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Increased number of B-cells in the red pulp of the spleen in ITP

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Abstract

Platelets are targeted by autoantibodies and destroyed in the reticuloendothelial system in the spleen, liver and bone marrow in patients with immune thrombocytopenia (ITP). Other mechanisms such as destruction by cytotoxic T-cells and defective production of platelets in the bone marrow also exist. Splenectomy normalizes the platelet count in 70% of ITP patients, however, precious little is known about the spleen in this disease. Our aim was therefore to investigate the splenic morphology and especially the number and localization of splenic leukocytes in patients with ITP and controls and to evaluate factors predicting outcome of splenectomy. Spleen sections from 29 ITP patients and 11 individuals splenectomized due to trauma were analyzed by immunohistochemistry. All except one of the ITP patients had a normalized platelet count 12 months after splenectomy and the platelet count was inversely correlated with age. ITP patients had an increased number of B-cells in the red pulp. The number of white pulp B-cells and number of T-cells in both compartments was unchanged. In conclusion, B-cells are increased in the red pulp of the spleen and together with cytotoxic T-cells, helper T-cells and macrophages line the sinusoids enabling the immunological attack on platelets in ITP.

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Acknowledgements

This work was supported by the Swedish Research Council (K2009-65X-15424-05-3, the Swedish federal government under the LUA/ALF agreement, the Foundations of the National Board of Health and Welfare, Torsten and Ragnar Söderberg Foundation, Clas Groschinsky Foundation, the Arosenius Foundation, Åke Wiberg Foundation, Jeansson Foundation, Tore Nilsson Foundation for Medical Research, Magnus Bergvall Foundation, Wilhelm and Martina Lundgren Science Foundation.

Authorship and disclosures

The authors have no disclosures. Börje Ridell, Bob Olsson, Margareta Jernås and Hans Wadenvik designed the experiments and analyzed the data and wrote and reviewed the paper.

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Authors and Affiliations

  1. Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden

    Bob Olsson

  2. Department of Pathology the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Börje Ridell

  3. Department of Internal Medicine the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Margareta Jernås & Hans Wadenvik

  4. Department of Psychiatry and Neurochemistry, V-house, Sahlgrenska University Hospital/Mölndal, SE-431 80, Mölndal, Sweden

    Bob Olsson

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  1. Bob Olsson
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  2. Börje Ridell
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  4. Hans Wadenvik
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Correspondence to Bob Olsson.

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Olsson, B., Ridell, B., Jernås, M. et al. Increased number of B-cells in the red pulp of the spleen in ITP. Ann Hematol 91, 271–277 (2012). https://doi.org/10.1007/s00277-011-1292-2

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  • DOI: https://doi.org/10.1007/s00277-011-1292-2

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