<i>Helicobacter pylori</i> induced Immune Thrombocytopenic Purpura and perspective role of <i>Helicobacter pylori</i> eradication therapy for treating Immune Thrombocytopenic Purpura
Arham Ihtesham, Shahzaib Maqbool, Muhammad Shahid Nadeem, Muhammad Bilawal Abbas Janjua, Omaima Sundus, Ali Bakht Naqqash, Waleed Inayat Mohamed, Syed Turab Haider, Muhmmad Ahmad, Mir Ahmad Talha Mustafa, Hafiz Osama Mehboob, Consultant Pediatrician, THQ Kabirwala, Pakistan
Abstract
<abstract> <p>Immune thrombocytopenic purpura (ITP) is an autoimmune disease characterised by production of autoantibodies against platelet surface antigens. Recent studies have demonstrated a paramount association of ITP and <italic>Helicobacter pylori (H-pylori)</italic> infection with significant rise in platelet count following <italic>H-pylori</italic> eradication therapy. The <italic>H-pylori</italic> infection induced ITP is validated by many proposed mechanisms such as molecular mimicry due to production of autoantibodies against <italic>H-pylori</italic> surface virulent factors (CagA) and cross reactivity of these antibodies with platelet surface antigens (GP IIb/IIIa, GP Ib/IX, and GP Ia/IIa), phagocytic perturbation due to enhanced phagocytic activity of monocytes, enhanced dendritic cell numbers and response, platelets aggregation due to presence of anti- <italic>H-pylori</italic> IgG and von Willebrand factor (vWf) and finally host immune response against <italic>H-pylori</italic> virulent factors CagA and VacA leading to ITP. The effectiveness of <italic>H-pylori</italic> eradication therapy has also been demonstrated with platelet count being used as a predictive factor for assessment of treatment efficacy. Out of 201 patients 118 were responding to the triple therapy and remaining 83 patients were non-responders, showing the response rate of 58.7%. Out of 118 responders 69 patients were showing complete response (CR) and 49 were showing partial response (PR) to the <italic>H-pylori</italic> eradication therapy. However, more studies are required to elucidate this association and treatment efficacy.</p> </abstract>