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Anti-Endothelial Cell Antibodies in Thrombotic Thrombocytopenic Purpura and Haemolytic Uraemic Syndrome

  • N. W. R. Wickham
  • S. J. Crisp
  • M. L. Rose
  • M. J. Dunn
  • M. Rowley
  • D. H. Bevan
Part of the NATO ASI Series book series (NSSA, volume 281)

Abstract

Thrombotic thrombocytopenic purpura (TTP) and haemolytic-uraemic syndrome (HUS), are rare and poorly understood disorders involving multiorgan microvascular platelet thrombus formation and microangiopathic haemolytic anaemic (Kaplan et al, 1992; Kaplan 1992; White et al, 1988). Only in HUS has an initiating pathologic stimulus been identified in the form of toxins associated with specific enteric infections (i.e., E Coli, Shigella)(Karmali et al., 1983; Karmali, 1989; Kavi and Wise, 1989). Because of the effectiveness of plasma exchange therapy (Moake, 1991; Rocketal, 1992; Bell et al, 1991) workers have looked for circulating factors that might explain the therapeutic response. Several have been detected, most notably, abnormally large high molecular weight von Willebrand multimers (Rose et al., 1984) a calcium-dependent cysteine protease (Murphy et al, 1987) and a platelet aggregating protein (p37) (Siddiqui et al, 1985). All these factors reflect responses to a damaging stimulus and are implicated in platelet activation, aggregation and deposition (Moake and McPherson, 1989; Moore et al, 1990; Lian et al, 1991).

Keywords

Hemolytic Uremic Syndrome Thrombotic Thrombocytopenic Purpura Haemolytic Uraemic Syndrome Haemolytic Uremic Syndrome Plasma Exchange Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Burns, E.R. and Zucker-Franklin, D., 1982, Pathologic effects of plasma from patients with thrombotic hrombocytopenic purpura on platelets and cultured vascular endothelial cells. Blood 60: 1030.PubMedGoogle Scholar
  2. Bell, W.R., Braine, H.G., Ness, P.M. and Kickler, T.S., 1991, Improved survival in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. N. Engl. J. Med. 325: 398.PubMedCrossRefGoogle Scholar
  3. Crisp, S.J., Dunn, M.J., Rose, M.L., Barbir, M., and Yacoub, M.H., 1994, Antiendothelial antibodies after heart transplantation: the accelerating factor in transplant-associated coronary artery disease? J. Heart Lung Transplant 13: 81.PubMedGoogle Scholar
  4. Dunn, M.J., Crisp, S.J., Rose, M.L., Taylor, P.M. and Yacoub M.H., 1992, Anti-endothelial antibodies and coronary artery disease after cardiac transplantation. Lancet 339 (8809): 1566.PubMedCrossRefGoogle Scholar
  5. Edgell, C.J.S, McDonald, C.C. and Graham, J.B., 1983, Permanent cell line expressing human factor VIII-related antigen established by hybridization. Proc. Nat. Acad. Sci. USA 80: 3734.PubMedCrossRefGoogle Scholar
  6. Editorial., 1991, Antibodies to endothelial cells. Lancet 337 (March 16): 649.Google Scholar
  7. Foster, P. A. and Anderson, J.C., 1979, Effects of plasma from patients with thrombotic thrombocytopenic purpura on cultured endothelial cells. Blood 54: 240.Google Scholar
  8. Kaplan, B.S., Trompeter, RS. and Moake, J.L., 1992, Haemolytic Uremic Syndrome and Thrombotic Thrombocytopenic Purpura, 558, New York: Marcel Dekker.Google Scholar
  9. Kaplan, B.S., 1992, Commentary on the relationship between hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, in Hemolytic Uremic Syndrome and Thrombotic Thrombocytopenic Purpura, Dekker. Kaplan, Trompeter, Moake (eds). 29–39, New York.Google Scholar
  10. Karmali, M.A., Steele, B.T., Petric, M. and Lim, C.,1983, Sporadic cases of haemolytic-uraemic syndrome associated with faecal cytotoxic and cytotoxin-producing Eschericia Coli in stools: Lancet (i): 619.Google Scholar
  11. Karmali, M.A., 1989, Infection by Verocytotoxin-producing Eschericia coli. Clin Microbiol Revs 2: 15.Google Scholar
  12. Kavi, J. and Wise, R, 1989, Causes of the haemolytic uraemic syndrome. Br Med J. 298: 65.CrossRefGoogle Scholar
  13. Kavi, J., Chant, I., Maris, M. and Rose, P., 1987, Cytopathic effect of verotoxin on endothelial cells: Lancet (ii):1035.Google Scholar
  14. Leung, D.Y.M., Moake, J.L., Havens, P.L., Kim, M. and Pober, J.S., 1988, Lytic anti-endothelial cell antibodies in haemolytic-uraemic syndrome: Lancet (July 23 ): 183.Google Scholar
  15. Lian, E.C., Siddiqui, F.A., Jamieson, G.A. and Tandon, N.N., 1991, Platelet agglutinating protein p37 causes platelet agglutination through its binding to membrane glycoprotein IV. Thromb Haemost 65 (1): 102.PubMedGoogle Scholar
  16. Martin, S., Benchley, P.E., Postlethwaite, R.J., Johnson, R.W.G. and Dyer, P.A., 1991, Detection of anti-epithelial antibodies in association with pediatric renal transplant failure using a novel microcytotoxicity assay. Tissue Antigens 37: 152.PubMedCrossRefGoogle Scholar
  17. Moake, J.L., 1991, TTO — desperation, empiricism, progress. N. Engl. J. Med. 325 (6): 426.PubMedCrossRefGoogle Scholar
  18. Moake, J.L. and McPherson, P.D., 1989, Abnormalities of von Willebrand factor multimers in thrombotic thrombocytopenic purpura and the hemolytic-uremic syndrome. Am. J. Med. 87: 9.CrossRefGoogle Scholar
  19. Moore, J.C., Murphy, W.G. and Kelton, J.G., 1990, Calpain proteolysis of von Willebrand factor enhances its binding to platelet membrane glycoprotein Ilb/HIa: an explanation for platelet aggregation in thrombotic thrombocytopenic purpura. Br. J. Haematol. 74 (4): 457.PubMedCrossRefGoogle Scholar
  20. Murphy, W.G., Moore, J.C. and Kelton, J.G., 1987, Calcium-dependent cysteine protease activity in the sera of patients with thrombotic thrombocytopenic purpura. Blood 70 (5): 1683.PubMedGoogle Scholar
  21. Pearson, J.D., 1991, Autoantibodies to endothelial cells, in Vascular Endothelium. Catravas, Callow, Gillis, Ryan (eds), 1991, 117, Plenum Press, New York.CrossRefGoogle Scholar
  22. Rock, G., Shumak, K., Kelton, J., Blanchette, V.S., Buskard, N., Nair, R. and Spasofif, R., 1992, Thrombotic thrombocytopenic purpura: outcome in 24 patients with renal impairment treated with plasma exchange. Canadian Apheresis Study Group: Transfusion 32 (8): 710.PubMedCrossRefGoogle Scholar
  23. Rose, P.E., Enayat, S.M., Sunderland, R., Short, P.E., Williams, C.E. and Hill, F.G.H., 1984, Abnormalities of factor VIII related protein multimers in the haemolytic uraemic syndrome. Arch Dis Child 59: 1135.PubMedCrossRefGoogle Scholar
  24. Siddiqui, F.A., and Lian, E.C., 1985, Novel platelet agglutinating protein from a thrombotic thrombocytopenic purpura plasma. J Clin Invest 76: 1330.PubMedCrossRefGoogle Scholar
  25. White, D.J., Yong, F. and McKendrick, M.W., 1988, Haemolytic syndrome in adults. Br Med J 296: 899.CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1996

Authors and Affiliations

  • N. W. R. Wickham
    • 2
  • S. J. Crisp
    • 1
  • M. L. Rose
    • 1
  • M. J. Dunn
    • 1
  • M. Rowley
    • 2
  • D. H. Bevan
    • 2
  1. 1.Department of Transplant Immunology Heart Science CentreHarefield HospitalMiddlesexUK
  2. 2.Department of HaematologySt George’s HospitalLondonUK

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