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Anti‐D (WinRho SD ™ ) treatment of children with chronic autoimmune thrombocytopenic purpura stimulates transient cytokine/chemokine production
Author(s) -
Semple J.W.,
Allen D.,
Rutherford M.,
Woloski M.,
David M.,
Wakefield C.,
Butchart S.,
Freedman J.,
Blanchette V.
Publication year - 2002
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/ajh.10065
Subject(s) - cytokine , medicine , chemokine , immunology , platelet , thrombocytopenic purpura , inflammation
Intravenous anti‐D is often used in the treatment of autoimmune thrombocytopenic purpura (AITP), but little is known about its mechanisms of action. To investigate anti‐D's potential in vivo mechanism(s) of action, a small group ( N = 7) of children with chronic AITP was studied. The children initially received either 25 or 50 μg/kg of WinRho‐SD in a four‐cycle cross‐over trial, and peripheral blood samples from the first and third cycles were assessed for cytokine levels at pre‐treatment, 3 hr, 1 day, and 8 days post‐treatment. Results showed that platelet counts significantly increased in all the children by day 8 post‐treatment. Analysis of serum by ELISA showed that there was a significant but transient rise in both pro‐ and anti‐inflammatory cytokine/chemokine levels (e.g., IL1RA, IL6, GM‐CSF, MCP‐1α, TNF‐α and MCP‐1) by 3 hr post‐treatment in both cycles which returned to baseline levels by 8 days post‐treatment. These results suggest that anti‐D administration may initially activate the RES in the form of cytokine/chemokine secretion, which is subsequently followed by an increase in platelet counts. It is possible that the induced cytokine/chemokine storm may have an effect on several physiological processes such as those mediating either adverse effects or potentially RES phagocytic activity. Am. J. Hematol. 69:225‐227, 2002. © 2002 Wiley‐Liss, Inc.