{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:22:15Z","timestamp":1774520535287,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":84,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Immunology Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the role of vitamin D (VitD), transforming growth factor\u2010\u03b21 (TGF\u2010\u03b21), and regulatory T cells (Treg) in the pathogenesis of primary immune thrombocytopenia (ITP) in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From February 2023 to September 2024, 51 children with ITP and 44 healthy children from the First Affiliated Hospital of Xinxiang Medical College were enrolled. The serum levels of VitD and TGF\u2010\u03b21 and the percentage of Treg cells in peripheral blood were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was no significant difference in age and sex between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &gt; 0.05). ITP group VitD, TGF\u2010\u03b21, and the level of Treg cells were significantly lower than those of the control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &lt; 0.05). In the ITP group, VitD and TGF\u2010\u03b21 (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.421), Treg cells (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.516), TGF\u2010\u03b21 and Treg cells (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.563), and platelet count (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.399, 0.305, 0.361, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &lt; 0.05). The median model analysis showed that VitD had a significant negative overall effect on ITP risk (regression coefficient\u2009=\u2009\u22120.014,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004), but its direct effect was no longer significant after the introduction of TGF\u2010\u03b21 and Treg, suggesting a complete mediation effect, where the path of VitD affecting ITP via TGF\u2010\u03b21 is significant (effect value\u2009=\u2009\u22120.015,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &lt; 0.001), but the mediated pathway involving Treg was not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is dysregulation of VitD, TGF\u2010\u03b21, and Treg cells in newly diagnosed children with ITP. TGF\u2010\u03b21 may be a key mediator of the regulation of ITP by VitD, suggesting the potential value of TGF\u2010 \u03b21 as an intervening target.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jimr\/4001873","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T09:07:26Z","timestamp":1774516046000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of the Mediating Effect of Vitamin D via the TGF\u2010\u03b21\/Treg Pathway in the Pathogenesis of Childhood Primary Immune Thrombocytopenia"],"prefix":"10.1155","volume":"2026","author":[{"given":"Peiling","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengru","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiyin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanyan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4964-3195","authenticated-orcid":false,"given":"Dongju","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6550-1696","authenticated-orcid":false,"given":"Shujun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2018.1.405"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yapd.2024.02.007"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25086"},{"key":"e_1_2_13_4_2","first-page":"253","volume-title":"A Consensus Conference from the Italian Association of Pediatric Hematology and Oncology","author":"Russo G.","year":"2024"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0000000000000447"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu12072097"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/biom13040709"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20190993"},{"key":"e_1_2_13_9_2","first-page":"47","article-title":"Role of T Lymphocytes in the Pathogenesis of Primary Immune Thrombocytopenia","volume":"12","author":"Hao C.","year":"2022","journal-title":"Chinese Medical Science"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-032713-120257"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/eji.202350460"},{"key":"e_1_2_13_12_2","first-page":"895","article-title":"Association of CD4 + CD25 + Treg Cells and TGF-\u03b21 in Patients With Idiopathic Thrombocytopenic Purpura","volume":"26","author":"Abduzman A.","year":"2010","journal-title":"Journal of Cellular and Molecular Immunology"},{"key":"e_1_2_13_13_2","first-page":"810","article-title":"Adapted Guideline for the Diagnosis and Treatment of Primary Immune Thrombocytopenia for Chinese Children (2021)","volume":"59","author":"Working Group of Chinese Guideline for the Diagnosis and Treatment of Childhood Primary Immune Thrombocytopenia","year":"2021","journal-title":"Chinese Journal of Pediatrics"},{"key":"e_1_2_13_14_2","first-page":"1059","article-title":"Practice for the Diagnosis and Treatment of Primary Immune Thrombocytopenia in Children (2019 Edition)","volume":"17","author":"National Health Commission","year":"2019","journal-title":"Clinical Education of General Practice"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/cimb47010065"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14419"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellimm.2020.104096"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.retram.2023.103389"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22147636"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201242370"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu12051233"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.1006\/abbi.1999.1605"},{"key":"e_1_2_13_23_2","first-page":"2825","article-title":"Progress in the Correlation Between Vitamin D Deficiency and Common Autoimmune Diseases in Children","volume":"43","author":"Ruirui X.","year":"2022","journal-title":"Jilin Medical Journal"},{"key":"e_1_2_13_24_2","first-page":"136","article-title":"Significance of 25-Hydroxyvitamin D3 Level Changes in Children With Primary Immune Thrombocytopenia","volume":"28","author":"Hao C.","year":"2018","journal-title":"Journal of New Knowledge of Medicine"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-023-05210-9"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-024-00994-x"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2022.2035117"},{"key":"e_1_2_13_28_2","first-page":"168","article-title":"Expression and Clinical Significance of Th1, Th2, Th17 and Treg Cells in Peripheral Blood of Children With ITP","volume":"22","author":"Peipei W.","year":"2020","journal-title":"Clinical Blood Transfusion and Testing"},{"key":"e_1_2_13_29_2","first-page":"7","article-title":"Th17\/Treg Balance and Its Clinical Significance in Children With Primary Immune Thrombocytopenia","volume":"36","author":"Jie G.","year":"2025","journal-title":"Chinese Maternal and Child Health Research"},{"key":"e_1_2_13_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-022-01978-0"},{"key":"e_1_2_13_31_2","first-page":"129","article-title":"Significance of Regulatory T Cells and Lymphocyte Subsets in the Pathogenesis of Immune Thrombocytopenia in Children","volume":"38","author":"Yanrui Y.","year":"2021","journal-title":"Journal of Xinxiang Medical College"},{"key":"e_1_2_13_32_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-101921-045939"},{"key":"e_1_2_13_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2019.12.010"},{"key":"e_1_2_13_34_2","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2012.682105"},{"key":"e_1_2_13_35_2","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2022.2099832"},{"key":"e_1_2_13_36_2","first-page":"1131","article-title":"Expression of IL-37, VEGFA and TGF-\u03b21 in Children With Primary Immune Thrombocytopenia and Their Correlation With T Cells","volume":"25","author":"Lin T.","year":"2023","journal-title":"Chinese Journal of Contemporary Pediatrics"},{"key":"e_1_2_13_37_2","first-page":"1403","article-title":"Effect of TGF-\u03b21 on Blood CD4(+)CD25(high) Regulatory T Cell Proliferation and Foxp3 Expression During Non-Small Cell Lung Cancer Blood Metastasis","volume":"16","author":"Hu Y.","year":"2018","journal-title":"Experimental and Therapeutic Medicine"},{"key":"e_1_2_13_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13861"},{"key":"e_1_2_13_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/imm.13472"},{"key":"e_1_2_13_40_2","first-page":"501","article-title":"Relationship Between Serum 25-Hydroxyvitamin D3 Level and Regulatory T Cell Subsets in Patients With Systemic Lupus Erythematosus","volume":"40","author":"Yingying G.","year":"2020","journal-title":"Modern Immunology"}],"container-title":["Journal of Immunology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jimr\/4001873","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/jimr\/4001873","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jimr\/4001873","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T09:07:28Z","timestamp":1774516048000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/jimr\/4001873"}},"subtitle":[],"editor":[{"given":"Poorani","family":"Gurumallesh Prabu","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/jimr\/4001873"],"URL":"https:\/\/doi.org\/10.1155\/jimr\/4001873","archive":["Portico"],"relation":{},"ISSN":["2314-8861","2314-7156"],"issn-type":[{"value":"2314-8861","type":"print"},{"value":"2314-7156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4001873"}}