title: CD8+ T cells mediate antibody-independent platelet clearance in mice.
abstract: Platelet transfusion provides an important therapeutic intervention in the treatment and prevention of bleeding. However, some patients rapidly clear transfused platelets, preventing the desired therapeutic outcome. Although platelet clearance can occur through a variety of mechanisms, immune-mediated platelet removal often plays a significant role. Numerous studies demonstrate that anti-platelet alloantibodies can induce significant platelet clearance following transfusion. In fact, for nearly 50 years, anti-platelet alloantibodies were considered to be the sole mediator of immune-mediated platelet clearance in platelet-refractory individuals. Although nonimmune mechanisms of platelet clearance can often explain platelet removal in the absence of anti-platelet alloantibodies, many patients experience platelet clearance following transfusion in the absence of a clear mechanism. These results suggest that other processes of antibody-independent platelet clearance may occur. Our studies demonstrate that CD8(+)T cells possess the unique ability to induce platelet clearance in the complete absence of anti-platelet alloantibodies. These results suggest a previously unrecognized form of immune-mediated platelet clearance with significant implications in the appropriate management of platelet-refractory individuals.
authors.affiliation: Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA; and.
authors.forename: Connie M
authors.initials: CM
authors.lastname: Arthur
authors.affiliation: Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA; and.
authors.forename: Seema R
authors.initials: SR
authors.lastname: Patel
authors.affiliation: Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA; and.
authors.forename: H Cliff
authors.initials: HC
authors.lastname: Sullivan
authors.affiliation: Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA; and.
authors.forename: Annie M
authors.initials: AM
authors.lastname: Winkler
authors.affiliation: Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT.
authors.forename: Chris A
authors.initials: CA
authors.lastname: Tormey
authors.affiliation: Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT.
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Hendrickson
authors.affiliation: Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA; and.
authors.forename: Sean R
authors.identifier: http://orcid.org/0000-0002-1130-9551
authors.initials: SR
authors.lastname: Stowell
mesh_terms: D000818:Animals; D001792:Blood Platelets / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007518:Isoantibodies / Q000276:immunology; D051379:Mice; D017713:Platelet Transfusion
chemical_list: D007518:Isoantibodies