High-dose dexamethasone modulates serum cytokine profile in patients with primary immune thrombocytopenia.

Primary immune thrombocytopenia (ITP) is an autoimmune heterogeneous disorder which is characterized by decreased platelet count. Serum cytokines play an important role in the pathogenesis of ITP by initiating and perpetuating various cellular and humoral autoimmune processes. To investigate a broad spectrum of cytokines in ITP patients and the effects of high-dose dexamethasone (HD-DXM) regimen on serum cytokines profile, a multiplex cytokine assay was used to measure the serum levels of 20 circulating cytokines simultaneously in 22 patients before and after oral administration of 40mg/day DXM for 4 consecutive days. A cohort of 10 healthy individuals was served as control. Serum levels of interleukin (IL)-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, growth-related oncogene (GRO), interferen (IFN)-γ and tumor necrosis factor (TNF)-α were significantly decreased in pre-treatment patients, compared with healthy controls (p<0.05). After HD-DXM treatment, IL-4, IL-5, IL-6, IL-12p70, IL-13, GRO, IFN-γ and TNF-α were significantly increased in remission patients as compared with patients before treatment (p<0.05). However, there was no significant difference (except TNF-α) between remission patients and healthy controls (p>0.05). All these cytokines decreased again in relapse patients. Our findings suggest that measuring cytokine levels might help in the clinical assessment of ITP, and the HD-DXM therapy could correct the derangement of serum cytokines.