Vitamin D and cloned-myeloproliferative leukemia virus onkogen place in primary immune thrombocytopenia

Objective:Immune thrombocytopenic purpura (ITP) is an acquired immunity-mediated disease. There is isolated thrombocytopenia and the thrombocyte threshold is 100,000 / microliter. Cloned Myeloid Leukemia Virus (C-MPL) is a member of type 1hematopoietic growth factor receptor family. A number of signaling pathway are activated following the connection of ligand to this receptor which has a significant role in megakaryopoiesis and, megakaryocyte maturation and differentiation are positively affected. Being effective through some inflammatory cells and cytokines; an active form of vitamin D 1,25(OH)2D3 is a potent immune modulator that can be used in many autoimmune disease. By binding to its receptors commonly found in more than 38 tissues, Vitamin D takes its effect through some inflammatory cells and cytokines. It has positive effects on megakaryopoiesis leading to increase in anti-inflammatory cytokines and decrease in proinflammatory cytokines. We aimed to determine whether there is an association between ITP as an autoimmune disease and c-MPL with Vitamin D. Materials and Method: In the study, 95 ITP patients over 18 years old and 35 lymphoma patients over 18 years old without bone marrow involvement as a control group were examined. Biochemical,hematological data, anti-nuclear antibody, anti-mitochondrial antibody, anti-smooth muscle antibody positivity, hepatitis and human immunodeficiency virus positivity, helicobacter pylori antigenic positivity in stool (gaita) during diagnosis and hematological parameters during follow-up were examined.Demographical data of patients and control groups were recorded. Bone marrow biopsy samples of 61 ITP patients and 30 lymphoma patients were stained with H&E and were examined on Olympus BX50 light microscope in terms of c-MPL and Vitamin D. The results were evaluated as negative and positive semi quantitative. Findings: We didn't find a significant increase in c-MPL and Vitamin D positivity in ITP patient group compared to control group. In ITP patients, we found significant c-MPL positivity in bone narrow in splenectomy patients compared with patients without splenectomy. This result may lead to splenectomy in ITP patients. We didn't find a significant increase in Vitamin D staining. Conclusion: We didn't get a significant result with c-MPL and Vitamin D which are known with their positive affects on megakaryopoiesis in our study performed in ITP patients. However, it may make contribution to ITP patophysiology and new treatment seeking in studies to be performed in larger case series. Key words: Immune thrombocytopenic purpura, c-MPL, Vitamin D