Vaccine-induced immune thrombotic thrombocytopenia.
Vaccine-induced immune thrombotic thrombocytopenia.
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DOI：
10.1182/blood.2022017696
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发表时间：
2023-04-06
期刊：
影响因子：
20.3
通讯作者：
Greinacher, Andreas
中科院分区：
文献类型：
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作者：
Cines, Douglas B.;Greinacher, Andreas
在COVID-19疫苗接种活动的头几个月内，发现了以前健康的接种者，他们通常在基于腺病毒载体的疫苗接种后发生严重血栓形成（通常是脑和/或内脏血管）和血小板减少症。这种综合征、疫苗诱导的免疫性血栓性血小板减少症（VITT）和肝素诱导的血小板减少症之间的相似性促使人们认识到抗血小板因子4（PF 4）抗体的作用，并基于IV免疫球蛋白和非肝素抗凝剂的管理策略，这改善了结局。我们更新了目前对VITT的理解，以及抗PF 4抗体在血栓性疾病中的潜在参与。Cines和Greinacher提供了一个关于COVID-19和疫苗诱导的免疫血栓性血小板减少症的当前知识的简洁血液聚光灯审查。这个问题在低收入和中等收入国家仍然高度相关，这些国家只能负担得起正在进行的疫苗接种活动的腺病毒载体疫苗。同样重要的是要了解哪种疫苗成分触发了对所涉及的血小板抗原（血小板因子4）的免疫应答，以设计更安全的接种系统来预防这种和未来的突发传染病。
Within the first months of the COVID-19 vaccination campaign, previously healthy recipients who developed severe thrombosis (often cerebral and/or splanchnic vasculature) and thrombocytopenia typically after adenoviral vector-based vaccination were identified. Similarities between this syndrome, vaccine-induced immune thrombotic thrombocytopenia (VITT), and heparin-induced thrombocytopenia prompted recognition of the role of antiplatelet factor 4 (PF4) antibodies and management strategies based on IV immunoglobulin and nonheparin anticoagulants, which improved outcome. We update current understanding of VITT and potential involvement of anti-PF4 antibodies in thrombotic disorders. Cines and Greinacher provide a succinct Blood Spotlight review of current knowledge about COVID-19 and vaccine-induced immune thrombotic thrombocytopenia. This problem remains highly relevant in low- and middle-income countries that can only afford adenoviral vector-based vaccines for ongoing vaccination campaigns. It is also important to understand which vaccine constituent(s) triggers the immune response to the implicated platelet antigen, platelet factor 4, to design safer delivery systems for vaccinations against this and future emergent infectious diseases.
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DOI：
10.1056/nejmoa2104840
发表时间：
2021-06-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Greinacher A;Thiele T;Warkentin TE;Weisser K;Kyrle PA;Eichinger S
通讯作者：
Eichinger S
影响因子：
6.7
作者：
Brandt, Sven;Krauel, Krystin;Greinacher, Andreas
通讯作者：
Greinacher, Andreas
影响因子：
20.3
作者：
Arepally GM;Ortel TL
通讯作者：
Ortel TL
影响因子：
39.3
作者：
Holm S;Kared H;Michelsen AE;Kong XY;Dahl TB;Schultz NH;Nyman TA;Fladeby C;Seljeflot I;Ueland T;Stensland M;Mjaaland S;Goll GL;Nissen-Meyer LS;Aukrust P;Skagen K;Gregersen I;Skjelland M;Holme PA;Munthe LA;Halvorsen B
通讯作者：
Halvorsen B
影响因子：
7.5
作者：
Bissola, Anna-Lise;Daka, Mercy;Arnold, Donald M.;Smith, James W.;Moore, Jane C.;Clare, Rumi;Ivetic, Nikola;Kelton, John G.;Nazy, Ishac
通讯作者：
Nazy, Ishac