Skip to main content

Advertisement

Log in

Future research in ITP: an ICIS consensus

  • Future Research
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

While much has been learned about the basic immunology and clinical characteristics of immune thrombocytopenia, many important questions remain with regard to pathogenesis, disease progression, identification of novel therapeutic targets and approaches, and clinical trials that rationalize and optimize use of existing therapies. The answers to these questions are likely to impact our understanding of the pathogenesis and therapeutic targets of autoimmune disease in general.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Rodeghiero F et al (2009) Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood 113(11):2386–2393

    Article  CAS  PubMed  Google Scholar 

  2. Abrahamson PE et al (2009) The incidence of idiopathic thrombocytopenic purpura among adults: a population-based study and literature review. Eur J Haematol 83(2):83–89

    Article  PubMed  Google Scholar 

  3. Cines DB et al (2009) The ITP syndrome: pathogenic and clinical diversity. Blood 113(26):6511–6521

    Article  CAS  PubMed  Google Scholar 

  4. Sukati H et al (2007) Mapping helper T-cell epitopes on platelet membrane glycoprotein IIIa in chronic autoimmune thrombocytopenic purpura. Blood 109(10):4528–4538

    Article  CAS  PubMed  Google Scholar 

  5. Zhang XL, Peng J, Sun JZ, Liu JJ, Guo CS, Wang ZG, Yu Y, Shi Y, Qin P, Li SG, Zhang LN, Hou M (2009) De novo induction of platelet-specific CD4(+)CD25(+) regulatory T cells from CD4(+)CD25(-) cells in patients with idiopathic thrombocytopenic purpura. Blood 113(11):2568–2577

    Article  CAS  PubMed  Google Scholar 

  6. Guo ZX et al (2009) The role of Th17 cells in adult patients with chronic idiopathic thrombocytopenic purpura. Eur J Haematol 82(6):488–489

    Article  CAS  PubMed  Google Scholar 

  7. Semple JW (2009) Infections, antigen-presenting cells,T cells, and immune tolerance: their role in the pathogenesis of immune thrombocytopenia. Hematol Oncol Clin N Am (in press)

  8. Olsson B et al (2008) Recruitment of T cells into bone marrow of ITP patients possibly due to elevated expression of VLA-4 and CX3CR1. Blood 112(4):1078–1084

    Article  CAS  PubMed  Google Scholar 

  9. Olsson B, Andersson P, Jernås M, Jacobsson S, Carlsson B, Carlsson LM, Wadenvik H (2003) T-cell-mediated cytotoxicity toward platelets in chronic idiopathic thrombocytopenic purpura. Nat Med 9(9):1123–1124

    Article  CAS  PubMed  Google Scholar 

  10. Liebman HA (2008) Immune thrombocytopenia (ITP): an historical perspective. Hematology Am Soc Hematol Educ Program, 205

  11. Zhang W et al (2009) Role of molecular mimicry of hepatitis C virus protein with platelet GPIIIa in hepatitis C-related immunologic thrombocytopenia. Blood 113(17):4086–4093

    Article  CAS  PubMed  Google Scholar 

  12. Ballem PJ et al (1992) Kinetic studies of the mechanism of thrombocytopenia in patients with human immunodeficiency virus infection. N Engl J Med 327(25):1779–1784

    Article  CAS  PubMed  Google Scholar 

  13. Burger T, Schnell J, Schmelczer M (1979) Platelet turnover and megakaryocytopoiesis in ITP. Acta Med Acad Sci Hung 36(1):45–51

    CAS  PubMed  Google Scholar 

  14. McMillan R et al (2004) Suppression of in vitro megakaryocyte production by antiplatelet autoantibodies from adult patients with chronic ITP. Blood 103(4):1364–1369

    Article  CAS  PubMed  Google Scholar 

  15. Bussel JB et al (2009) Safety and efficacy of long-term treatment with romiplostim in thrombocytopenic patients with chronic ITP. Blood 113(10):2161–2171

    Article  CAS  PubMed  Google Scholar 

  16. Bussel JB et al (2009) Effect of eltrombopag on platelet counts and bleeding during treatment of chronic idiopathic thrombocytopenic purpura: a randomised, double-blind, placebo-controlled trial. Lancet 373(9664):641–648

    Article  CAS  PubMed  Google Scholar 

  17. Stasi R, Provan D (2008) Helicobacter pylori and chronic ITP. Hematology Am Soc Hematol Educ Program, 206–211

  18. Arnold DM et al (2009) Platelet count response to H. pylori treatment in patients with immune thrombocytopenic purpura with and without H. pylori infection: a systematic review. Haematologica 94(6):850–856

    Article  PubMed  Google Scholar 

  19. Li Z et al (2005) Role of molecular mimicry to HIV-1 peptides in HIV-1-related immunologic thrombocytopenia. Blood 106(2):572–576

    Article  CAS  PubMed  Google Scholar 

  20. Newman PJ, Aster R, Boylan B (2007) Human platelets circulating in mice: applications for interrogating platelet function and survival, the efficacy of antiplatelet therapeutics, and the molecular basis of platelet immunological disorders. J Thromb Haemost 5(Suppl 1):305–309

    Article  PubMed  Google Scholar 

  21. Sood R, Wong W, Gotlib J, Jeng M, Zehnder JL (2008) Gene expression and pathway analysisof immune thrombocytopenia. Br J Haematol 140(1):99–103

    CAS  PubMed  Google Scholar 

  22. Zhang MB, Sood R, Jones C, Wong W, Jeng M, Zehnder JL (2008) Elevated vanin1 and advillin expression is associated with progression to chronic ITP in children. Blood 112:397a

    Article  CAS  Google Scholar 

  23. Foster CB et al (2001) Polymorphisms in inflammatory cytokines and Fcgamma receptors in childhood chronic immune thrombocytopenic purpura: a pilot study. Br J Haematol 113(3):596–599

    Article  CAS  PubMed  Google Scholar 

  24. Carcao MD et al (2003) Fcgamma receptor IIa and IIIa polymorphisms in childhood immune thrombocytopenic purpura. Br J Haematol 120(1):135–141

    Article  CAS  PubMed  Google Scholar 

  25. Tamminga R et al (2009) Possible lower rate of chronic ITP after IVIG for acute childhood ITP: an analysis from registry I of the Intercontinental Cooperative ITP Study Group (ICIS). Br J Haematol 146(2):180–184

    Article  PubMed  Google Scholar 

  26. Kuhne T et al (2000) Ethnicity and environment may affect the phenotype of immune thrombocytopenic purpura in children. Pediatr Res 48(3):374–379

    Article  CAS  PubMed  Google Scholar 

  27. Neunert CE et al (2009) Relationships among bleeding severity, health-related quality of life, and platelet count in children with immune thrombocytopenic purpura. Pediatr Blood Cancer 53(4):652–654

    Article  PubMed  Google Scholar 

  28. Cheng Y et al (2003) Initial treatment of immune thrombocyopenic purpura with high-dose dexamethasone. N Engl J Med 349:831–836

    Article  CAS  PubMed  Google Scholar 

  29. Mazzucconi MG et al (2007) Therapy with high-dose dexamethasone (HD-DXM) in previously untreated patients affected by idiopathic thrombocytopenic purpura: a GIMEMA experience. Blood 109(4):1401–1407

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank all of the members of the Future Research study group for their contributions to the discussion during the 2009 ICIS meeting in Basel. The group members listed alphabetically with academic affiliation are: Aronis, Sophie: Aghia Sophia Children's Hospital, Athens, Greece; Buchanan, George: University of Texas Southwestern Medical Center, Dallas, USA; Cines, Douglas B.: University of Pennsylvania, Philadelphia, USA; Hainmann, Ina: University Clinic Freiburg, Freiburg, Germany; Holzhauer, Susanne: University Clinic Charité, Berlin, Germany; Huber, Andreas: Kantonspital Aarau, Aarau, Switzerland; Imbach, Paul: University Children’s Hospital Basel, Basel, Switzerland; Kohan, Regina: Hospital General de Agudos ‘Ramos Mejia’, Insituto Municipal de Hematologia, Buenos Aires, Argentina; Lusher, Jeanne M.: Children's Hospital of Michigan, Detroit, USA; Nakadate, Hisaya: Kitasato University Hospital, Tokyo, Japan; Neufeld, Ellis J.: Children's Hospital Boston, Harvard Medical School, Boston, USA; Pshenichnaya, Ksenia: St. Petersburg City Pediatric Diagnostic Centre, St. Petersburg, Russia; Ramenghi, Ugo: University of Torino, Torino, Italy; Richert-Przygonska, Monika, Bydgoszcz, Poland; Semple, John W.: St. Michaels Hospital, University of Toronto, Toronto, Canada; Suvajdzic Vukovic, Nada: Clinical Centre of Serbia, Belgrade, Serbia; Zehnder, James L.: Stanford University Medical Center, Stanford, USA.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to James L. Zehnder.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zehnder, J.L., Semple, J.W., Imbach, P. et al. Future research in ITP: an ICIS consensus. Ann Hematol 89 (Suppl 1), 19–23 (2010). https://doi.org/10.1007/s00277-010-0917-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-010-0917-1

Keywords

Navigation