title: The clinical significance of circulating B cells secreting anti-glycoprotein IIb/IIIa antibody and platelet glycoprotein IIb/IIIa in patients with primary immune thrombocytopenia.
abstract: OBJECTIVE
  The objective of the study is to evaluate the possible roles of the detection of circulating B cells secreting anti-glycoprotein IIb/IIIa antibody, platelet glycoprotein IIb/IIIa, and anti-glycoprotein IIb/IIIa antibody in the diagnosis of primary immune thrombocytopenia  (ITP) patients.
  
  
  METHODS
  Circulating B cells secreting anti-glycoprotein IIb/IIIa antibody, platelet glycoprotein IIb/IIIa and anti-glycoprotein IIb/IIIa antibody in 64 patients with ITP, 33 non-ITP patients, and 32 controls were measured with enzyme-linked immunospot assay  (ELISPOT), monoclonal antibody immobilization of platelet antigens assay (MAIPA) and flow cytometic analysis (FCM), respectively.
  
  
  RESULTS
  Compared with the controls and non-ITP patients, the frequency of circulating B cells secreting anti-glycoprotein IIb/IIIa antibody  was significantly increased, whereas the positive rate of platelet glycoprotein IIb/IIIa was significantly decreased (P < 0.05) in ITP patients, respectively. The sensitivities for the diagnosis of ITP of ELISPOT and FCM were 68.8% and 57.8%, and the specificities of 90.9%  and 90.9%, respectively. The sensitivities of ELISPOT and FCM were higher than MAIPA's sensitivity (39.1%) (P < 0.05). However, there was no apparent difference of the sensitivities of ELISPOT and FCM and the specificities of those three detections (MAIPA's specificity  was 81.8%) (P > 0.05).
  
  
  CONCLUSIONS
  ELISPOT and FCM for detecting the circulating B cells secreting anti-glycoprotein IIb/IIIa antibody and the platelet glycoprotein IIb/IIIa were as specific as that of MAIPA for assay of anti-glycoprotein IIb/IIIa antibody, but  ELISPOT and FCM had higher sensitivities. So ELISPOT and FCM were sensitive and specific for identifying patients with autoantibody-mediated thrombocytopenia and these should be used as diagnostic tests in clinic.
authors.affiliation: The Second Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
authors.forename: Jian-fang
authors.initials: JF
authors.lastname: Chen
authors.forename: Lin-hua
authors.initials: LH
authors.lastname: Yang
authors.forename: Li-xian
authors.initials: LX
authors.lastname: Chang
authors.forename: Jian-jun
authors.initials: JJ
authors.lastname: Feng
authors.forename: Jun-qing
authors.initials: JQ
authors.lastname: Liu
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D001402:B-Lymphocytes / Q000378:metabolism* / Q000473:pathology; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D018655:Lymphocyte Count / Q000379:methods; D008297:Male; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000276:immunology / Q000473:pathology
chemical_list: D001323:Autoantibodies; D019039:Platelet Glycoprotein GPIIb-IIIa Complex