蛋白A免疫吸附疗法治疗HIV相关免疫性血小板减少症：初步报告
Protein A immunoadsorption therapy in HIV-related immune thrombocytopenia: a preliminary report.
作者信息
Bertram J H, Snyder H W, Gill P S, Shulman I, Henry D H, Jenkins D, Kiprov D D
机构信息
University of Southern California, Los Angeles.
出版信息
Artif Organs. 1988 Dec;12(6):484-90. doi: 10.1111/j.1525-1594.1988.tb02809.x.
Nine homosexual patients with immune thrombocytopenia were treated with autologous plasma that had been perfused over silica-immobilized Staphylococcus aureus protein A (SpA). Pretreatment platelet counts ranged from 10,000 to 98,000 cells/mm3 (mean: 54,000 cells/mm3). Six patients responded to therapy. Platelets increased by a mean of 95,000 cells/mm3 (p less than 0.007) and reached normal levels (greater than 150,000 cells/mm3) in four patients. Increased platelet counts are presently sustained in these four individuals after 5 months of follow-up. Increases in platelet counts significantly correlated with decreases in platelet-associated IgG (PAIgG), platelet-directed IgG (PDIgG), and immune complexes (CIC). PAIgG and PDIgG declined by a mean of 67% (p less than 0.003) and 58% (p less than 0.007), respectively. CIC decreased by a mean of 37% (p = 0.02). Complement was concomitantly activated in all four examined patients. C3a and C5a increased 23-fold and 2.6-fold, respectively, while total hemolytic complement decreased by 50%. Activated complement components and removal of CIC and IgG thus may contribute to the platelet-enhancing activity of SpA immunoadsorption therapy.
9例免疫性血小板减少症的同性恋患者接受了经硅胶固定的金黄色葡萄球菌蛋白A（SpA）灌注的自体血浆治疗。治疗前血小板计数范围为10,000至98,000个细胞/mm³（平均：54,000个细胞/mm³）。6例患者对治疗有反应。血小板平均增加95,000个细胞/mm³（p<0.007），4例患者血小板计数达到正常水平（大于150,000个细胞/mm³）。在5个月的随访后，这4例患者目前血小板计数持续增加。血小板计数的增加与血小板相关IgG（PAIgG）、血小板靶向IgG（PDIgG）和免疫复合物（CIC）的减少显著相关。PAIgG和PDIgG平均分别下降67%（p<0.003）和58%（p<0.007）。CIC平均下降37%（p = 0.02）。所有4例接受检查的患者补体均同时被激活。C3a和C5a分别增加23倍和2.6倍，而总溶血补体下降50%。因此，激活的补体成分以及CIC和IgG的清除可能有助于SpA免疫吸附疗法的血小板增强活性。
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