME, Baytan B, Güneş AM. Childhood immune thrombocytopenia: Long-term follow-up data evaluated by the criteria of the international working group on immune thrombocytopenic purpura..
Donato H. Neonatal thrombocytopenia: A review. I. Definitions, differential diagnosis, causes, immune thrombocytopenia. de Pediatría. 2021 Jun 1:188.
Chen ZY, Oswald BE, Sullivan JA, Dahmani FZ, Pasman Y, Liu Z, Chen P, Ni H. Platelet physiology and immunology: pathogenesis and treatment of classical and non-classical fetal and neonatal alloimmune thrombocytopenia. Annals of Blood. 2019 Dec 26;4.
Aureli A, Marziani B, Sconocchia T, Del Principe MI, Buzzatti E, Pasqualone G, Venditti A, Sconocchia G. Immunotherapy as a turning point in the treatment of acute myeloid leukemia. Cancers. 2021 Dec 13;13(24):6246.
Alaa, R. (2024). Prevalence of Immune Thrombocytopenia Purpura in Wasit Province. Wasit Journal for Pure sciences, 3(3), 160-164.
Provan D, Semple JW. Recent advances in the mechanisms and treatment of immune thrombocytopenia. EBioMedicine. 2022 Feb 1;76.
Bussel J, Cooper N, Boccia R, Zaja F, Newland A. Immune thrombocytopenia. Expert review of hematology. 2021 Nov 2;14(11):1013-25.
Madkhali MA. Recent advances in the management of immune thrombocytopenic purpura (ITP): A comprehensive review. Medicine. 2024 Jan 19;103(3):e36936.
Chen ZY. Pathogenesis of Fetal and Neonatal Alloimmune Thrombocytopenia: Role of Maternal Immune Response on Fetus Survival and Megakaryocytes (Master's thesis, University of Toronto (Canada)).
Neunert C, Terrell DR, Arnold DM, Buchanan G, Cines DB, Cooper N, Cuker A, Despotovic JM, George JN, Grace RF, Kühne T. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood advances. 2019 Dec 10;3(23):3829-66.
Ahmad A, Imran M, Ahsan H. Biomarkers as biomedical bioindicators: Approaches and techniques for the detection, analysis, and validation of novel biomarkers of diseases. Pharmaceutics. 2023 May 31;15(6):1630.
González de la Aleja A, Herrero C, Torres-Torresano M, de la Rosa JV, Alonso B, Capa-Sardón E, Muller IB, Jansen G, Puig-Kröger A, Vega MA, Castrillo A. Activation of LXR nuclear receptors impairs the anti-inflammatory gene and functional profile of M-CSF-dependent human monocyte-derived macrophages. Frontiers in Immunology. 2022 Feb 24;13:835478..
Conti F, Moratti M, Leonardi L, Catelli A, Bortolamedi E, Filice E, Fetta A, Fabi M, Facchini E, Cantarini ME, Miniaci A. Anti-inflammatory and immunomodulatory effect of high-dose immunoglobulins in children: from approved indications to off-label use. Cells. 2023 Jan;12(19):2417.
Yang C, Mai H, Peng J, Zhou B, Hou J, Jiang D. STAT4: an immunoregulator contributing to diverse human diseases. International journal of biological sciences. 2020 Mar 5;16(9):1575.
Hanna, S. J., Tatovic, D., Thayer, T. C., & Dayan, C. M. (2021). Insights from single cell RNA sequencing into the immunology of type 1 diabetes-cell phenotypes and antigen specificity. Frontiers in immunology, 12, 751701.
Calkin AC, Tontonoz P. Liver x receptor signaling pathways and atherosclerosis. Arteriosclerosis, thrombosis, and vascular biology. 2010 Aug 1;30(8):1513-8.
Wang B, Tontonoz P. Liver X receptors in lipid signalling and membrane homeostasis. Nature Reviews Endocrinology. 2018 Aug;14(8):452-63.
Lepore Signorile M, Grossi V, Fasano C, Simone C. Colorectal cancer chemoprevention: a dream coming true?. International Journal of Molecular Sciences. 2023 Apr 20;24(8):7597..
Kos M, Tomaka P, Mertowska P, Mertowski S, Wojnicka J, Błażewicz A, Grywalska E, Bojarski K. The Many Faces of Immune Thrombocytopenia: Mechanisms, Therapies, and Clinical Challenges in Oncological Patients. Journal of Clinical Medicine. 2024 Nov 8;13(22):6738.
Pietras NM, Gupta N, Vaillant AA, Pearson-Shaver AL. Immune thrombocytopenia. InStatPearls [Internet] 2024 May 5. StatPearls Publishing.
Lepore Signorile M, Grossi V, Fasano C, Simone C. Colorectal cancer chemoprevention: a dream coming true. International Journal of Molecular Sciences. 2023 Apr 20;24(8):7597.
Feng B, West M, Patel NC, Wager T, Hou X, Johnson J, Tremaine L, Liras J. Científicos Emprendedores. J Pharm Sci. 2019 Feb 19.
Schifferli A, Cavalli F, Godeau B, Liebman HA, Recher M, Imbach P, Kühne T. Understanding immune thrombocytopenia: looking out of the box. Frontiers in Medicine. 2021 Jun 24; 8:613192.
Mititelu A, Onisâi MC, Roșca A, Vlădăreanu AM. Current understanding of immune thrombocytopenia: a review of pathogenesis and treatment options. International Journal of Molecular Sciences. 2024 Feb 10;25(4):2163.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Hayder Dawood saleem, Muthana Ibrahim Maleek
This work is licensed under a Creative Commons Attribution 4.0 International License.
