Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune Thrombocytopenia
We conducted this randomized trial to investigate the efficacy and safety of rapamycin treatment in adults with chronic immune thrombocytopenia (ITP). Eighty-eight patients were separated into the control (cyclosporine A plus prednisone) and experimental (rapamycin plus prednisone) groups. The CD4+C...
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| Format: | Article |
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Wiley
2013-01-01
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| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2013/548085 |
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| author | Jiaming Li Zhaoyue Wang Lan Dai Lijuan Cao Jian Su Mingqing Zhu Ziqiang Yu Xia Bai Changgeng Ruan |
| author_facet | Jiaming Li Zhaoyue Wang Lan Dai Lijuan Cao Jian Su Mingqing Zhu Ziqiang Yu Xia Bai Changgeng Ruan |
| author_sort | Jiaming Li |
| collection | DOAJ |
| description | We conducted this randomized trial to investigate the efficacy and safety of rapamycin treatment in adults with chronic immune thrombocytopenia (ITP). Eighty-eight patients were separated into the control (cyclosporine A plus prednisone) and experimental (rapamycin plus prednisone) groups. The CD4+CD25+CD127low regulatory T (Treg) cells level, Foxp3 mRNA expression, and the relevant cytokines levels were measured before and after treatment. The overall response (OR) was similar in both groups (experimental group versus control group: 58% versus 62%, P=0.70). However, sustained response (SR) was more pronounced in the experimental group than in the control group (68% versus 39%, P<0.05). Both groups showed similar incidence of adverse events (7% versus 11%, P=0.51). As expected, the low pretreatment baseline level of Treg cells was seen in all patients (P<0.001); however, the experimental group experienced a significant rise in Treg cell level, and there was a strong correlation between the levels of Treg cells and TGF-beta after the treatment. In addition, the upregulation maintained a stable level during the follow-up phase. Thus, rapamycin plus low dose prednisone could provide a new promising option for therapy of ITP. |
| format | Article |
| id | doaj-art-13bf02de324143d895cb4ac5f6dd23a1 |
| institution | OA Journals |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
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| series | Clinical and Developmental Immunology |
| spelling | doaj-art-13bf02de324143d895cb4ac5f6dd23a12025-08-20T02:01:40ZengWileyClinical and Developmental Immunology1740-25221740-25302013-01-01201310.1155/2013/548085548085Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune ThrombocytopeniaJiaming Li0Zhaoyue Wang1Lan Dai2Lijuan Cao3Jian Su4Mingqing Zhu5Ziqiang Yu6Xia Bai7Changgeng Ruan8Key Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaKey Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaKey Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaKey Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaKey Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaKey Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaKey Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaKey Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaKey Lab of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, ChinaWe conducted this randomized trial to investigate the efficacy and safety of rapamycin treatment in adults with chronic immune thrombocytopenia (ITP). Eighty-eight patients were separated into the control (cyclosporine A plus prednisone) and experimental (rapamycin plus prednisone) groups. The CD4+CD25+CD127low regulatory T (Treg) cells level, Foxp3 mRNA expression, and the relevant cytokines levels were measured before and after treatment. The overall response (OR) was similar in both groups (experimental group versus control group: 58% versus 62%, P=0.70). However, sustained response (SR) was more pronounced in the experimental group than in the control group (68% versus 39%, P<0.05). Both groups showed similar incidence of adverse events (7% versus 11%, P=0.51). As expected, the low pretreatment baseline level of Treg cells was seen in all patients (P<0.001); however, the experimental group experienced a significant rise in Treg cell level, and there was a strong correlation between the levels of Treg cells and TGF-beta after the treatment. In addition, the upregulation maintained a stable level during the follow-up phase. Thus, rapamycin plus low dose prednisone could provide a new promising option for therapy of ITP.http://dx.doi.org/10.1155/2013/548085 |
| spellingShingle | Jiaming Li Zhaoyue Wang Lan Dai Lijuan Cao Jian Su Mingqing Zhu Ziqiang Yu Xia Bai Changgeng Ruan Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune Thrombocytopenia Clinical and Developmental Immunology |
| title | Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune Thrombocytopenia |
| title_full | Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune Thrombocytopenia |
| title_fullStr | Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune Thrombocytopenia |
| title_full_unstemmed | Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune Thrombocytopenia |
| title_short | Effects of Rapamycin Combined with Low Dose Prednisone in Patients with Chronic Immune Thrombocytopenia |
| title_sort | effects of rapamycin combined with low dose prednisone in patients with chronic immune thrombocytopenia |
| url | http://dx.doi.org/10.1155/2013/548085 |
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