Ghosh Kanjaksha, Kulkarni B, Shetty S, Nair S
Institute of Immunohaematology (ICMR), KEM Hospital, Parel, Mumbai, India.
Indian J Hum Genet. 2009 Jan;15(1):23-7. doi: 10.4103/0971-6866.50866.
Antiplatelet antibodies are known to be present in a wide spectrum of patients, which include chronic Idiopathic Thrombocytopenic Purpura (ITP), infections, etc., including Glanzmann's thrombasthenia (GT) patients who receive multiple platelet transfusions. The presence of natural antibodies to platelet receptors is not studied in cases of GT. We studied the antiplatelet antibodies in 23 patients with GT, 15 of which had received multiple transfusions and eight that had not received transfusions, along with 50 cases of chronic ITP. The prevalence and specificity of platelet-bound antibodies were detected by inhibition assays using O-group platelets on flow cytometry. The mean antiplatelet antibodies in 15 patients of GT who had not received transfusions and eight patients with multiple transfusions was 8427 + 2131.88 and 9038 + 2856 antibodies/platelet, respectively, while in case of the 50 ITP patients studied, it was 22166 + 5616 antibodies/platelet (Normal Range 1500-3200 antibodies/platelet). We conclude that GT patients who have not received transfusions may develop antiplatelet antibodies to the missing/abnormal receptor. Whether this is due to a molecular mimicry or due to some other mechanism needs to be explored.
已知抗血小板抗体存在于广泛的患者群体中，包括慢性特发性血小板减少性紫癜（ITP）、感染等患者，也包括接受多次血小板输注的血小板无力症（GT）患者。在GT病例中，尚未对血小板受体天然抗体的存在情况进行研究。我们研究了23例GT患者的抗血小板抗体，其中15例接受过多次输血，8例未接受过输血，同时研究了50例慢性ITP患者。通过在流式细胞仪上使用O型血小板的抑制试验检测血小板结合抗体的患病率和特异性。15例未接受输血的GT患者和8例接受多次输血的患者的平均抗血小板抗体分别为8427 + 2131.88和9038 + 2856抗体/血小板，而在研究的50例ITP患者中，为22166 + 5616抗体/血小板（正常范围1500 - 3200抗体/血小板）。我们得出结论，未接受输血的GT患者可能会针对缺失/异常受体产生抗血小板抗体。这是由于分子模拟还是其他某种机制导致的，还有待探索。
