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Background: Thrombopoietin (TPO), the major hormone controlling platelet production, and transforming growth factor-beta1 (TGF-¦Â1), a kind of growth suppressor acting on megakaryopoiesis, have been measured in thrombocytopenias with discordant results. The aim of this study was to explore the relationship between TPO, TGF-¦Â1 and idiopathic thrombocytopenic purpura (ITP) in children.
Methods: TPO and TGF-¦Â1 levels in the serum and bone marrow of 45 children with ITP were measured using the enzyme-linked immunosorbent assay (ELISA) method. Twelve healthy children were enrolled as controls.
Results: The serum level of TPO was higher in ITP children than in the controls, but no significant difference was observed between them (P>0.05). The serum level of TGF-¦Â1 was significantly higher in ITP children than in the controls (P<0.01). The serum level of TPO after therapy was lower than that before treatment, but there was no significant difference between them. Some ITP children having a poor response to steroids had a significantly higher serum TPO level than those having good response and the controls. The bone marrow level of TPO was higher in ITP children than in the controls and also higher than the serum level. There was a positive correlation between the serum level and bone marrow level of TPO (r=0.99, P<0.01). The bone marrow level of TGF-¦Â1 was higher than the normal serum level. There was a positive relation between serum level and bone marrow level of TGF-¦Â1 (r=0.80, P<0.01). Before treatment, ITP children had a low platelet count but a high level of TPO. After treatment, when the platelet count increased, the level of TPO reduced. There was a negative correlation between TPO and platelet count (r=-0.649, P<0.05) and between TPO and megakaryocyte count (r=-0.519, P<0.05).
Conclusions: In the pathogenesis of ITP, TGF-¦Â1 is a feedback regulating factor. The levels of TPO and TGF-¦Â1 in serum and bone marrow could help evaluate ITP children¡¯s conditions, estimate prognosis, and enact treatment regimens.
Key words: children; thrombocytopenia; thrombopoietin; transforming growth factor-beta1; eneyme-linked immunosorbent assay; relativity
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