Work

Platelet count and sleep quality in immune thrombocytopenia: correlation with 5-hydroxytryptamine and therapeutic implications of platelet-5-HT-melatonin axis dysregulation

Year: 2025

Type: article

Abstract: Background: Immune thrombocytopenia (ITP) disrupts platelet homeostasis via autoimmune mechanisms, yet its systemic effects beyond bleeding risk remain poorly characterized. Sleep disturbances are frequently reported in ITP patients, but the relationship between thrombocytopenia, serotonergic signaling, and sleep architecture remains undefined. This study investigates whether platelet dynamics modulate sleep quality through the "platelet-5-HT-melatonin axis" and explores therapeutic implications of this axis in ITP. Methods: /L). Circulating 5-hydroxytryptamine (5-HT) levels were quantified in 42 patients via ELISA. Longitudinal changes in sleep metrics and 5-HT were analyzed using linear mixed-effects models (LMMs), with Cohen's d effect size to assess clinical relevance. Correlations between platelet count, PSQI scores, and inflammatory markers (hs-CRP, IL-6) were explored. Results: < 0.001), alongside reduced fatigue scores. Mechanistically, thrombocytopenia impaired 5-HT uptake and reduced nocturnal melatonin secretion, while elevated hs-CRP and IL-6 indicated inflammation-driven hypothalamic-pituitary-adrenal axis dysregulation. Conclusion: ITP-associated thrombocytopenia disrupts sleep architecture through serotonergic dysregulation and chronic inflammation. Standard glucocorticoid therapy not only restores platelet counts but also ameliorates sleep quality and fatigue, highlighting the therapeutic potential of platelet-targeted interventions for comorbid sleep disorders. These findings advocate for routine sleep assessment in ITP management and integration of 5-HT-modulating strategies into comprehensive care frameworks to address the hematologic-immunologic-sleep axis.

Source: Frontiers in Neurology

DOI: 10.3389/fneur.2025.1645796

Authors: Yingying Jiao, Wenxuan Fan, Yu Wang, Yuehong Qin, Yujiao Zhang, Jieyu Ye

Institutions: Nanfang Hospital, Southern Medical University

Language: English

Topic: Platelet Disorders and Treatments

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801