In vitro TNF blockade enhances ex vivo expansion of regulatory T cells in patients with immune thrombocytopenia Academic Article uri icon


MeSH Major

  • Antibodies
  • Purpura, Thrombocytopenic, Idiopathic
  • T-Lymphocytes, Regulatory
  • Tumor Necrosis Factor-alpha


  • Tumour necrosis factor-α (TNF) is an inflammatory cytokine that is elevated in a number of autoimmune diseases including immune thrombocytopenia (ITP), a bleeding disorder characterized by low platelet counts. In vitro TNF blockade increases expansion of the regulatory T cell (Treg) IKZF2 (also termed Helios) subset in T cell-monocyte cocultures from healthy donors, but its role on proliferative responses of Tregs in ITP patients, who have altered immunoregulatory compartment, remains unclear. TNF in CD4+ T cells from patients with chronic ITP were elevated and negatively correlated with peripheral Treg frequencies, suggesting a possible inhibitory effect of TNF on ITP Tregs. In vitro antibody neutralization with anti-TNF in T cell-monocyte cocultures resulted in a robust expansion of pre-existing ITP Tregs, higher than in healthy controls. Similar to the effects of anti-TNF antibodies, TNF blockade with antibodies against TNFRSF1B (anti-TNFRSF1B, previously termed anti-TNFRII) almost doubled ITP Treg expansion whereas neutralization with anti-TNFRSF1A (anti-TNFRI) antibodies had no effect on proliferative responses of Tregs. In addition, TNFRSF1B levels on ITP Tregs were significantly elevated, which may explain the increased susceptibility of patient Tregs to the actions of TNF blockade. Altogether, these data raise the possibility that TNF blockers, through their ability to increase Treg proliferation, may be efficacious in ITP patients.

publication date

  • January 2015



  • Academic Article



  • eng

PubMed Central ID

  • PMC5358513

Digital Object Identifier (DOI)

  • 10.1111/bjh.13126

PubMed ID

  • 25252160

Additional Document Info

start page

  • 274

end page

  • 83


  • 168


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