Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP.
Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP.
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DOI：
10.1182/blood.v70.4.1040.bloodjournal7041040
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发表时间：
1987-10
期刊：
影响因子：
20.3
通讯作者：
R. Mcmillan;P. Tani;F. Millard;P. Berchtold;Renshaw Lw;V. Woods
中科院分区：
文献类型：
--
作者：
R. Mcmillan;P. Tani;F. Millard;P. Berchtold;Renshaw Lw;V. Woods
慢性免疫性血小板减少性紫癜（ITP）是由于循环抗血小板抗体破坏血小板所致。尽管已经使用各种方法证明了抗血小板糖蛋白 IIb/IIIa (GPIIb/IIIa) 复合物和 GPIb 的自身抗体，但尚未有用于检测血小板相关或血浆自身抗体的实用测定法。我们研究了 59 名慢性免疫性血小板减少性紫癜患者，使用新开发的免疫珠测定法和之前报道的微孔测定法测量了针对 GPIIb/IIIa 复合物和 GPIb 的血小板相关抗体和血浆自身抗体。使用免疫珠测定法在 28 名患者中的 21 名中检测到血小板相关自身抗体（75.0%；13 名患者具有抗 GPIIb/IIIa，8 名患者具有抗 GPIb）。 59 名患者中有 34 名出现血浆自身抗体（57.6%；21 名患者有抗 GPIIb/IIIa，11 名患者有抗 GPIb，2 名两者都有）。使用免疫珠测定的 59 名患者中有 30 名出现阳性结果，而使用微量滴定孔测定的 59 名患者中只有 14 名出现阳性结果，这表明在添加抗体之前溶解血小板（如微量滴定孔测定中那样）会改变表位稳定性。在所研究的 31 名血小板减少症对照患者中，两种检测结果均呈阴性。我们的结论是，这些临床适用的检测方法可以在大多数慢性 ITP 患者中检测到自身抗体，从而证实自身免疫过程的存在。
Chronic immune thrombocytopenic purpura (ITP) is due to platelet destruction by circulating antiplatelet antibody. Although autoantibodies against the platelet glycoprotein IIb/IIIa (GPIIb/IIIa) complex and GPIb have been demonstrated using various methods, practical assays for detection of platelet-associated or plasma autoantibodies have not been available. We studied 59 patients with chronic immune thrombocytopenic purpura in whom platelet-associated and plasma autoantibodies against the GPIIb/IIIa complex and GPIb were measured using a newly developed immunobead assay and a previously reported microtiter-well assay. Platelet-associated autoantibody was detected using the immunobead assay in 21 of 28 patients (75.0%; 13 with anti-GPIIb/IIIa, 8 with anti-GPIb). Plasma autoantibodies were noted in 34 of 59 patients (57.6%; 21 with anti-GPIIb/IIIa, 11 with anti-GPIb, and 2 with both). Positive results were noted in 30 of 59 patients using the immunobead assay and in only 14 of 59 using the microtiter-well assay, suggesting that solubilization of the platelets prior to antibody addition, as in the microtiter-well assay, alters epitope stability. Of the 31 thrombocytopenic control patients studied, all gave negative results using both assays. We conclude that these clinically adaptable assays allow detection of autoantibodies in most patients with chronic ITP, confirming the presence of an autoimmune process.