Immune thrombocytopenic purpura (ITP) is an idiopathic bleeding disorder. B cell activating factor (BAFF) and ‘A proliferation-inducing ligand’ (APRIL) have regulatory effects on B and T cells and may represent relevant factors in the pathogenesis of ITP. Serum levels and gene expression were investigated in ITP patients. Both BAFF and APRIL serum levels were significantly elevated in active ITP. However, gene expression analysis revealed both factors to have a tendency toward downregulation. Glucocorticoid treatment significantly reduced BAFF but not APRIL serum levels, which may be mediated by differences in transcription factor binding sites. The glucocorticoid receptor binding site is present in the BAFF promotor region, but not in the APRIL promotor region. Prednisolone in combination with vitamin D3 may be effective in reducing APRIL serum levels. In conclusion, glucocorticoid treatment exerts different regulatory effects on both BAFF and APRIL, whereas antioxidant supplementation may also be beneficial in reducing serum levels.

免疫性血小板减少性紫癜（ITP）是一种特发性出血性疾病。B细胞活化因子（BAFF）和“ A诱导增殖配体”（APRIL）对B细胞和T细胞具有调节作用，并且可能代表了ITP发病机理中的相关因素。对ITP患者的血清水平和基因表达进行了研究。活跃ITP的BAFF和APRIL血清水平均显着升高。但是，基因表达分析显示这两个因素都有下调的趋势。糖皮质激素治疗可显着降低BAFF，但不能降低APRIL血清水平，这可能是由于转录因子结合位点的差异所介导的。糖皮质激素受体结合位点存在于BAFF启动子区域，但不存在于APRIL启动子区域。泼尼松龙与维生素D3结合可能有效降低APRIL血清水平。总之，糖皮质激素治疗对BAFF和APRIL都有不同的调节作用，而抗氧化剂的补充也可能有益于降低血清水平。