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. 2022 Sep;198(5):916-922.
doi: 10.1111/bjh.18309. Epub 2022 Jun 14.

Thrombopoietin receptor agonists increase splenic regulatory T-cell numbers in immune thrombocytopenia

Marco Pizzi  1 , Fabrizio Vianello  2 , Gianni Binotto  2 , Nicola Vianelli  3 , Giuseppe Carli  4 , Giuseppe Auteri  3   5 , Ilaria Nichele  4 , Marta Sbaraglia  1 , Simone Zoletto  2 , Federico Scarmozzino  1 , Rita Bresciani  1 , Fabio d'Amore  2 , Alberto Friziero  6 , Vincenza Guzzardo  1 , Irene Bertozzi  7 , Barbara Famengo  8 , Emanuele S G d'Amore  8 , Elena Sabattini  9 , Angelo Paolo Dei Tos  1
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Thrombopoietin receptor agonists increase splenic regulatory T-cell numbers in immune thrombocytopenia

Marco Pizzi et al. Br J Haematol. 2022 Sep.

Abstract

Thrombopoietin receptor agonists (TPO-RA) are a valid therapy for immune thrombocytopenia (ITP), due to megakaryocyte stimulation and (poorly characterised) immune-modulatory effects. The spleen is pivotal in the pathogenesis of ITP, yet little is known on its immune microenvironment and on effects of TPO-RA on this organ. To address these topics, we analysed 35 spleens removed for primary refractory ITP. Pre-splenectomy TPO-RA administration correlated with increased splenic regulatory T cells (Tregs), type 2 T-helper cells and histiocyte density and with reduced red pulp sinusoids. Surgical outcome was not associated with TPO-RA administration, other pre-splenectomy therapies and/or Treg density. In conclusion, TPO-RA affect the splenic microenvironment, but this has no impact on splenectomy outcome.

Keywords: TPO receptor agonist; immune microenvironment; immune thrombocytopenia; splenectomy.

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REFERENCES

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