Autosensitization and Immune Complexes in Chronic Idiopathic Thrombocytopenic Purpura

Overview

Journal Clin Exp Immunol

Publisher Oxford University Press

Specialty Allergy & Immunology

Date 1980 Jan 1

PMID 6993065

Citations 4

Authors

R Clancy

R Trent

V Danis

R Davidson

Affiliations

Soon will be listed here.

Abstract

Argument exists as to whether platelet damage in chronic idiopathic thrombocytopenic purpura (ITP) is mediated by an autoimmune response to platelet antigen or by immune complexes. We have studied thirty-nine patients with ITP for evidence of (i) sensitization to platelet antigen, using a macrophage migration inhibition factor (MIF) assay, (ii) circulating immune complexes, using a Clq deviation technique, and (iii) serum-induced platelet 'immunoinjury', using a 3H-serotonin release assay. Eighty-one per cent of the patient group had a migration index of less than 0.8 (normal range 0.8-1.3), while 91% of those tested had a serum factor (presumably immune complexes) which bound to labelled Clq. The serotonin release assay was abnormal in 32% of twenty-two patients, and the results of this test bore no clear relationship to either those of the Clq deviation test or the MIF results. We conclude that most patients with ITP are sensitized to platelet-associated antigen, and have circulating immune complexes. The contribution of these factors to platelet destruction and the nature of the antigen in the complexes remain to be demonstrated. The serotonin release assay is less sensitive, non-specific, and has limited value in the diagnosis of ITP.

Citing Articles

Comparative study of IgG binding to megakaryocytes in immune and myelodysplastic thrombocytopenic patients.

Elzaeem D, Sharkawi E, Zaki E, Ghobrial A, El-Fatah A, El-Hamed W Ann Hematol. 2021; 100(7):1701-1709.

PMID: 33982136 DOI: 10.1007/s00277-021-04556-2.

Laboratory investigation of immune thrombocytopenia.

Warner M, Kelton J J Clin Pathol. 1997; 50(1):5-12.

PMID: 9059347 PMC: 499703. DOI: 10.1136/jcp.50.1.5.

Immune complexes in human diseases: a review.

Theofilopoulos A, Dixon F Am J Pathol. 1980; 100(2):529-94.

PMID: 6157327 PMC: 1903541.

Analysis of antigen involved in circulating immune complexes in patients with idiopathic thrombocytopenic purpura.

Kurata Y, Hayashi S, Aochi H, Nagamine K, Oshida M, Mizutani H Clin Exp Immunol. 1987; 67(2):293-9.

PMID: 3608226 PMC: 1542597.

References

Karpatkin S, Siskind G . In vitro detection of platelet antibody in patients with idiopathic thrombocytopenic purpura and systemic lupus erythematosus. Blood. 1969; 33(6):795-812. View

Ardlie N, Packham M, Mustard J . Adenosine diphosphate-induced platelet aggregation in suspensions of washed rabbit platelets. Br J Haematol. 1970; 19(1):7-17. DOI: 10.1111/j.1365-2141.1970.tb01596.x. View

McMillan R, Smith R, Longmire R, Yelenosky R, Reid R, CRADDOCK C . Immunoglobulins associated with human platelets. Blood. 1971; 37(3):316-22. View

Clancy R . Cellular immunity to autologous platelets and serum-blocking factors in idiopathic thrombocytopenic purpura. Lancet. 1972; 1(7740):6-9. DOI: 10.1016/s0140-6736(72)90003-7. View

Mustard J, Perry D, Ardlie N, Packham M . Preparation of suspensions of washed platelets from humans. Br J Haematol. 1972; 22(2):193-204. DOI: 10.1111/j.1365-2141.1972.tb08800.x. View

Karpatkin S, Strick N, Siskind G . Detection of splenic anti-platelet antibody synthesis in idiopathic autoimmune thrombocytopenic purpura (ATP). Br J Haematol. 1972; 23(2):167-76. DOI: 10.1111/j.1365-2141.1972.tb03470.x. View

Wybran J, Fudenberg H . Cellular immunity to platelets in idiopathic thrombocytopenic purpura. Blood. 1972; 40(6):856-61. View

Marsman A, van der Hart M, WALIG C, EIJSVOOGEL V . Migration inhibition experiments with mixtures of human peripheral blood lymphocytes and guinea pig peritoneal exudate cells. Eur J Immunol. 1972; 2(6):546-50. DOI: 10.1002/eji.1830020614. View

HIRSCHMAN R, Shulman N . The use of platelet serotonin release as a sensitive method for detecting anti-platelet antibodies and a plasma anti-platelet factor in patients with idiopathic thrombocytopenic purpura. Br J Haematol. 1973; 24(6):793-802. DOI: 10.1111/j.1365-2141.1973.tb01707.x. View

10.

Handin R, Piessens W, MOLONEY W . Stimulation of nonimmunized lymphocytes by platelet-antibody complexes in idiopathic thrombocytopenic purpura. N Engl J Med. 1973; 289(14):714-8. DOI: 10.1056/NEJM197310042891403. View

11.

McMillan R, Longmire R, Yelenosky R, Donnell R, Armstrong S . Quantitation of platelet-binding IgG produced in vitro by spleens from patients with idiopathic thrombocytopenic purpura. N Engl J Med. 1974; 291(16):812-7. DOI: 10.1056/NEJM197410172911602. View

12.

Dixon R, ROSSE W, Ebbert L . Quantitative determination of antibody in idiopathic thrombocytopenic purpura. Correlation of serum and platelet-bound antibody with clinical response. N Engl J Med. 1975; 292(5):230-6. DOI: 10.1056/NEJM197501302920503. View

13.

Fauci A . Corticosteroids and circulating lymphocytes. Transplant Proc. 1975; 7(1):37-40. View

14.

Tamerius J, Nepom J, Hellstrom I, Hellstrom K . Tumor-associated blocking factors: isolation from sera of tumor-bearing mice. J Immunol. 1976; 116(3):724-30. View

15.

MUELLER-ECKHARDT C, Mayser B, Heinrich D . The problem of platelet autoantibodies. II. The applicability of the 14C-serotonin release test. Vox Sang. 1977; 33(4):234-45. DOI: 10.1111/j.1423-0410.1977.tb04468.x. View

16.

Morimoto C, Abe T, Hara M, Homma M . Cell-mediated immune response in idiopathic thrombocytopenic purpura. In vitro cellular response to autologous and homologous platelet and platelet membrane by macrophage inhibitory test. Clin Immunol Immunopathol. 1977; 8(2):181-9. DOI: 10.1016/0090-1229(77)90108-8. View

17.

Stefanini M, DAMESHEK W, Chatterjea J, ADELSON E, MEDNICOFF I . Studies on platelets. IX. Observations on the properties and mechanism of action of a potent platelet agglutinin detected in the serum of a patient with idiopathic thrombocytopenic purpura, with a note on the pathogenesis of the disease. Blood. 1953; 8(1):26-64. View

18.

JACKLIN H, Furth F, LOZNER E . Studies on the causes of false-positive results in the laboratory detection of platelet agglutinins in thrombocytopenic purpura. Am J Clin Pathol. 1961; 36:95-104. DOI: 10.1093/ajcp/36.2.95. View

19.

va de WIEL W, va de WIEL-DORFMEYER H, van LOGHEM J . Studies on platelet antibodies in man. Vox Sang. 1961; 6:641-68. DOI: 10.1111/j.1423-0410.1961.tb04053.x. View