Morimoto Norihito, Takeuchi Hiroaki, Takahashi Toru, Ueta Tadashi, Tanizawa Yukio, Kumon Yoshitaka, Kobayashi Michiya, Sugiura Tetsuro
Department of Clinical Laboratory Medicine, Kochi University School of Medicine, Kochi, Japan.
Scand J Infect Dis. 2007;39(5):409-16. doi: 10.1080/00365540601105723.
We examined the association between Helicobacter pylori infection and chronic idiopathic thrombocytopenic purpura (cITP) to clarify the development of H. pylori-associated cITP. cITP patients were classified into 3 different groups: Hp-negative (HP-N); Hp-positive, completely or partially responsive to treatment (CR); and Hp-positive and unresponsive to treatment (NR). Reactivity of antibodies to H. pylori before and after eradication was examined by immunoblotting. We used immunoblotting with immunoprecipitation to establish whether platelets form complexes with H. pylori proteins and if these complexes react with patients' sera. CR group showed large (>50 kDa) and low molecular weight protein bands, especially of 36, 27 and 17-kDa. These low molecular weight bands were detected significantly more in the CR group compared to other groups. When healthy human platelets were incubated with H. pylori lysate, they aggregated with the lysate, indicating that complexes were formed between the platelets and the lysate. The complexes immunoprecipitated with anti-human thrombocyte antibodies, and showed a 17 kDa band in the CR, but not in other groups. At least 3 low molecular weight proteins of H. pylori were involved in H. pylori-associated cITP. Immunocomplexes consisting of platelets, low molecular weight proteins of H. pylori and anti-H. pylori antibodies may represent an extra mechanism in development of H. pylori- associated cITP.
我们研究了幽门螺杆菌感染与慢性特发性血小板减少性紫癜（cITP）之间的关联，以阐明幽门螺杆菌相关cITP的发病机制。cITP患者被分为3个不同组：幽门螺杆菌阴性（HP-N）；幽门螺杆菌阳性，对治疗完全或部分有反应（CR）；以及幽门螺杆菌阳性且对治疗无反应（NR）。通过免疫印迹法检测根除前后抗幽门螺杆菌抗体的反应性。我们使用免疫沉淀免疫印迹法来确定血小板是否与幽门螺杆菌蛋白形成复合物，以及这些复合物是否与患者血清发生反应。CR组显示出大分子量（>50 kDa）和低分子量蛋白条带，尤其是36、27和17 kDa的条带。与其他组相比，CR组中这些低分子量条带的检测显著更多。当健康人血小板与幽门螺杆菌裂解物孵育时，它们与裂解物聚集，表明血小板与裂解物之间形成了复合物。这些复合物用抗人血小板抗体进行免疫沉淀，在CR组中显示出17 kDa条带，而在其他组中未显示。至少3种幽门螺杆菌的低分子量蛋白参与了幽门螺杆菌相关cITP的发病。由血小板、幽门螺杆菌低分子量蛋白和抗幽门螺杆菌抗体组成的免疫复合物可能代表了幽门螺杆菌相关cITP发病的一种额外机制。
