Role of interleukin-27 in immune thrombocytopenic purpura and its impact on disease response

Background Aberrant cytokine profiles play important roles in immune thrombocytopenia (ITP) pathogenesis. Interleukin- 27 (IL-27) has pleiotropic immunomodulatory effects. However, the role of IL-27 in ITP and its impact on disease response are still controversial. Patients and methods This study included 60 adult ITP patients [20 de-novo patients (group 1), 20 with complete response (CR) to corticosteroids (group 2), and 20 with refractory ITP (group 3)]. Serum IL-27 level was assessed in all patients using enzyme-linked immunosorbent assay. Results The mean IL-27 for all patients was significantly higher than that for controls (P 0.001). There were significant differences in mean IL-27 levels between group 1 and group 2 (P=0.002) and between group 2 and group 3 (P=0.030). There was a significant negative correlation between IL-27 level in all studied patients and platelet count (P=0.003). A serum level of IL-27 of 32 pg/ml had a sensitivity of 100% and specificity of 90% in differentiating de-novo ITP patients from healthy controls as detected by means of receiver operating characteristic curve. Moreover, a serum level of IL-27 of 72.5 pg/ml had a sensitivity of 65% and specificity of 75% in differentiating refractory patients from those with CR. Conclusion Serum IL-27 is significantly elevated in ITP patients (de novo, in CR, and refractory) and it can be used as a predictor for disease occurrence and to a lower extent for its responsiveness to corticosteroid therapy.