Evidence map›Paper›PMID 41237341›Full record

ArticleBlood2026

Integrin αvβ8-mediated TGF-β1 activation regulates the sustained response in immune thrombocytopenia after TPO-RA withdrawal.

Heng Mei, Min Xu, Jinhui Shu, Lu Tang, Qinying Xie, Lili Luo, Qiuzhe Wei, Huiwen Jiang, Zhangyin Ming, Yu Hu

Abstract read
In one paragraph

Article in Blood, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Heng MeiInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.ORCID 0000-0001-7941-2443
Min XuInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Jinhui ShuInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Lu TangInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Qinying XieInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Lili LuoInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Qiuzhe WeiInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Huiwen JiangInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.ORCID 0000-0001-9973-4335
Zhangyin MingDepartment of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Yu HuInstitute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.ORCID 0000-0002-2815-4568

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

abstractOnly 30% to 50% of patients with immune thrombocytopenia (ITP) exhibit a sustained response upon thrombopoietin receptor agonists (TPO-RA) withdrawal, underscoring the necessity for mechanistic elucidation. We enrolled 49 patients treated with TPO-RA for 4 months and performed a follow-up study for 3 months, classifying them into sustained responders (n = 21), and nonsustained responders (n = 28). Compared with total transforming growth factor β1 (TGF-β1) levels, activated TGF-β1 levels (3854 ± 4380 vs 943 ± 1500 pg/mL; P< .001) were significantly elevated in sustained responders, with integrin αvβ8 regulating TGF-β1 activation and restoring immune tolerance. We established a passive ITP model using platelet factor 4-TGF-β1 conditional knockout (CKO) mice, which exhibited a shorter duration of sustained response than wild-type (WT) mice. CKO mice demonstrated a reduced regulatory T-cell (Treg) population, an increased M1-to-M2 macrophage ratio, and more severe megakaryocyte destruction after anti-CD41 injection. Exogenous administration of αvβ8 (250 ng/kg) effectively activated TGF-β1 and prolonged remission after TPO discontinuation in WT mice. Additionally, CD4+ T cells were transfected with lentiviral small interfering RNA or short hairpin RNA to modulate integrin β8 expression and these were injected into severe combined immunodeficiency mice undergoing an active model of ITP. Results showed that β8 overexpression increased Tregs and reduced megakaryocyte damage. Mechanistically, TPO-RA modulated αvβ8-mediated TGF-β1 activation through the activator protein 1family and Smad family member 2 signaling pathways. Furthermore, D-mannose combined with TPO prolonged the response in ITP mice by upregulating αvβ8 and activating TGF-β1. Overall, the integrin αvβ8-mediated activation of TGF-β1 pathway represents a promising therapeutic target for ITP, with substantial potential for clinical application.

Indexed as

IntegrinsPurpura, Thrombocytopenic, IdiopathicReceptors, ThrombopoietinThrombopoietinTransforming Growth Factor beta1AdultAnimalsFemaleHumansMaleMiceMice, Inbred C57BLMice, KnockoutMiddle AgedT-Lymphocytes, Regulatoryintegrin alphavbeta8IntegrinsReceptors, ThrombopoietinTGFB1 protein, humanThrombopoietinTransforming Growth Factor beta1

Identifiers

PMID41237341
PMCPMC12917309

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.