Davis G L
Michigan State University, East Lansing 48823, USA.
Clin Lab Sci. 1998 Nov-Dec;11(6):356-61.
The ability of platelets to aggregate and to form a platelet plug is central to the maintenance of normal hemostasis. When platelets have normal function, the severity of bleeding is related to the degree of thrombocytopenia. In patients with normal platelet production, the most common cause of thrombocytopenia is due to immune mechanisms that results in platelet injury and removal from the circulation. These mechanisms involve the binding of platelet-associated immunoglobulins and are classified as immune. Immune thrombocytopenias can be caused by autoantibodies (autoimmune thrombocytopenia), alloantibodies (isoimmune thrombocytopenia), or drug-induced immune complexes and conditions secondary to autoimmune disorders such as systemic lupus erythematosus. In this paper the focus is on alloimmune thrombocytopenias resulting from the formation of alloantibodies to platelet specific antigens. The clinical importance of the platelet alloantigens is due to their ability to elicit alloantibody production. Alloantigens, also referred to as isoantigens, are substances that induce the production of alloantibodies when they are infused into individuals of the same species who lack the specific alloantigen.
血小板聚集并形成血小板栓子的能力对于维持正常止血至关重要。当血小板功能正常时,出血的严重程度与血小板减少的程度相关。在血小板生成正常的患者中,血小板减少最常见的原因是免疫机制导致血小板损伤并从循环中清除。这些机制涉及血小板相关免疫球蛋白的结合,被归类为免疫性的。免疫性血小板减少症可由自身抗体(自身免疫性血小板减少症)、同种抗体(同种免疫性血小板减少症)、药物诱导的免疫复合物以及继发于自身免疫性疾病(如系统性红斑狼疮)的情况引起。本文重点关注因针对血小板特异性抗原形成同种抗体而导致的同种免疫性血小板减少症。血小板同种抗原的临床重要性在于它们引发同种抗体产生的能力。同种抗原,也称为同种异体抗原,是当它们被注入缺乏特定同种抗原的同种个体时诱导产生同种抗体的物质。