The College of Pharmacy discussed the PhD dissertation entitled “Possible Impact of CD40 Gene Polymorphism on Humoral and Cellular Mediated Immune Response to Romiplostim in Patients with Chronic Immune Thrombocytopenic Purpura” by the student Aisha Muthana Abd-Aljabbar and the supervisor, Professor Dr. Samer Emad Mohammed, at the Clinical Pharmacy Department.
The study aimed to evaluate the immune cytokines (IL-10, IL-35, and TGF-β), investigate the relationship between CD40 gene polymorphisms (rs1883832 and rs4810485), response to romiplostim treatment among Iraqi adult patients with chronic immune thrombocytopenic purpura (ITP), as well as assess CD40 gene haplotypes, linkage disequilibrium (LD), their relationship with treatment non-response. The study evaluated patients’ illness perceptions and their association with treatment response.
The study included 78 individuals with chronic idiopathic immune thrombocytopenic purpura, selected according to diagnostic criteria established by Iraqi hematologists. The study was conducted at the Center for Hematology and Bone Marrow Transplantation, Medical City, Baghdad, Iraq, from May 1, 2025, to September 1, 2025. Brief illness-perception questionnaires were administered to 84 patients with ITP to collect relevant data.
The results showed that the effectiveness of romiplostim in treating Iraqi patients. The regulatory T-cell (Treg)-related cytokines IL-10, IL-35, TGF-β may contribute to immune dysregulation in adults with the disease. No statistically significant differences were observed in the frequencies of genotypes for the variants rs4810485, rs1535045, rs997412137, rs774291557 between responders and non-responders to treatment, except for the TC genotype of the rs1883832 variant in the CD40 gene, which was significantly associated with response to romiplostim. CD40 gene haplotypes showed a strong association with treatment response, suggesting a potential role of genetic factors in determining therapeutic response. The study showed that patients perceived the treatment as effective but had a low level of understanding of their disease and treatment, highlighting the need for patient education and medical counseling.
The study recommended conducting future studies that include a healthy control group for comparison, expanding research on CD40 gene polymorphisms, haplotypes , their association with response to romiplostim, conducting studies with larger sample sizes to validate the findings, strengthening patient education ,counseling regarding the nature of the disease and its treatment.
