Objectives: To evaluate the telomere/telomerase system and its clinical significance in immune thrombocytopenia (ITP) patients.
Methods: A total of 237 ITP patients, 20 SLE patients and 200 age-and sex-matched healthy controls were included in this study. CD4(+), CD8(+) and CD19(+) lymphocytes were purified by magnetic beads sorting from peripheral blood of 37 active chronic ITP patients and 22 age-and sex-matched healthy controls. Telomerase activity was assayed by Telo TTAGGG Telomerase PCR ELISA KIT. The relative telomere length of peripheral blood mononuclear cell (PBMC) was measured by a quantitative polymerase chain reaction-based method (Q-PCR) from 200 ITP patients and 178 age-and sex-matched healthy controls.
Results: Telomerase activity was increased in CD4(+), CD8(+) and CD19(+) lymphocytes from ITP patients compared to those from healthy controls (p = 0.000). The level of telomerase activity in CD19(+) lymphocyte was higher than those in CD4(+) and CD8(+) lymphocytes. Telomerase activity of CD19+ lymphocytes had a modest negative correlation with platelet count in ITP patients (p = 0.042). The relative telomere length of PBMC in ITP patients was significantly shorter than that in the healthy controls (p = 0.002). Telomere length of PBMC in active ITP patients was significantly shorter than that in the controls (p = 0.000) and a tendency to be shorter even in inactive ITP patients (p = 0.065). Moreover, the telomere length in refractory and non-refractory ITP patients were both significantly shorter than that in the controls (p = 0.025; p = 0.000). However no significant difference in telomere length of PBMC was found between refractory ITP patients and non-refractory ITP patients (p = 0.234).
Conclusion: An abnormal regulating telomere/telomerase system might be involved in the pathogenesis of ITP. Further studies may elucidate whether the telomere length could be considered as a predictive biomarker for the prognosis of ITP.