The Effect of Antiplatelet Autoantibodies on Megakaryocytopoiesis
- 116 Downloads
Immune thrombocytopenic purpura (ITP) is a disorder manifested by isolated thrombocytopenia. In vivo infusion studies in the 1950s and 1960s provided evidence that the thrombocytopenia was due to autoantibody-induced platelet destruction. However, there is mounting evidence that platelet production in this disorder may also be suppressed by antibodies. Early morphologic studies showed megakaryocytic damage in ITP, and these results have been confirmed by ultrastructural studies. Autologous platelet turnover studies in the 1980s showed that most ITP patients have either normal or reduced platelet turnover rather than increased turnover, as would be expected if platelet destruction were the only pathogenetic mechanism. More recently, in vitro culture studies of both adult and pediatric ITP have shown that some ITP plasmas suppress both megakaryocytopoiesis and thrombopoiesis. In view of these findings, both platelet destruction and suppression of platelet production seem likely to be involved in the pathogenesis of ITP.
Key wordsITP Antiplatelet antibody Immune thrombocytopenia
Unable to display preview. Download preview PDF.
- 1.Frank E. Die essentielle Thrombopenie. (Konstitutionelle Purpura- Pseudohämophilie), I: Klinische Bild. Berl Klin Wochenschr. 1915;52:454–458.Google Scholar
- 2.Kaznelson P. Verschwinden der hämorrhagischen Diathese bei einem Falle von “essentieller Thrombopenie” (Frank) nach Milzexstirpation: Splenogene thrombolytische Purpura. Wien Klin Wochenschr. 1916;29:1451–1454.Google Scholar
- 11.Vainchenker W, Deschamps JF, Bastin JM, et al. Two monoclonal antiplatelet antibodies as markers of human megakaryocyte maturation: immunofluorescent staining and platelet peroxidase detection in megakaryocyte colonies and in in vivo cells from normal and leukemic patients. Blood. 1982;59:514–521.PubMedPubMedCentralGoogle Scholar
- 12.McKenna JL, Pisciotta AV. Fluorescence of megakaryocytes in idiopathic thrombocytopenic purpura (ITP) stained with fluorescent antiglobulin serum. Blood. 1962;19:664–674.Google Scholar
- 15.Dameshek W, Miller EB. The megakaryocytes in idiopathic thrombocytopenic purpura, a form of hypersplenism. Blood. 1946;1:27–52.Google Scholar
- 16.Diggs LW, Hewlett JS. A study of the bone marrow from thirty-six patients with idiopathic hemorrhagic (thrombopenic) purpura. Blood. 1948;3:1090–1104.Google Scholar
- 17.Pisciotta AV, Stefanini M, Dameshek W. Studies on platelets, X: morphologic characteristics of megakaryocytes by phase contrast microscopy in normals and in patients with idiopathic thrombocytopenic purpura. Blood. 1953;8:703–723.Google Scholar
- 18.Stahl CP, Zucker-Franklin D, McDonald TP. Incomplete antigenic cross-reactivity between platelets and megakaryocytes: relevance to ITP. Blood. 1986;67:421–428.Google Scholar
- 22.Heyns AP, Badenhorst PN, Lotter MG, Pieters H, Wessels P, Kotze HF. Platelet turnover and kinetics in immune thrombocytopenic purpura: results with autologous 111In-labeled and homologous 51Cr-labeled platelets differ. Blood. 1986;67:86–92.Google Scholar
- 23.Ballem PJ, Segal GM, Stratton JR, Gernsheimer T, Adamson JW, Slichter S. Mechanisms of thrombocytopenia in chronic autoimmune thrombocytopenic purpura: evidence for both impaired platelet production and increased platelet clearance. J Clin Invest. 1987;80:33–40.CrossRefPubMedPubMedCentralGoogle Scholar
- 32.Nugent DJ, Kunicki TJ. Autoimmune thrombocytopenic purpura. In: Theofilopoulos A, Bona C, eds. The Molecular Pathology of Autoimmune Diseases. New York, NY: Taylor & Francis; 2002:543–566.Google Scholar