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Minimal evidence of platelet and endothelial cell reactive antibodies in thrombotic thrombocytopenic purpura
Author(s) -
Raife Thomas J.,
Atkinson Bonnie,
Aster Richard H.,
McFarland Janice G.,
Gottschall Jerome L.
Publication year - 1999
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/(sici)1096-8652(199910)62:2<82::aid-ajh3>3.0.co;2-h
Subject(s) - endothelial stem cell , platelet , antibody , immunology , thrombotic thrombocytopenic purpura , autoantibody , medicine , umbilical vein , human umbilical vein endothelial cell , endothelium , antigen , flow cytometry , pathology , biology , biochemistry , in vitro
Thrombotic thrombocytopenic purpura (TTP) is a syndrome characterized by microvascular thrombosis with thrombocytopenia and end‐organ injury. Evidence suggests that platelet or endothelial cell injury may be initial pathological events in TTP. A number of factors in patient plasma, including immunoglobulins, have been proposed to mediate cellular injury in TTP. However, systematic analyses of TTP patient plasma for the presence of platelet or endothelial cell antibodies are lacking. We, therefore, analyzed 48 TTP patient plasma samples for the presence of platelet and endothelial cell antibodies by using enzyme‐linked immunosorbent assay, flow cytometry, and microlymphocytotoxicity. Twelve of 48 TTP patient samples (25%) reacted against purified platelet glycoproteins. Nine (19%) also contained antibodies that bound to allogeneic target platelets in flow‐cytometric assays. Nine of 48 samples (19%) contained antibodies to human umbilical vein endothelial cells in flow‐cytometric assays, and seven of 48 patient samples (15%) bound to human dermal microvascular endothelial cells. Six of 48 (13%) patient plasma samples contained antibodies that bound to human umbilical vein endothelial cells activated with γ‐interferon and tumor necrosis factor‐α. Of twenty samples that were reactive in one or more platelet or endothelial cell assay, eight contained human leukocyte antigen antibodies reactive in microlymphocytotoxicity. These studies demonstrate that antibodies reactive against platelet or endothelial cell antigens are not prevalent in TTP, and that more than a third of antibodies detected are human leukocyte antigen alloantibodies. Our findings suggest that autoantibodies against platelets or endothelial cells are not important in the pathogenesis of this syndrome. Am. J. Hematol. 62:82–87, 1999. © 1999 Wiley‐Liss, Inc.

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