The cellular immunology associated with autoimmune thrombocytopenic purpura: an update.
Chronic autoimmune thrombocytopenic purpura (AITP) is an organ specific autoimmune bleeding disease in which autoantibodies are directed against the individual's own platelets, resulting in increased Fc-mediated platelet destruction by macrophages in the reticuloendothelial system. Although AITP is primarily mediated by IgG auto-antibodies, their production is regulated by the influence of T lymphocytes and antigen presenting cells (APC). This review argues that enhanced T helper cell/antigen presenting cell interactions in patients with AITP may be responsible for IgG anti-platelet auto-antibody production. Understanding these cellular immune responses in AITP may lead to the development of more immune specific therapies for the management of this disease.
Semple
J W
JW
Division of Haematology, St Michael's Hospital, Ontario, Canada. semple@smh.toronto.on.ca
Lazarus
A H
AH
Freedman
J
J
D000938:Antigen-Presenting Cells / Q000276:immunology*; D016824:Antigens, Human Platelet / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000276:immunology* / Q000473:pathology; D001402:B-Lymphocytes / Q000276:immunology; D001792:Blood Platelets / Q000276:immunology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000502:physiology; D006801:Humans; D007111:Immunity, Cellular; D007074:Immunoglobulin G / Q000276:immunology; D008211:Lymphocyte Cooperation; D016131:Lymphocyte Subsets / Q000276:immunology*; D008262:Macrophage Activation; D016173:Macrophage Colony-Stimulating Factor / Q000502:physiology; D008264:Macrophages / Q000502:physiology; D018448:Models, Immunological; D012157:Mononuclear Phagocyte System / Q000473:pathology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000276:immunology* / Q000473:pathology; D016176:T-Lymphocyte Subsets / Q000276:immunology
D016824:Antigens, Human Platelet; D001323:Autoantibodies; D001324:Autoantigens; D007074:Immunoglobulin G; D016173:Macrophage Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor