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Recruitment of T cells into bone marrow of ITP patients possibly due to elevated expression of VLA-4 and CX3CR1.

Journal article
Authors Bob Olsson
Börje Ridell
Lena M S Carlsson
Stefan Jacobsson
Hans Wadenvik
Published in Blood
Volume 112
Issue 4
Pages 1078-84
ISSN 1528-0020
Publication year 2008
Published at Institute of Biomedicine, Department of Clinical Chemistry and Transfusion Medicine
Institute of Biomedicine, Department of Pathology
Institute of Medicine, Department of Internal Medicine
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 1078-84
Language en
Keywords Adolescent, Adult, Aged, Bone Marrow, pathology, Cell Movement, Female, Gene Expression Profiling, Humans, Immunity, Integrin alpha4beta1, genetics, Male, Middle Aged, Purpura, Thrombocytopenic, Idiopathic, immunology, Receptors, CXCR4, genetics, Receptors, Chemokine, genetics, T-Lymphocyte Subsets, T-Lymphocytes, physiology, Up-Regulation, genetics
Subject categories Medical and Health Sciences


In idiopathic thrombocytopenic purpura (ITP), platelets are destroyed in the spleen, liver, and bone marrow (BM) by autoantibodies and cytotoxic T cells. In a DNA microarray screen of peripheral blood T cells, we found that VLA-4, CX3CR1, and CXCR4, involved in T-cell homing, had increased expression in ITP patients compared with controls. However, we only found increased protein expression of VLA-4 on T cells from peripheral blood by flow cytometry. To address a possible recruitment of T cells into the organs involved in platelet destruction, we analyzed T cells in BM. In BM, T-cell surface expression of VLA-4 and CX3CR1 was increased in ITP patients compared with controls. Furthermore, the number of CD3(+) T cells in BM, but not in blood, was increased in ITP patients compared with controls. This finding was confirmed by immunohistochemistry of BM biopsies. The number of regulatory T cells (CD4(+)/CD25(bright)) was decreased in the BM of ITP patients, whereas Fas expression was increased. In conclusion, ITP is associated with accumulation and activation of T cells in the BM. Recruitment of T cells into the target organ (eg, BM) is plausible and may be facilitated through increased VLA-4 and CX3CR1 expression. These molecules might serve as new treatment targets in ITP.

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