Expression and clinical significance of plasma S100A8/A9 and sOX40L levels in children with primary immune thrombocytopenia
Chen Yanyan
Li Yali
Liu Qingqing
Chen Ling
Jin Xin
Abstract：Objective To investigate the expression of plasma S100 calcium-binding protein A8/A9(S100A8/A9)and soluble OX40 ligand(sOX40L)in children with primary immune thrombocytopenia(ITP)and their relationship with bleeding severity and prognosis.Methods A total of 120 children with ITP(ITP group)and 60 healthy children(control group)admitted to Affiliated 3201 Hospital of Xi'an Jiaotong University School of Medicine from October 2021 to February 2024 were prospectively selected.Based on bleeding grade,ITP children were divided into non-bleeding subgroup(19 cases),minor bleeding subgroup(32 cases),mild bleeding subgroup(32 cases),moderate bleeding subgroup(26 cases),and severe bleeding subgroup(11 cases).According to 1-year prognosis,they were categorized into poor prognosis and good prognosis subgroups.Enzyme-linked immunosorbent assay was used to detect plasma S100A8/A9 and sOX40L levels.Multivariate Lo-gistic regression and ROC analysis were employed to analyze the relationship between plasma S100A8/A9 and sOX40L levels and poor prognosis in children with ITP,and to evaluate predictive efficacy.Results Compared with the control group,plas-ma levels of S100A8/A9 and sOX40L in the ITP group were significantly increased(t/P=36.784/＜0.001,32.693/＜0.001).Plasma S100A8/A9 and sOX40L levels progressively increased across the non-bleeding,minor bleeding,mild bleeding,mod-erate bleeding,and severe bleeding subgroups(F/P=265.204/＜0.001,344.140/＜0.001).After 1 year of follow-up,the poor prognosis rate among 120 ITP children was 17.50％(21/120).Compared with the good prognosis subgroup,the poor progno-sis subgroup showed higher bleeding grade,lower platelet count(PLT),lower absolute lymphocyte value,and higher S100A8/A9 and sOX40L levels(t/P=7.226/＜0.001,5.537/＜0.001,3.745/＜0.001,4.951/＜0.001,5.084/＜0.001).Increased bleeding grade,high S100A8/A9,and high sOX40L were independent risk factors for poor prognosis in ITP children,while high plate-let count was an independent protective factor[OR(95％CI)=3.952(1.062-14.703),1.137(1.043-1.241),1.557(1.158-2.093),0.839(0.730-0.965)].The area under the curve(AUC)of plasma S100A8/A9,sOX40L levels,and their combination for predicting poor prognosis in ITP children were 0.798,0.817,and 0.897,respectively.The combined detection was superior to either marker alone(Z/P=2.478/0.013,2.145/0.032).Conclusion Plasma levels of S100A8/A9 and sOX40L are elevated in children with ITP,correlating with increased bleeding severity and poorer prognosis.The combination of plasma S100A8/A9 and sOX40L levels demonstrates high predictive efficacy for prognosis.
Keywords：Primary immune thrombocytopeniaS100 calcium-binding protein A8/A9Soluble Oxford 40 ligandBleeding severityPrognosisChildren
Publication Date：2026-01-18
Online Publishing Date：2026-02-04(First online date of this platform, not the publication date of the document)
Pages：6( 71-76 )