interleukin-8 and Purpura--Thrombotic-Thrombocytopenic

Thrombotic microangiopathy (TMA) has attracted attention as a complication of bone marrow transplantation (BMT). The association of Helicobacter pylori (H. pylori) with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (TTP/HUS) after BMT was studied. Among 74 consecutive patients undergoing transplantation, six developed TTP/HUS (the TTP/HUS group) and 68 did not (controls). These six patients were compared with the other 68 patients to investigate differences of the IL-12 and 8 levels, H. pylori and various clinical characteristics. The patients who developed TTP/HUS seemed not apparently different from those who did not in background characteristics, except that they had a significantly higher H. pylori-positive rate (p < 0.05). In the TTP/HUS group, however, the levels of interleukin-12 and interleukin-8 increased significantly during the leukocyte recovery after BMT and at the onset of TTP/HUS, respectively, to 45.8 +/- 57.6 pg/mL and 274.8 +/- 65.9 pg/mL (p < 0.05 for both), when compared with their levels of 5.0 pg/mL in the control group. Thus, H. pylori may play a role in the pathogenesis of TTP/HUS after BMT, with cytokines (interleukin-8 and interleukin-12) also being involved.

Topics: Adolescent; Adult; Bone Marrow Transplantation; Colony Count, Microbial; Female; Helicobacter Infections; Helicobacter pylori; Hemolytic-Uremic Syndrome; Humans; Interleukin-12; Interleukin-8; Leukocytes; Male; Middle Aged; Purpura, Thrombotic Thrombocytopenic; Retrospective Studies; Risk Factors; Transplantation Conditioning

We monitored the levels of various cytokines and chemokines, as well as an adhesion molecule and factors related to vascular endothelial damage, in three patients with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome after bone marrow transplantation. Measurements were done at the onset of this condition and during plasma exchange for treatment. At the onset of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, the levels of interleukin-8, thrombomodulin, and plasminogen activator inhibitor-1 were all markedly increased. A close relationship was observed between improvement in symptoms by plasma exchange and a decrease in interleukin-8 level, suggesting that this chemokine may be related to the development of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome after bone marrow transplantation.

Topics: Adult; Biomarkers; Blood Coagulation Factors; Bone Marrow Transplantation; Cell Adhesion Molecules; Cytokines; Endothelium, Vascular; Female; Hematologic Neoplasms; Hemolytic-Uremic Syndrome; Humans; Interleukin-8; Male; Purpura, Thrombotic Thrombocytopenic; Transplantation, Homologous