Emerging Concepts in Immune Thrombocytopenia

Frontiers in Immunology
Maurice SwinkelsA J Gerard Jansen

Abstract

Immune thrombocytopenia (ITP) is an autoimmune disease defined by low platelet counts which presents with an increased bleeding risk. Several genetic risk factors (e.g., polymorphisms in immunity-related genes) predispose to ITP. Autoantibodies and cytotoxic CD8+ T cells (Tc) mediate the anti-platelet response leading to thrombocytopenia. Both effector arms enhance platelet clearance through phagocytosis by splenic macrophages or dendritic cells and by induction of apoptosis. Meanwhile, platelet production is inhibited by CD8+ Tc targeting megakaryocytes in the bone marrow. CD4+ T helper cells are important for B cell differentiation into autoantibody secreting plasma cells. Regulatory Tc are essential to secure immune tolerance, and reduced levels have been implicated in the development of ITP. Both Fcγ-receptor-dependent and -independent pathways are involved in the etiology of ITP. In this review, we present a simplified model for the pathogenesis of ITP, in which exposure of platelet surface antigens and a loss of tolerance are required for development of chronic anti-platelet responses. We also suggest that infections may comprise an important trigger for the development of auto-immunity against platelets in ITP. Post-tran...Continue Reading

References

Aug 1, 1992·British Journal of Haematology·L K BoshkovP F Halloran
Sep 1, 1991·The Journal of Clinical Investigation·R KekomakiT J Kunicki
Oct 1, 1988·American Journal of Clinical Pathology·K V VoelkerdingK Raska
Apr 1, 1985·The Journal of Clinical Investigation·D B CinesA D Schreiber
Nov 20, 1993·Lancet·A W HohmannR M Comacchio
Sep 2, 1994·Science·A L GurneyM W Moore
Feb 1, 1996·The Journal of Experimental Medicine·F J de SauvageM W Moore
Jun 1, 1996·British Journal of Haematology·S KosugiY Matsuzawa
Apr 30, 1998·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·V DominguezC Larralde
May 23, 1998·Annual Review of Immunology·I S Grewal, R A Flavell
Apr 25, 2001·Clinical Immunology : the Official Journal of the Clinical Immunology Society·S ShenoyJ H Russell
Jun 19, 2001·British Journal of Haematology·C B FosterUNKNOWN Early Chronic ITP Study Group
Jul 28, 2001·Trends in Immunology·H A Doyle, M J Mamula
Mar 22, 2002·Nature Reviews. Immunology·M J ShlomchikM J Mamula
Mar 22, 2002·The Journal of Immunology : Official Journal of the American Association of Immunologists·Masataka KuwanaYasuo Ikeda
Dec 21, 2002·British Journal of Haematology·Manuel D CarcaoGregory A Denomme
Sep 3, 2003·European Journal of Haematology·Hatsue OgawaraHirokazu Murakami

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Citations

Apr 30, 2019·Journal of Pediatric Hematology/oncology·Husam BeyazitSinan Akbayram
Jun 25, 2019·Journal of Pediatric Hematology/oncology·Seyed Mohammad Sadegh PezeshkiNajmaldin Saki
Apr 28, 2020·Laboratory Medicine·Jeremy JacobsAmy Gabbard
Jun 10, 2020·British Journal of Haematology·George NesrSiamak Arami
Jul 31, 2020·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Alaa Efat HassanMohamed Abdelhafez
May 28, 2020·Journal of Pediatric Hematology/oncology·Priscila E KamiokaJorge D A Carneiro
Sep 2, 2020·Current Opinion in Hematology·John W SempleRick Kapur
Apr 11, 2019·Frontiers in Immunology·Guillaume VialJean-François Viallard
Jul 31, 2020·Advances in Therapy·Alan D KayeElyse M Cornett
Jul 6, 2019·Frontiers in Cardiovascular Medicine·Ibrahim AlmazniNeil V Morgan
Dec 20, 2019·Rinshō shinkeigaku = Clinical neurology·Takeo SatoYasuyuki Iguchi
Aug 28, 2020·Frontiers in Immunology·Conglei LiHeyu Ni
Sep 19, 2020·Annals of Hematology·José Carlos Jaime-PérezDavid Gómez-Almaguer
Jul 22, 2020·Annals of Hematology·Fathima HaseefaMehrnoosh Hashemzadeh
Oct 5, 2018·American Journal of Clinical Pathology·Amy E SchmidtMyra Coppage
Jun 2, 2020·Frontiers in Immunology·Angelina MimounSébastien Lacroix-Desmazes
Nov 4, 2020·Clinical Science·Sarah M HicksElizabeth E Gardiner
Dec 1, 2020·Expert Review of Hematology·Maria L LozanoDavid J Kuter
Dec 22, 2020·British Journal of Haematology·Denis Santana-SantosAndreia Rangel-Santos
Jan 20, 2021·International Reviews of Immunology·Maryam MohtashamiReza Yazdani
Dec 7, 2020·British Journal of Haematology·Beatriz de la Cruz-BenitoNora V Butta
Jan 8, 2021·International Journal of General Medicine·Ying SunWenjun Liu
Dec 31, 2020·International Journal of Molecular Sciences·Alessandra Di PaolaFrancesca Rossi
Nov 14, 2020·International Journal of Molecular Sciences·Young Eun ParkMaggie L Kalev-Zylinska
Mar 28, 2021·Blood Reviews·José Carlos Jaime-PérezDavid Gómez-Almaguer
May 1, 2021·Journal of Clinical Medicine·Andrés Ramírez-LópezNora V Butta
May 6, 2021·Revista Da Sociedade Brasileira De Medicina Tropical·Fatma Yılmaz Aydın, Vehbi Demircan

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Methods Mentioned

BETA
glycosylation

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