الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Immune Thrombocytopenic purpura (ITP) is an autoimmune disease characterized by an isolated low platelet count in the absence of other underlying causes. The pathophysiology of ITP was attributed to platelet autoantibody production. However, the multifactorial and complex pathogenesis involving both cellular and humoral immunity became more realized. The cytokine balance regulates the immune system under normal conditions, which found to be impaired in many autoimmune diseases. Several studies investigated the role of the serum cytokines in pathogenesis of ITP. Interleukin-10 (IL-10) is an anti-inflammatory cytokine with an important role in preventing inflammatory and autoimmune diseases.
Numerous studies have shown an association between IL-10 gene polymorphisms and various immunological disorders, including systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis and asthma. However, few studies were carried out on the Egyptian children to detect the actual role of IL-10 on the susceptibility and clinical course of ITP. In this context, the aim of the present study was to study the IL-10 gene promoter polymorphisms (rs1800896), (rs1800871) and (rs1800872) SNPs as well as IL-10 serum level and their relation to the susceptibility and clinical course of childhood primary ITP.
This study was carried out on ninety children admitted at or attended the Pediatric Hematology Department at Alexandria University Children Hospital (AUCH). The study participants included 30 newly diagnosed ITP patients, 30 chronic ITP and 30 age and sex matched healthy children as a control group. All the patients of newly diagnosed and chronic ITP were defined according to the criteria set by the International Working group (IWG).
All of the study participants were subjected to; complete blood count, serum interleukin-10 assessment by ELISA and genotyping of The IL-10 promoter (rs1800896), (rs1800871) and (rs1800872) SNPs.
The results revealed that IL-10 serum level was significantly higher in newly diagnosed patients than in both; children who had chronic ITP and controls. IL-10 (rs1800896), (rs1800871) and (rs1800872) SNPs genotype distribution in the studied groups were in accordance to Hardy-Weinberg equilibrium. There was no statistical significance between the three studied groups as regards genotype distribution and allele frequency. The risk assessment of IL-10 (rs1800896), (rs1800871) and (rs1800872) SNPs genotypes and alleles in ITP patients versus the control group showed no statistical significance. The correlation between IL-10 (rs1800896), (rs1800871) and (rs1800872) SNPs with IL-10 serum level revealed that IL-10 (rs1800896) and (rs1800872) SNPs AA genotype were associated with lower IL-10 serum level in ITP patients. However, IL-10 (rs1800871) genotypes showed no statistical significance regarding IL-10 serum levels.