Effect of the soluble selectin after splenectomy on idiopathic thrombocytopenic purpura

Objective:To investigate the level of the soluble selectin expression in idiopathic thrombocytopenic purpura,and the relationship between the soluble selectin expression and the effect of therapy by splenectomy.Methods:Group A:19 ITP patients who did not respond to primary treatment by corticosteroid. Splenectomy has been performed in all patients under general anesthesia. Group B:15 healthy controls. The level of soluble E selectin,soluble P selectin and soluble L selectin was measured using a sandwich enzymelinked immunosorbent assay(ELISA) before or after operation;at the same time,platelet was counted.Results:①The levels of sE selectin were higher in group A before operation compared to that in group B(58.2 ng/ml vs 28.3 ng/ml,P0.05),but after operation it decreased near to normal levels in one month. The levels of sP selectin/plt in group A was much higher(7.69 vs 0.6 fg/platelet in B group,P0.05) before splenectomy and decreased quickly after splenectomy and reach normal levels in 30 days. The sL selectin levels were not different between two groups before and after operation.②The responses to the splenectomy treatments were classified on the basis of the platelet count as poor(50000 per cubic millimeter),good(50000 to 150000 per cubic millimeter),or excellent(150000 per cubic millimeter). 18 of 19 ITP patients got follow up,17 excellent and 1 good,the mean platelet count was significantly elevated(188.3×10 9/L in 30 days,198.6×10 9/L in 180 days,136.6×10 9/L in 1 year,234.1×10 9/L in 2 year,176.5×10 9/L in 3 year).Conclusion:The selectin may contribute to the destruction of platelets in ITP. The higher levels of sE selectin and sP selectin/plt may decrease quickly after splenectomy.