MicroRNA-cytokine interplay and treg dysregulation in pediatric immune thrombocytopenia: implications for disease chronicity.
6 affiliations
- 1Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
- 2Pediatric department, Faculty of Medicine, Tanta University, Tanta, Egypt. [email protected].
- 3Medical Biochemistry Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
- 4Microbiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
- 5Public Health Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
- 6Pediatric department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Abstract
This study aimed to investigate the immune-epigenetic profile of pediatric immune thrombocytopenic purpura (ITP) and its association with disease chronicity. This case-control study included 93 participants: 33 children with newly diagnosed ITP, 28 with chronic ITP (> 12 months), and 32 age- and sex-matched healthy controls. We assessed platelet count, serum transforming growth factor-β (TGF-β), interleukin-10 (IL-10) levels, circulating CD4⁺CD25⁺FoxP3⁺ Treg frequency, and relative expression of miR-106b-5p and miR-146a-5p. ITP patients demonstrated significantly lower platelet counts, Treg frequency, and TGF-β levels, with elevated IL-10 levels compared to controls. miR-106b-5p expression was significantly upregulated in ITP, particularly in chronic cases, and negatively correlated with platelet count, Treg frequency, and TGF-β. Conversely, miR-146a-5p was significantly downregulated and positively correlated with platelet count and Treg frequency. Chronic ITP exhibited more pronounced miRNA dysregulation and Treg depletion. ROC analysis revealed high diagnostic accuracy of both miRNAs for chronic ITP, with miR-146a-5p demonstrating superior sensitivity.Conclusion
This study highlights the interplay between immune dysregulation and epigenetics in ITP. The opposing roles of miR-106b-5p and miR-146a-5p in Treg function and cytokine homeostasis suggest their potential contribution to disease chronicity and their potential as chronicity biomarkers. These findings provide a foundation for future research aimed at improving ITP patient stratification, identifying therapeutic targets, and advancing precision-based interventions.What is known
• Despite extensive research, the aetiopathogenesis of immune thrombocytopenic purpura (ITP) remains incompletely understood, involving complex interactions between immune dysregulation, cytokine imbalance, and emerging epigenetic factors, such as microRNAs. • This work aimed to investigate the immunological and molecular mechanisms underlying ITP in the pediatric population, focusing on cytokine profiles (TGF-β, IL-10), regulatory T cells (Tregs), and the relative expression of miR-106b-5p and miR-146a-5p, and to assess their value as predictive tools for chronic ITP.What is new
• This study highlights the critical interplay between immune dysregulation and epigenetics in ITP. The opposing roles of miR-106b-5p and miR-146a-5p suggest their involvement in disease chronicity. These miRNAs may serve as non-invasive markers for ITP chronicity and as candidate targets for therapy to restore immune tolerance in ITP. Despite the cross-sectional nature of the current work, it provides a foundation for future research aimed at improving ITP patient stratification, identifying therapeutic targets, and advancing precision-based interventions.
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BibTeX
@article{qassem2026micrornacytokine,
title = {{MicroRNA-cytokine interplay and treg dysregulation in pediatric immune thrombocytopenia: implications for disease chronicity.}},
author = {Shaima S Qassem and Doaa El Amrousy and Asmaa A Ghalwash and Maha El Nady and Reem Awny and Amira Abdel-Kareem and Sarah Samy and Lamia M Morad},
journal = {European journal of pediatrics},
year = {2026},
month = oct,
doi = {10.1007/s00431-026-07449-6},
url = {https://europepmc.org/article/MED/42905215},
note = {CC BY},
}
RIS
TY - JOUR
TI - MicroRNA-cytokine interplay and treg dysregulation in pediatric immune thrombocytopenia: implications for disease chronicity.
AU - Shaima S Qassem
AU - Doaa El Amrousy
AU - Asmaa A Ghalwash
AU - Maha El Nady
AU - Reem Awny
AU - Amira Abdel-Kareem
AU - Sarah Samy
AU - Lamia M Morad
PY - 2026
DA - 2026/10/21
JO - European journal of pediatrics
DO - 10.1007/s00431-026-07449-6
UR - https://europepmc.org/article/MED/42905215
AB - This study aimed to investigate the immune-epigenetic profile of pediatric immune thrombocytopenic purpura (ITP) and its association with disease chronicity. This case-control study included 93 participants: 33 children with newly diagnosed ITP, 28 with chronic ITP (> 12 months), and 32 age- and sex-matched healthy controls. We assessed platelet count, serum transforming growth factor-β (TGF-β), interleukin-10 (IL-10) levels, circulating CD4⁺CD25⁺FoxP3⁺ Treg frequency, and relative expression of miR-106b-5p and miR-146a-5p. ITP patients demonstrated significantly lower platelet counts, Treg frequency, and TGF-β levels, with elevated IL-10 levels compared to controls. miR-106b-5p expression was significantly upregulated in ITP, particularly in chronic cases, and negatively correlated with platelet count, Treg frequency, and TGF-β. Conversely, miR-146a-5p was significantly downregulated and positively correlated with platelet count and Treg frequency. Chronic ITP exhibited more pronounced miRNA dysregulation and Treg depletion. ROC analysis revealed high diagnostic accuracy of both miRNAs for chronic ITP, with miR-146a-5p demonstrating superior sensitivity.Conclusion This study highlights the interplay between immune dysregulation and epigenetics in ITP. The opposing roles of miR-106b-5p and miR-146a-5p in Treg function and cytokine homeostasis suggest their potential contribution to disease chronicity and their potential as chronicity biomarkers. These findings provide a foundation for future research aimed at improving ITP patient stratification, identifying therapeutic targets, and advancing precision-based interventions.What is known • Despite extensive research, the aetiopathogenesis of immune thrombocytopenic purpura (ITP) remains incompletely understood, involving complex interactions between immune dysregulation, cytokine imbalance, and emerging epigenetic factors, such as microRNAs. • This work aimed to investigate the immunological and molecular mechanisms underlying ITP in the pediatric population, focusing on cytokine profiles (TGF-β, IL-10), regulatory T cells (Tregs), and the relative expression of miR-106b-5p and miR-146a-5p, and to assess their value as predictive tools for chronic ITP.What is new • This study highlights the critical interplay between immune dysregulation and epigenetics in ITP. The opposing roles of miR-106b-5p and miR-146a-5p suggest their involvement in disease chronicity. These miRNAs may serve as non-invasive markers for ITP chronicity and as candidate targets for therapy to restore immune tolerance in ITP. Despite the cross-sectional nature of the current work, it provides a foundation for future research aimed at improving ITP patient stratification, identifying therapeutic targets, and advancing precision-based interventions.
SN - 0340-6199
SN - 1432-1076
ER -