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Tregs are capable of co-expressing effector Th markers in different inflammatory milieu, which probably indicates Treg dysfunction and incompetence to counter over-activated immune responses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Ninety-two primary ITP patients from March 2013 to December 2018 were included, and proinflammatory plasticity in different Treg compartments, age groups, and <jats:italic>TGFBR2<\/jats:italic> variant carrier status were investigated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Patients were categorized into elderly (n\u2009=\u200944) and younger (n\u2009=\u200948) groups according to an age of 50\u00a0years at disease onset. The overall remission rate was 82.6% after first-line regimens, including 47.8% complete remission. <jats:italic>TGFBR2<\/jats:italic> variants were found in 7 (7.6%) patients with three V216I and four T340M heterozygote carriers. ITP patients demonstrated elevated co-expression of IL-17 and decreased co-expression of both IFN-\u03b3 and IL-13 than health control (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The elderly group demonstrated elevated prevalence of <jats:italic>TGFBR2<\/jats:italic> variants (<jats:italic>p<\/jats:italic>\u2009=\u20090.037) and elevated co-expression of IL-17 (<jats:italic>p<\/jats:italic>\u2009=\u20090.017) in Tregs, while female predominance was found in the younger group (<jats:italic>p<\/jats:italic>\u2009=\u20090.037). In the elderly group, <jats:italic>TGFBR2<\/jats:italic> variant carriers demonstrated further elevated co-expression of IL-17 (<jats:italic>p<\/jats:italic>\u2009=\u20090.023) and decreased co-expression of both IFN-\u03b3 (<jats:italic>p<\/jats:italic>\u2009=\u20090.039) and IL-13 (<jats:italic>p<\/jats:italic>\u2009=\u20090.046) in the aTreg compartment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our findings revealed additional aberrations of Treg proinflammatory plasticity in elderly primary ITP patients, and highlighted the potential role of Treg dysfunction and senescence in the pathogenesis and management among these patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12865-023-00541-8","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T15:02:50Z","timestamp":1680879770000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Proinflammatory plasticity towards Th17 paradigm of regulatory T cells consistent with elevated prevalence of TGFBR2 variants in elderly patients with primary immune thrombocytopenia"],"prefix":"10.1186","volume":"24","author":[{"given":"Jingjing","family":"Cao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanxia","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luya","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xibing","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Min","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanli","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boting","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9581-1134","authenticated-orcid":false,"given":"Yunfeng","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,7]]},"reference":[{"issue":"2","key":"541_CR1","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1111\/j.1365-2141.2009.07615.x","volume":"145","author":"WM Schoonen","year":"2009","unstructured":"Schoonen WM, Kucera G, Coalson J, Li L, Rutstein M, Mowat F, Fryzek J, Kaye JA. 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