Exploring the impacts of lymphocyte function associated antigen-1 α subunit, cluster of differentiation 14, and cluster of differentiation 61 in immune thrombocytopenic purpura: insight into dynamics and treatment outcomes

Background
One of the autoimmune illnesses, immune thrombocytopenia (ITP), is characterized by thrombocytopenia and a higher risk of bleeding. ITP has a highly complexed etiology. LFA-1 or lymphocyte function associated antigen-1, and cluster of differentiation 14 (CD14) expression on monocytes (MCs) suggested to be crucial in ITP pathogenesis. The objective of this study was to assess LFA-1 (α subunit) expression on lymphocytes, CD14 on MCs to investigate its potential function in individuals with primary ITP, as well as the severity and responsiveness to different lines of immunosuppressive therapy, and also to determine phase dependent expression of some platelets (PLT) glycoprotein and its role in bleeding risk.


Patients and methods

Cross-sectional hospital-based research was conducted. On group 33 patients (16: 82) years old of primary ITP patients. LFA-1 α subunit (CD11a) was examined by using flow cytometry on CD3
+
T-cells, CD3
+
CD4
+
T-cells, and CD19
+
B-cells.



Results

Higher mean of LFA-1 (α subunit) (CD11a) on all lymphocyte subpopulations in refractory group more than responders and the difference was statistically insignificant except for CD11a on CD3 has some tendency to be significant (
P
=0.08). Higher mean of circulating MCs in refractory patients with lower PLT count. Statistically strong positive correlation between ITP bleeding score in the persistent group of patients and total circulating MCs (
r
=0.94) (
P
=0.01). CD61 was higher mean in persistent phase and results show some tendency to be significant (
P
=0.08). Furthermore, CD61 has a negative and statistically significant correlation as regard ITP bleeding score in chronic patients (
r
=−0.41) (
P
=0.04).



Conclusion
A putative involvement for LFA-1 (α subunit) in the pathophysiology of ITP exists. The degree of CD11a expression on T and B-cells was unaffected by immunosuppressive treatment in ITP, neither the PLT count nor the bleeding severity. Phase dependent expression of some PLT glycoprotein has a role in severity of bleeding.