{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:22:26Z","timestamp":1787570546616,"version":"build-2736575974"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"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. Pediatr."],"abstract":"\n Background<\/jats:title>\n Primary immune thrombocytopenia (ITP) represents the most common acquired bleeding disorder among children. Since its immune mechanism is not fully clarified, precise immune markers still need to be identified for guiding and intervening in recurrent and refractory cases.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This cross-sectional study included children diagnosed with ITP between August 2022 and November 2024. Peripheral blood levels of CD3\n +<\/jats:sup>\n T, CD4\n +<\/jats:sup>\n T, CD8\n +<\/jats:sup>\n T, and B cells were quantified via flow cytometry analysis. Intracellular IFN-\n \u03b3<\/jats:italic>\n expression was analyzed. Spearman correlation analysis was conducted in combination with platelet count and WHO bleeding score.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared with healthy controls, children with ITP exhibited a markedly reduced platelet count and elevated bleeding frequency (both\n P<\/jats:italic>\n \u2009\n &lt;<\/jats:italic>\n \u2009\n 0.<\/jats:italic>\n 0001). The proportion of CD8\n +<\/jats:sup>\n T cells significantly increased in both the relapse group and the severe group, and the CD4\n +<\/jats:sup>\n \/CD8\n +<\/jats:sup>\n ratio decreased in the severe group. The proportions of CD3\n \u2212<\/jats:sup>\n IFN-\n \u03b3<\/jats:italic>\n cells, CD4\n +<\/jats:sup>\n \u2009IFN-\n \u03b3<\/jats:italic>\n T cells, and CD8\n +<\/jats:sup>\n \u2009IFN-\n \u03b3<\/jats:italic>\n T cells were all higher in ITP children than in healthy controls, with higher CD3\n +<\/jats:sup>\n \u2009CD8\n +<\/jats:sup>\n \u2009IFN-\n \u03b3<\/jats:italic>\n T cells expression detected in the severe group (all\n P<\/jats:italic>\n \u2009&lt;\u20090.05). Platelet was negatively correlated with the proportion of CD3\n +<\/jats:sup>\n \u2009CD8\n +<\/jats:sup>\n \u2009IFN-\n \u03b3<\/jats:italic>\n T cells (r\u2009=\u2009\u22120.2583,\n P<\/jats:italic>\n \u2009=\u20090.012).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Aberrant activation of the CD8\n +<\/jats:sup>\n T cell\/IFN-\n \u03b3<\/jats:italic>\n axis is closely associated with thrombocytopenia, disease recurrence, and severity in pediatric ITP, and may serve as a potential immune-targeted intervention candidate for refractory ITP.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fped.2026.1905260","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:37:20Z","timestamp":1785476240000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation between the CD8+ T cell\/IFN-\u03b3 axis and clinical disease progression at different phases of ITP"],"prefix":"10.3389","volume":"14","author":[{"given":"Jie","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chentao","family":"Shen","sequence":"additional","affiliation":[{"name":"Suzhou Wujiang District Children\u2019s Hospital","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmei","family":"Chen","sequence":"additional","affiliation":[{"name":"Sir Run Run Hospital, Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Children\u2019s Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"B1","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"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1111\/bjh.20105","article-title":"Acute stroke in children with immune thrombocytopenia: a systematic review and meta-analysis","volume":"206","author":"Ly","year":"2025","journal-title":"Br J Haematol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1002\/ajh.70148","article-title":"Daratumumab in pediatric chronic refractory primary immune thrombocytopenia (ITP): rapid platelet recovery, sustained response, and immune reconstitution dynamics","volume":"101","author":"Hu","year":"2026","journal-title":"Am J Hematol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1542\/pir.2025-006782","article-title":"Immune thrombocytopenia in children","volume":"47","author":"Dolatshahi","year":"2026","journal-title":"Pediatr Rev"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e69635","DOI":"10.7759\/cureus.69635","article-title":"Diagnosis and management of immune thrombocytopenia in paediatrics: a comprehensive review","volume":"16","author":"Thakur","year":"2024","journal-title":"Cureus"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e105588","DOI":"10.7759\/cureus.105588","article-title":"Clinical characteristics and predictors of chronicity in children with immune thrombocytopenia","volume":"18","author":"Alali","year":"2026","journal-title":"Cureus"},{"key":"B7","doi-asserted-by":"publisher","first-page":"5673","DOI":"10.1007\/s00431-023-05242-3","article-title":"Contribution of T helper 17 cells and interleukin-17 to the pathogenesis of primary immune thrombocytopenia in Egyptian children","volume":"182","author":"Hassan","year":"2023","journal-title":"Eur J Pediatr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1595977","DOI":"10.3389\/fimmu.2025.1595977","article-title":"The gut-immune axis in primary immune thrombocytopenia (ITP): a paradigm shifts in treatment approaches","volume":"16","author":"Guo","year":"2025","journal-title":"Front Immunol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1688","DOI":"10.1177\/15353702211009787","article-title":"Regulation of Th1\/Th2 and Th17\/treg by pDC\/mDC imbalance in primary immune thrombocytopenia","volume":"246","author":"Li","year":"2021","journal-title":"Exp Biol Med (Maywood)"},{"key":"B10","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1182\/blood-2015-03-635417","article-title":"CD8+ T cells are predominantly protective and required for effective steroid therapy in murine models of immune thrombocytopenia","volume":"126","author":"Ma","year":"2015","journal-title":"Blood"},{"key":"B11","doi-asserted-by":"publisher","first-page":"156971","DOI":"10.1016\/j.cyto.2025.156971","article-title":"Fcrn inhibitors in immune thrombocytopenia: a comprehensive review of therapeutic advances and clinical outcomes","volume":"193","author":"Nilforoushzadeh","year":"2025","journal-title":"Cytokine"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1920","DOI":"10.1016\/j.jtha.2023.02.030","article-title":"\u03b22-adrenergic receptor agonist corrects immune thrombocytopenia by reestablishing the homeostasis of T cell differentiation","volume":"21","author":"Zhang","year":"2023","journal-title":"J Thromb Haemost"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1002\/ajh.27337","article-title":"Pediatric refractory chronic immune thrombocytopenia: identification, patients\u2019 characteristics, and outcome","volume":"99","author":"Pincez","year":"2024","journal-title":"Am J Hematol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"3578","DOI":"10.1182\/bloodadvances.2023012541","article-title":"The 2022 review of the 2019 American society of hematology guidelines on immune thrombocytopenia","volume":"8","author":"Neunert","year":"2024","journal-title":"Blood Adv"},{"key":"B15","doi-asserted-by":"publisher","first-page":"3411","DOI":"10.1007\/s00431-021-04121-z","article-title":"Increased proportion of Th17\/treg cells at the new diagnosed stage of chronic immune thrombocytopenia in pediatrics: the pilot study from a multi-center","volume":"180","author":"Gu","year":"2021","journal-title":"Eur J Pediatr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"253","DOI":"10.2450\/BloodTransfus.501","article-title":"Recommendations for the management of acute immune thrombocytopenia in children A consensus conference from the Italian association of pediatric hematology and oncology","volume":"22","author":"Russo","year":"2024","journal-title":". Blood Transfus"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2417","DOI":"10.1182\/blood.2022018380","article-title":"The role of CD8+ T-cell clones in immune thrombocytopenia","volume":"141","author":"Malik","year":"2023","journal-title":"Blood"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1499014","DOI":"10.3389\/fimmu.2025.1499014","article-title":"The function of T cells in immune thrombocytopenia","volume":"16","author":"Bu","year":"2025","journal-title":"Front Immunol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"102977","DOI":"10.1016\/j.rpth.2025.102977","article-title":"Natural killer cell granule protein 7 contributes to CD8+ T cell-mediated platelet apoptosis in immune thrombocytopenia","volume":"9","author":"Wang","year":"2025","journal-title":"Res Pract Thromb Haemost"},{"key":"B20","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/ejh.13705","article-title":"T cell-mediated autoimmunity in immune thrombocytopenia","volume":"108","author":"Vrbensky","year":"2022","journal-title":"Eur J Haematol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"109475","DOI":"10.1016\/j.thromres.2025.109475","article-title":"Inhibiting mTORC1 pathway by rapamycin restores the balance of CD8+ T cell subsets and reduces CD8+ T cell-mediated platelet destruction in immune thrombocytopenia","volume":"254","author":"Ni","year":"2025","journal-title":"Thromb Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"3326","DOI":"10.1182\/blood-2012-06-434605","article-title":"CD16+ monocytes Control T-cell subset development in immune thrombocytopenia","volume":"120","author":"Zhong","year":"2012","journal-title":"Blood"},{"key":"B23","doi-asserted-by":"publisher","first-page":"3430","DOI":"10.1007\/s10753-025-02275-8","article-title":"Plasma exosomes derived from patients with primary immune thrombocytopenia attenuate TBX21+ regulatory T cell-mediated immune suppression via MiR-363-3p","volume":"48","author":"Huang","year":"2025","journal-title":"Inflammation"},{"key":"B24","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1111\/bjh.20173","article-title":"CD19+IL-10+ regulatory B cells induced by IL-12p35 regulates functional T-cell subsets in patients with immune thrombocytopenia","volume":"207","author":"Hua","year":"2025","journal-title":"Br J Haematol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/s12308-025-00656-4","article-title":"Immune cell subset variations in immune thrombocytopenia: a prospective observational study","volume":"18","author":"Purohit","year":"2025","journal-title":"J Hematop"},{"key":"B26","doi-asserted-by":"publisher","first-page":"954706","DOI":"10.3389\/fimmu.2022.954706","article-title":"IFN-\u03b3, should not be ignored in SLE","volume":"13","author":"Liu","year":"2022","journal-title":"Front Immunol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"127","DOI":"10.3345\/cep.2022.00920","article-title":"Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-\u03b3 in pediatric immune thrombocytopenia","volume":"66","author":"El-Gendy","year":"2023","journal-title":"Clin Exp Pediatr"},{"key":"B28","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1093\/intimm\/4.4.475","article-title":"Co-engagement of CD3 with LFA-1 or ICAM-1 adhesion molecules enhances the frequency of activation of single murine CD4+ and CD8+ T cells and induces synthesis of IL-3 and IFN-gamma but not IL-4 or IL-6","volume":"4","author":"Maraskovsky","year":"1992","journal-title":"Int Immunol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"103210","DOI":"10.1016\/j.rpth.2025.103210","article-title":"Haemostasis alterations in immune thrombocytopenia and their clinical significance","volume":"9","author":"Pincez","year":"2025","journal-title":"Res Pract Thromb Haemost"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1002\/ajh.27669","article-title":"Identifying Microbiota and immune host factors associated with bleeding risk in children with immune thrombocytopenia","volume":"100","author":"Saini","year":"2025","journal-title":"Am J Hematol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"2442","DOI":"10.1111\/bjh.19857","article-title":"Risk factors and disease trajectories of recurrent immune thrombocytopenia in children","volume":"205","author":"Yang","year":"2024","journal-title":"Br J Haematol"}],"updated-by":[{"DOI":"10.3389\/fped.2026.1964035","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000}}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1905260\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:39:38Z","timestamp":1787567978000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1905260\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":31,"alternative-id":["10.3389\/fped.2026.1905260"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1905260","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]},"article-number":"1905260"}}