ORIGINAL RESEARCH article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1645932
Association of TCRαβ + double-negative T cells with the response to glucocorticoids in pediatric patients with immune thrombocytopenia
Provisionally accepted
- Beijing Children's Hospital Capital Medical University, Beijing, China
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Objectives: Pediatric primary immune thrombocytopenia (ITP) is an acquired autoimmune disease that can be partially restored by glucocorticoids.TCRαβ + CD4 -CD8 -double negative T cells (TCRαβ + DNT) has been linked to the pathophysiology of ITP; however, the role of TCRαβ + DNT in response to high-dose dexamethasone (HD-DXM) is unclear. In this study, we aimed to explore the alteration in TCRαβ + DNT in ITP and the effect of HD-DXM on this subset.Materials and Methods: Pediatric patients (aged <18 years) newly diagnosed with ITP were recruited for this retrospective study. Th1, Th17, Treg, and TCRαβ + DNT levels were measured by flow cytometry using specific antibodies. All patients received HD-DXM treatment and underwent periodic outpatient follow-up for 2-6 months. Patients were divided into the overall response (OR) and no response (NR) groups according to their responses to HD-DXM treatment.We enrolled 130 pediatric patients with ITP (OR, 95 cases; NR, 35 cases) and 50 age-and sex-matched healthy controls. Compared with Th17-to Treg, Th17, and Th1, univariate analysis identified that the proportion of TCRαβ + DNT at baseline was more effective in predicting the response to HD-DXM (P<0.05). A significantly increased frequency of TCRαβ + DNT was found in patients with ITP compared to healthy controls (percentage of T cells: 1.31% vs. 1.00%, P<0.0001; percentage of lymphocytes: 0.76% vs. 0.68%, P=0.010). Patients in the NR group had a higher percentage of TCRαβ + DNT than the OR at the initial diagnosis (TCRαβ + DNT/T: 1.52% vs. 1.30%, P<0.01; TCRαβ + DNT/Lym: 0.84% vs. 0.72%, P<0.01). After treatment with HD-DXM, the elevated TCRαβ + DNT was effectively reduced in the OR group, but not in the NR group (TCRαβ + DNT/T: P<0.05; TCRαβ + DNT/Lym: P=0.001; TCRαβ + DNT counts: P<0.01).TCRαβ + DNT appears to play a significant role in the pathogenesis of pediatric ITP and may be involved in the immune response to HD-DXM. The correction of elevated TCRαβ + DNT in patients who respond to HD-DXM may provide a novel insight for immune therapy in pediatric ITP.
Keywords: Double-negative T cell, glucocorticoid, High-dose dexamethasone, immune thrombocytopenia, pediatric
Received: 12 Jun 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Chen, Xie, Jingyao, Fu, WU and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhenping Chen, Beijing Children's Hospital Capital Medical University, Beijing, China
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