Prospective screening of 205 patients with ITP, including diagnosis, serological markers, and the relationship between platelet counts, endogenous thrombopoietin, and circulating antithrombopoietin antibodies
Prospective screening of 205 patients with ITP, including diagnosis, serological markers, and the relationship between platelet counts, endogenous thrombopoietin, and circulating antithrombopoietin antibodies
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DOI：
10.1002/ajh.20104
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发表时间：
2004-07-01
影响因子：
12.8
通讯作者：
Bussel, J
中科院分区：
文献类型：
--
作者：
Aledort, LM;Hayward, CPM;Bussel, J
免疫性血小板减少性紫癜（ITP）的特点是循环血小板破坏和抗血小板抗体的存在。目前许多免疫调节疗法通过减少血小板破坏而起作用，通常没有持久的效果。这项前瞻性、探索性研究通过确定ITP患者的人口统计学和合并症临床因素、治疗方法的使用、自身免疫的血清学标记物，以及血小板计数、内源性血小板生成素（eTPO）浓度和循环抗tpo抗体存在之间的可能关系来表征ITP患者。205名患者（19名儿童，186名成人）的病史和实验室评估数据均在单次就诊中收集。报告病史显示血栓/缺血性事件发生率为5%。自身免疫标志物包括直接抗球蛋白试验和抗核抗体的发现频率高于正常人群；未做抗血小板抗体检测。eTPO浓度与健康志愿者的浓度相当。我们的研究证实ITP患者循环eTPO浓度与血小板计数之间没有显著的负相关（Spearman r = -0.15）。205例患者中有2例（1%）在生物检测中具有重组人TPO的中和活性；然而，该活性仅在1例患者中被证实为抗tpo抗体。(C) 2004 Wiley-Liss, Inc。
Immune thrombocytopenia purpura (ITP) is characterized by destruction of circulating platelets and the presence of antiplatelet antibodies. Many of the current immunomodulatory therapies act by reducing platelet destruction and usually do not have a lasting effect. This prospective, exploratory study characterized patients with ITP by identifying their demographic and comorbid clinical factors, use of treatments, serologic markers of autoimmunity, and possible relationships between platelet counts, concentrations of endogenous thrombopoietin (eTPO), and the presence of circulating anti-TPO antibodies. Data including medical history and laboratory evaluations were collected at a single patient visit on 205 patients (19 children, 186 adults). Reported histories revealed a 5% rate of thrombotic/ischemic events. Autoimmune markers including direct antiglobulin test and antinuclear antibodies were found more frequently than in the normal population; antiplatelet antibody testing was not done. eTPO concentrations were comparable to concentrations found in healthy volunteers. Our study confirmed that no significant inverse correlation occurred between circulating concentrations of eTPO and platelet counts in patients with ITP (Spearman r = -0.15). Two of the 205 patients tested (1%) had neutralizing activity of recombinant human TPO in a biological assay; however, this activity was confirmed to be anti-TPO antibody in only 1 patient. (C) 2004 Wiley-Liss, Inc.