{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:16:53Z","timestamp":1728361013037},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2004,10,18]],"date-time":"2004-10-18T00:00:00Z","timestamp":1098057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Hematol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Background<\/jats:title>\n                        <jats:p>In view of clinical observations and laboratory results that support a central role of the spleen in idiopathic thrombocytopenic purpura (ITP) pathophysiology, we studied the effect of splenectomy on type-1 and type-2 cytokine gene expression in an adult ITP case, refractory to conservative treatment.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Case presentation<\/jats:title>\n                        <jats:p>The patient was subjected to splenectomy 9 months after the diagnosis with complete response, attaining platelet counts over 150 \u00d7 10<jats:sup>6<\/jats:sup>\/L within 10 days after the operation. Two consecutive blood samples were obtained from the patient, 3 and 7 months after the splenectomy for the purposes of this study. A control group consisted of 11 healthy adults. Peripheral blood mononuclear cells were prepared from each blood sample and cultured <jats:italic>in vitro<\/jats:italic> for 8 h with the addition of the mitogens phorbol myristate acetate and ionomycin. Total cellular RNA extracted from 10<jats:sup>6<\/jats:sup> cells was submitted to semiquantitave reverse transcriptase-polymerase chain reaction (RT-PCR) for the amplification of IL-2, IFN-\u03b3, IL-4, IL-5, and IL-10 metagraphs. The PCR products were run on ethidium-stained agarose gels, photographed and quantified by densitometry.<\/jats:p>\n                        <jats:p>A steep decrease of type-1 cytokine expression (IL-2, IFN-\u03b3) and their calculated sum expressing Th1 activity was observed at 7 months post-splenectomy compared to 3 months post-splenectomy, in parallel with a rise of platelet count from 190 \u00d7 10<jats:sup>6<\/jats:sup>\/L to 265 \u00d7 10<jats:sup>6<\/jats:sup>\/L. The change of type-2 cytokine expression (IL-4, IL-5, IL-10) was slight and the Th2 activity (IL-4+IL-5) remained largely unchanged. The Th1\/Th2 ratio, that reflects the pathogenic disease-specific T-cell immune deviation, was accordingly reduced 7 months post-splenectomy (Th1\/Th2 = 1.3) compared to 3 months (Th1\/Th2 = 3.5).<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>The reduction of the Th1\/Th2 cytokine ratio that was observed over time after splenectomy was accompanied by full clinical remission. Nevertheless, the persistence of a type-1 polarization, even after several months following spleen removal, is suggestive of a more basic abnormality of the immune function in these patients.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/1471-2326-4-4","type":"journal-article","created":{"date-parts":[[2004,10,21]],"date-time":"2004-10-21T06:24:15Z","timestamp":1098339855000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of splenectomy on type-1\/type-2 cytokine gene expression in a patient with adult idiopathic thrombocytopenic purpura (ITP)"],"prefix":"10.1186","volume":"4","author":[{"given":"Fotios P","family":"Panitsas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasia","family":"Mouzaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2004,10,18]]},"reference":[{"key":"14_CR1","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1056\/NEJMra010501","volume":"346","author":"DB Cines","year":"2002","unstructured":"Cines DB, Blanchette VS: Immune thrombocytopenic purpura. 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