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Recent progress in understanding the pathogenesis of immune thrombocytopenia

Semple, John W LU ; Provan, Drew; Garvey, M Bernadette and Freedman, John (2010) In Current Opinion in Hematology 17(6). p.5-590
Abstract

PURPOSE OF REVIEW: Immune thrombocytopenia (ITP) is a bleeding disorder in which both antibody and cell-mediated autoimmune responses are directed against an individual's own platelets and/or megakaryocytes, leading to either enhanced platelet destruction and/or reduced platelet production, respectively. The cause of this platelet-specific autoimmunity remains unknown, but there has been a constant stream of recent publications that suggest ITP is the result of T-cell dysregulation.

RECENT FINDINGS: In the last 18 months, a rich tapestry of studies has emerged that seems to clarify some immunopathologic issues in ITP while raising new questions related to ITP pathogenesis. The current view on the immunopathogenic mechanisms... (More)

PURPOSE OF REVIEW: Immune thrombocytopenia (ITP) is a bleeding disorder in which both antibody and cell-mediated autoimmune responses are directed against an individual's own platelets and/or megakaryocytes, leading to either enhanced platelet destruction and/or reduced platelet production, respectively. The cause of this platelet-specific autoimmunity remains unknown, but there has been a constant stream of recent publications that suggest ITP is the result of T-cell dysregulation.

RECENT FINDINGS: In the last 18 months, a rich tapestry of studies has emerged that seems to clarify some immunopathologic issues in ITP while raising new questions related to ITP pathogenesis. The current view on the immunopathogenic mechanisms associated with ITP appears to particularly concentrate on how incompetent CD4+ T-regulatory cells (Tregs) allow autoimmune effector mechanisms to proceed and cause thrombocytopenia. There is a parallel body of recent literature focusing on molecular mimicry mechanisms, B-cell abnormalities, abnormal cytokine patterns and genetic studies in ITP. Of interest, one can recognize inter-relationships between these immune dysregulations.

SUMMARY: This article will discuss the literature from the past 18 months pertaining to these observations and will show that whereas many of the T-cell defects have been clarified, new questions have also come to light and more immunopathological research is warranted.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Blood Platelets, Humans, T-Lymphocytes, Thrombocytopenia, Journal Article, Review
in
Current Opinion in Hematology
volume
17
issue
6
pages
6 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • Scopus:78049291385
ISSN
1531-7048
DOI
10.1097/MOH.0b013e32833eaef3
language
English
LU publication?
no
id
fb593864-7a86-4c24-896a-e31cd6a69f9a
date added to LUP
2016-09-23 12:05:30
date last changed
2017-01-01 08:35:03
@article{fb593864-7a86-4c24-896a-e31cd6a69f9a,
  abstract     = {<p>PURPOSE OF REVIEW: Immune thrombocytopenia (ITP) is a bleeding disorder in which both antibody and cell-mediated autoimmune responses are directed against an individual's own platelets and/or megakaryocytes, leading to either enhanced platelet destruction and/or reduced platelet production, respectively. The cause of this platelet-specific autoimmunity remains unknown, but there has been a constant stream of recent publications that suggest ITP is the result of T-cell dysregulation.</p><p>RECENT FINDINGS: In the last 18 months, a rich tapestry of studies has emerged that seems to clarify some immunopathologic issues in ITP while raising new questions related to ITP pathogenesis. The current view on the immunopathogenic mechanisms associated with ITP appears to particularly concentrate on how incompetent CD4+ T-regulatory cells (Tregs) allow autoimmune effector mechanisms to proceed and cause thrombocytopenia. There is a parallel body of recent literature focusing on molecular mimicry mechanisms, B-cell abnormalities, abnormal cytokine patterns and genetic studies in ITP. Of interest, one can recognize inter-relationships between these immune dysregulations.</p><p>SUMMARY: This article will discuss the literature from the past 18 months pertaining to these observations and will show that whereas many of the T-cell defects have been clarified, new questions have also come to light and more immunopathological research is warranted.</p>},
  author       = {Semple, John W and Provan, Drew and Garvey, M Bernadette and Freedman, John},
  issn         = {1531-7048},
  keyword      = {Blood Platelets,Humans,T-Lymphocytes,Thrombocytopenia,Journal Article,Review},
  language     = {eng},
  number       = {6},
  pages        = {5--590},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Current Opinion in Hematology},
  title        = {Recent progress in understanding the pathogenesis of immune thrombocytopenia},
  url          = {http://dx.doi.org/10.1097/MOH.0b013e32833eaef3},
  volume       = {17},
  year         = {2010},
}