{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T21:42:57Z","timestamp":1792618977035,"version":"4.5.0"},"reference-count":45,"publisher":"Elsevier BV","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004350","name":"Studienstiftung des Deutschen Volkes","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004350","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009425","name":"Landsteiner Foundation for Blood Transfusion Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009425","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["jthjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Thrombosis and Haemostasis"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1016\/j.jtha.2025.06.004","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T12:19:29Z","timestamp":1749557969000},"page":"2969-2981","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Increased effector memory CD4+ T cells are associated with chronic childhood immune thrombocytopenia"],"prefix":"10.1016","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5555-376X","authenticated-orcid":false,"given":"David E.","family":"Schmidt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja M.J.","family":"Heitink\u2013Poll\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit P.","family":"Nicolet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leendert","family":"Porcelijn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marrie C.A.","family":"Bruin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Weterings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Ellen","family":"van der Schoot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Kapur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gestur","family":"Vidarsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masja","family":"de Haas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jtha.2025.06.004_bib1","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1182\/blood-2008-07-162503","article-title":"Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group","volume":"113","author":"Rodeghiero","year":"2009","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib2","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.26405","article-title":"Patterns and influences in health-related quality of life in children with immune thrombocytopenia: a study from the Dallas ITP Cohort","volume":"64","author":"Flores","year":"2017","journal-title":"Pediatr Blood Cancer"},{"key":"10.1016\/j.jtha.2025.06.004_bib3","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.3324\/haematol.2014.106963","article-title":"Health-related quality of life in children with newly diagnosed immune thrombocytopenia","volume":"99","author":"Heitink\u2013Poll\u00e9","year":"2014","journal-title":"Haematologica"},{"key":"10.1016\/j.jtha.2025.06.004_bib4","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/jth.15125","article-title":"A clinical prediction score for transient versus persistent childhood immune thrombocytopenia","volume":"19","author":"Schmidt","year":"2021","journal-title":"J Thromb Haemost"},{"key":"10.1016\/j.jtha.2025.06.004_bib5","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.1053\/j.seminhematol.2013.03.013","article-title":"Childhood immune thrombocytopenia\u2014who will spontaneously recover?","volume":"50","author":"Yacobovich","year":"2013","journal-title":"Semin Hematol"},{"key":"10.1016\/j.jtha.2025.06.004_bib6","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1111\/jth.15232","article-title":"Biological stratification of clinical disease courses in childhood immune thrombocytopenia","volume":"19","author":"Schmidt","year":"2021","journal-title":"J Thromb Haemost"},{"key":"10.1016\/j.jtha.2025.06.004_bib7","doi-asserted-by":"crossref","first-page":"E16","DOI":"10.3390\/jcm6020016","article-title":"Pathogenesis and therapeutic mechanisms in immune thrombocytopenia (ITP)","volume":"6","author":"Zufferey","year":"2017","journal-title":"J Clin Med"},{"key":"10.1016\/j.jtha.2025.06.004_bib8","doi-asserted-by":"crossref","first-page":"S63","DOI":"10.1053\/j.seminhematol.2013.03.011","article-title":"Immune dysregulation in immune thrombocytopenia","volume":"50","author":"Yazdanbakhsh","year":"2013","journal-title":"Semin Hematol"},{"key":"10.1016\/j.jtha.2025.06.004_bib9","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/MOH.0000000000000612","article-title":"An update on the pathophysiology of immune thrombocytopenia","volume":"27","author":"Semple","year":"2020","journal-title":"Curr Opin Hematol"},{"key":"10.1016\/j.jtha.2025.06.004_bib10","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1056\/NEJM197901183000302","article-title":"Immune thrombocytopenia. Use of a Coombs antiglobulin test to detect IgG and C3 on platelets","volume":"300","author":"Cines","year":"1979","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jtha.2025.06.004_bib11","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1056\/NEJM197405022901803","article-title":"Phagocytosis of antibody-coated platelets by human granulocytes","volume":"290","author":"Handin","year":"1974","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jtha.2025.06.004_bib12","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1056\/NEJM197401312900505","article-title":"In vitro platelet phagocytosis by splenic leukocytes in idiopathic thrombocytopenic purpura","volume":"290","author":"McMillan","year":"1974","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jtha.2025.06.004_bib13","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1182\/blood.V55.5.730.730","article-title":"Influence of the amount of platelet-bound IgG on platelet survival and site of sequestration in autoimmune thrombocytopenia","volume":"55","author":"Kernoff","year":"1980","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib14","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1182\/blood-2015-02-628461","article-title":"Platelet function tests, independent of platelet count, are associated with bleeding severity in ITP","volume":"126","author":"Frelinger","year":"2015","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib15","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1160\/TH17-06-0387","article-title":"Platelet function in ITP, independent of platelet count, is consistent over time and is associated with both current and subsequent bleeding severity","volume":"118","author":"Frelinger","year":"2018","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.jtha.2025.06.004_bib16","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1182\/blood-2013-08-519686","article-title":"Functional platelet defects in children with severe chronic ITP as tested with 2 novel assays applicable for low platelet counts","volume":"123","author":"van Bladel","year":"2014","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib17","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1111\/j.1365-2141.2011.08973.x","article-title":"Platelet apoptosis in paediatric immune thrombocytopenia is ameliorated by intravenous immunoglobulin","volume":"156","author":"Winkler","year":"2012","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2025.06.004_bib18","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1182\/blood-2002-05-1475","article-title":"Immune thrombocytopenic purpura (ITP) plasma and purified ITP monoclonal autoantibodies inhibit megakaryocytopoiesis in vitro","volume":"102","author":"Chang","year":"2003","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib19","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1182\/blood-2003-08-2672","article-title":"Suppression of in vitro megakaryocyte production by antiplatelet autoantibodies from adult patients with chronic ITP","volume":"103","author":"McMillan","year":"2004","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib20","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1080\/09537104.2018.1475637","article-title":"Megakaryocyte apoptosis in immune thrombocytopenia","volume":"29","author":"Vrbensky","year":"2018","journal-title":"Platelets"},{"key":"10.1016\/j.jtha.2025.06.004_bib21","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1111\/bjh.12832","article-title":"Impaired proplatelet formation in immune thrombocytopenia: a novel mechanism contributing to decreased platelet count","volume":"165","author":"Lev","year":"2014","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2025.06.004_bib22","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1182\/blood-2003-01-0275","article-title":"Ultrastructural study shows morphologic features of apoptosis and para-apoptosis in megakaryocytes from patients with idiopathic thrombocytopenic purpura","volume":"103","author":"Houwerzijl","year":"2004","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib23","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1016\/j.jaci.2016.10.023","article-title":"Effects of nongenetic factors on immune cell dynamics in early childhood: the Generation R Study","volume":"139","author":"van den Heuvel","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"10.1016\/j.jtha.2025.06.004_bib24","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1182\/asheducation-2018.1.405","article-title":"Pediatric ITP: is it different from adult ITP?","volume":"2018","author":"Despotovic","year":"2018","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"10.1016\/j.jtha.2025.06.004_bib25","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1177\/1076029612454937","article-title":"CD4+ CD25+High Foxp3+ regulatory T cells, B lymphocytes, and T lymphocytes in patients with acute ITP in Assiut Children Hospital","volume":"20","author":"Zahran","year":"2014","journal-title":"Clin Appl Thromb Hemost"},{"key":"10.1016\/j.jtha.2025.06.004_bib26","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/MPH.0b013e3181f46b82","article-title":"Role of CD4+CD25+ T cells in children with idiopathic thrombocytopenic purpura","volume":"33","author":"Aboul\u2013Fotoh","year":"2011","journal-title":"J Pediatr Hematol Oncol"},{"key":"10.1016\/j.jtha.2025.06.004_bib27","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/cei.12279","article-title":"Alterations in immune cell subsets and their cytokine secretion profile in childhood idiopathic thrombocytopenic purpura (ITP)","volume":"176","author":"Talaat","year":"2014","journal-title":"Clin Exp Immunol"},{"key":"10.1016\/j.jtha.2025.06.004_bib28","doi-asserted-by":"crossref","first-page":"4245","DOI":"10.1182\/blood.V87.10.4245.bloodjournal87104245","article-title":"Differences in serum cytokine levels in acute and chronic autoimmune thrombocytopenic purpura: relationship to platelet phenotype and antiplatelet T-cell reactivity","volume":"87","author":"Semple","year":"1996","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib29","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1182\/blood-2018-02-830844","article-title":"Intravenous immunoglobulin vs observation in childhood immune thrombocytopenia: a randomized controlled trial","volume":"132","author":"Heitink\u2013Poll\u00e9","year":"2018","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib30","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1067\/mpd.2002.128547","article-title":"Grading of hemorrhage in children with idiopathic thrombocytopenic purpura","volume":"141","author":"Buchanan","year":"2002","journal-title":"J Pediatr"},{"key":"10.1016\/j.jtha.2025.06.004_bib31","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.1182\/blood-2005-08-3518","article-title":"Prospective phase 1\/2 study of rituximab in childhood and adolescent chronic immune thrombocytopenic purpura","volume":"107","author":"Bennett","year":"2006","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2025.06.004_bib32","doi-asserted-by":"crossref","DOI":"10.1038\/ncomms14049","article-title":"Massively parallel digital transcriptional profiling of single cells","volume":"8","author":"Zheng","year":"2017","journal-title":"Nat Commun"},{"key":"10.1016\/j.jtha.2025.06.004_bib33","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1016\/j.cell.2019.05.031","article-title":"Comprehensive integration of single-cell data","volume":"177","author":"Stuart","year":"2019","journal-title":"Cell"},{"key":"10.1016\/j.jtha.2025.06.004_bib34","doi-asserted-by":"crossref","DOI":"10.1126\/science.aax9198","article-title":"A genome-wide transcriptomic analysis of protein-coding genes in human blood cells","volume":"366","author":"Uhlen","year":"2019","journal-title":"Science"},{"key":"10.1016\/j.jtha.2025.06.004_bib35","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.clim.2009.05.020","article-title":"Refined characterization and reference values of the pediatric T- and B-cell compartments","volume":"133","author":"van Gent","year":"2009","journal-title":"Clin Immunol"},{"key":"10.1016\/j.jtha.2025.06.004_bib36","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/S0022-3476(97)70200-2","article-title":"Immunophenotyping of blood lymphocytes in childhood. Reference values for lymphocyte subpopulations","volume":"130","author":"Comans\u2013Bitter","year":"1997","journal-title":"J Pediatr"},{"key":"10.1016\/j.jtha.2025.06.004_bib37","first-page":"2627","article-title":"CD4+CD29+T cells are blamed for the persistent inflammatory response in ulcerative colitis","volume":"8","author":"Zhu","year":"2015","journal-title":"Int J Clin Exp Pathol"},{"key":"10.1016\/j.jtha.2025.06.004_bib38","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S0022-510X(03)00214-4","article-title":"Immune parameters associated with early treatment effects of high-dose intravenous methylprednisolone in multiple sclerosis","volume":"216","author":"Wang","year":"2003","journal-title":"J Neurol Sci"},{"key":"10.1016\/j.jtha.2025.06.004_bib39","doi-asserted-by":"crossref","DOI":"10.1016\/j.jneuroim.2021.577500","article-title":"Systemic cellular immunity and neuroinflammation during acute flare-up in multiple sclerosis and neuromyelitis optica spectrum disorder patients","volume":"353","author":"Uchida","year":"2021","journal-title":"J Neuroimmunol"},{"key":"10.1016\/j.jtha.2025.06.004_bib40","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0022-510X(97)00082-8","article-title":"A longitudinal study of circulating lymphocyte subsets in the peripheral blood during the acute stage of Guillain\u2013Barr\u00e9 syndrome","volume":"151","author":"Sindern","year":"1997","journal-title":"J Neurol Sci"},{"key":"10.1016\/j.jtha.2025.06.004_bib41","doi-asserted-by":"crossref","first-page":"6686","DOI":"10.1073\/pnas.1913940117","article-title":"CD29 identifies IFN-\u03b3-producing human CD8+ T cells with an increased cytotoxic potential","volume":"117","author":"Nicolet","year":"2020","journal-title":"Proc Natl Acad Sci U S A"},{"key":"10.1016\/j.jtha.2025.06.004_bib42","doi-asserted-by":"crossref","first-page":"2966","DOI":"10.4049\/jimmunol.2100138","article-title":"CD29 enriches for cytotoxic human CD4+ T cells","volume":"207","author":"Nicolet","year":"2021","journal-title":"J Immunol"},{"key":"10.1016\/j.jtha.2025.06.004_bib43","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/vox.12894","article-title":"Antiplatelet antibody immunoassays in childhood immune thrombocytopenia: a systematic review","volume":"115","author":"Schmidt","year":"2020","journal-title":"Vox Sang"},{"key":"10.1016\/j.jtha.2025.06.004_bib44","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.thromres.2006.09.008","article-title":"Reduced Cd4+Cd25+ T cells in patients with idiopathic thrombocytopenic purpura","volume":"120","author":"Sakakura","year":"2007","journal-title":"Thromb Res"},{"key":"10.1016\/j.jtha.2025.06.004_bib45","first-page":"2417","article-title":"The role of CD8+ T-cell clones in immune thrombocytopenia","volume":"141","author":"Malik","year":"2023","journal-title":"Blood"}],"container-title":["Journal of Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1538783625003629?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1538783625003629?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:02:53Z","timestamp":1778868173000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1538783625003629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":45,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["S1538783625003629"],"URL":"https:\/\/doi.org\/10.1016\/j.jtha.2025.06.004","relation":{},"ISSN":["1538-7836"],"issn-type":[{"value":"1538-7836","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Increased effector memory CD4+ T cells are associated with chronic childhood immune thrombocytopenia","name":"articletitle","label":"Article Title"},{"value":"Journal of Thrombosis and Haemostasis","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jtha.2025.06.004","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Inc. on behalf of International Society on Thrombosis and Haemostasis.","name":"copyright","label":"Copyright"}]}}