{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:50:13Z","timestamp":1782190213363,"version":"3.54.5"},"reference-count":91,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Understanding the role of genetic polymorphisms in cluster of differentiation (CD)-related genes is crucial for elucidating susceptibility to immune thrombocytopenia (ITP). This study evaluates the polymorphisms of\n                      <jats:italic>CD16<\/jats:italic>\n                      ,\n                      <jats:italic>CD32<\/jats:italic>\n                      ,\n                      <jats:italic>CD40<\/jats:italic>\n                      , and\n                      <jats:italic>CD152<\/jats:italic>\n                      in ITP patients through a systematic review, meta-analysis, and trial sequential analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature review was conducted by a single investigator across multiple databases, including PubMed\/Medline, Web of Science, Scopus, and Cochrane Library, up to 7 December 2025. The effect sizes were calculated using Review Manager 5.3 and presented as odds ratios (OR) with a 95% confidence interval. Analyses for publication bias, meta-regression, and sensitivity were performed using Comprehensive Meta-Analysis version 3.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-three articles were included in both qualitative and quantitative syntheses. Significant associations were found for the Fc\u03b3RIIIA-158 F\/V polymorphism across all genetic models, with the highest pooled OR of 2.61 in the homozygous model. No significant associations were observed for the\n                      <jats:italic>Fc<\/jats:italic>\n                      \u03b3\n                      <jats:italic>RIIA-131 H\/R<\/jats:italic>\n                      ,\n                      <jats:italic>Fc<\/jats:italic>\n                      \u03b3\n                      <jats:italic>RIIB-232 I\/T<\/jats:italic>\n                      ,\n                      <jats:italic>CTLA-4 exon 1 A49G<\/jats:italic>\n                      ,\n                      <jats:italic>CTLA-4 CT60<\/jats:italic>\n                      ,\n                      <jats:italic>CD40 rs4810485 G<\/jats:italic>\n                      &amp;gt;\n                      <jats:italic>T<\/jats:italic>\n                      , and\n                      <jats:italic>CD40 rs1883832 C<\/jats:italic>\n                      &amp;gt;\n                      <jats:italic>T<\/jats:italic>\n                      polymorphisms. The highest heterogeneity was noted in the heterozygous model for\n                      <jats:italic>Fc<\/jats:italic>\n                      \u03b3\n                      <jats:italic>RIIA-131 H\/R<\/jats:italic>\n                      (I\n                      <jats:sup>2<\/jats:sup>\n                      = 69%), the allelic model for\n                      <jats:italic>Fc<\/jats:italic>\n                      \u03b3\n                      <jats:italic>RIIB-232 I\/T<\/jats:italic>\n                      (I\n                      <jats:sup>2<\/jats:sup>\n                      = 60%), the allelic model for\n                      <jats:italic>CTLA-4 exon 1 A49G<\/jats:italic>\n                      (I\n                      <jats:sup>2<\/jats:sup>\n                      = 43%), the dominant model for\n                      <jats:italic>CTLA-4 CT60<\/jats:italic>\n                      (I\n                      <jats:sup>2<\/jats:sup>\n                      = 80%), and the allelic model for\n                      <jats:italic>CD40 rs1883832 C<\/jats:italic>\n                      &amp;gt;\n                      <jats:italic>T<\/jats:italic>\n                      (I\n                      <jats:sup>2<\/jats:sup>\n                      = 87%). The\n                      <jats:italic>CD40 rs4810485 G<\/jats:italic>\n                      &amp;gt;\n                      <jats:italic>T<\/jats:italic>\n                      polymorphism showed no heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%) in most models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>Fc<\/jats:italic>\n                      \u03b3\n                      <jats:italic>RIIIA-158 F\/V<\/jats:italic>\n                      polymorphism is consistently associated with disease susceptibility across various genetic models. Other polymorphisms did not show significant associations, indicating the need for further research to validate these findings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1777678","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:29:30Z","timestamp":1782188970000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of CD16, CD32, CD40, and CD152 polymorphisms in immune thrombocytopenia patients: a systematic review, meta-analysis, and trial sequential analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yan","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Blood Transfusion, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People\u2019s Hospital, Quzhou","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangjian","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Blood Transfusion, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People\u2019s Hospital, Quzhou","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanzhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou","place":["Zhejiang, China"]},{"name":"School of Medicine, Shaoxing University, Shaoxing","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1007\/s13312-020-1966-8","article-title":"Immune thrombocytopenia: American society of hematology guidelines, 2019.","volume":"57","author":"Sahi","year":"2020","journal-title":"Indian Pediatr."},{"key":"B2","doi-asserted-by":"publisher","first-page":"3829","DOI":"10.1182\/bloodadvances.2019000966","article-title":"American society of hematology 2019 guidelines for immune thrombocytopenia.","volume":"3","author":"Neunert","year":"2019","journal-title":"Blood Adv."},{"key":"B3","doi-asserted-by":"publisher","first-page":"3780","DOI":"10.1182\/bloodadvances.2019000812","article-title":"Updated international consensus report on the investigation and management of primary immune thrombocytopenia.","volume":"3","author":"Provan","year":"2019","journal-title":"Blood Adv."},{"key":"B4","doi-asserted-by":"publisher","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 J Am Soc Hematol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1002\/ajh.24702","article-title":"Newly diagnosed immune thrombocytopenia adults: clinical epidemiology, exposure to treatments, and evolution. 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