title: [Recent advances in pathophysiology and treatment of immune thrombocytopenia].
abstract: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia caused by immune-mediated platelet destruction and impairment of platelet production. Recent studies have uncovered details involving the target regions of platelet-associated anti-GPIIb/IIIa antibodies, pathological differences depending on the specificity of target antigens, and cellular abnormalities, especially impairment of regulatory T cells contributing to the pathogenesis of ITP. Treatment of ITP has been changed dramatically by the application of thrombopoietin receptor agonists, TPO-RAs, in patients unresponsive to traditional steroids and splenectomy. Rituximab has also been used in Western countries for ITP patients and its long-term efficacy has become increasingly clear. Clinical problems awaiting solution in ITP management include improving the efficacy of treatments for newly-diagnosed ITP, confirmation of the long-term efficacy and safety of TPO-RAs, and determination of the positioning of rituximab in the treatment sequence of ITP.
authors.affiliation: Department of Hematology and Oncology, Graduate School of Medicine, Osaka University.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kashiwagi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tomiyama
mesh_terms: D000818:Animals; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D001803:Blood Transfusion / Q000379:methods; D006801:Humans; D007167:Immunotherapy; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D000069283:Rituximab; D013601:T-Lymphocytes / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab