By : Rania M fawzy¹, Amal S Nasr¹, Noha M. El Husseiny²*, Mona Gamil², Heba H. El Demellawy³, Hend M Hassan¹, Ibrahim A. Ibrahim ²

1 Clinical Pathology Department – Faculty of Medicine-Cairo University- Egypt.

2-Internal medicine Department – Faculty of Medicine- Cairo University^– Egypt.

3  Internal Medicine Department- Faculty of Medicine-Beni-Sweif University- Egypt

*Correspondence: noha_el_husseiny77@yahoo.com

Abstract

Background: Annexin V is a cellular protein used to detect apoptotic cells by its ability to bind to phosphatidylserine, a marker of apoptosis when it is on the outer leaflet of the plasma membrane.CXCR4 is expressed on cells of megakaryocytic series, especially platelets,  and plays an important role in megakaryopoiesis. Both were  used to study pathogenesis  of ITP in children. The aim of this study was to evaluate Annexin V as marker of early apoptosis and the CXCR4 expression as marker of megakaryopoiesis  in adult patients with ITP. Patients and methods: This study was conducted on 60 patients with ITP with a mean age 39.23± 12.49 and 40 healthy subjects with a mean age 36.08± 9.4 as a control group. Using the flow cytometry, we investigated apoptotic markers of platelets annexin V and megakaryopoiesis marker CXCR4  expression. Results: The percentage of the platelet with early apoptosis positive markers (Annexin -D1) were less frequent in the ITP group compared to the control group (p<0.001), the percentage of the platelet with late apoptosis positive markers (Annexin -D2), living platelet (Annexin-D3), necrotic platelet (Annexin-D4) were more frequent in the ITP group compared to the control group (p=0.62, p<0.001, p=0.016) respectively.  The percentage of the platelets with CXCR4 expression was lower in ITP patients compared to the controls (p<0.001). Conclusion: pathogenesis of ITP in adults is complicated. Platelet Annexin V together with CXCR4 expression may detect apoptosis resistance in adult patients with ITP.

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