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Involvement of Fcγ receptor polymorphism in the therapeutic response of idiopathic thrombocytopenic purpura
Author(s) -
Fujimoto TetsuroTakahiro,
Inoue Maki,
Shimomura Takeshi,
Fujimura Kingo
Publication year - 2001
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2001.03109.x
Subject(s) - medicine , platelet , immunology , thrombocytopenic purpura , genotype , splenectomy , autoantibody , receptor , antibody , chemistry , spleen , gene , biochemistry
Clearance of autoantibody‐sensitized platelets through Fcγ receptors on phagocytic cells is one of the main mechanisms of thrombocytopenia in idiopathic thrombocytopenic purpura (ITP). We examined the FcγRIIA‐131R/H and FcγRIIIA‐158V/F polymorphisms in 104 adult chronic ITP patients, and in 59 healthy control subjects using polymerase chain reaction‐based allele‐specific restriction analysis. The frequency of FcγRIIA genotypes (131H/H, H/R, R/R) was not significantly different between patients and controls, and did not correlate with the responsiveness to treatment. In contrast, among FcγRIIIA genotypes, frequency of 158F/F homotype was smaller in ITP ( P < 0·05). Furthermore, in FcγRIIIA‐158V/V homotype, the complete remission (CR) rate with medication (treatment with corticosteroid or other immunosuppressive agents) was significantly higher (60%) than that in 158V/F (10%) or 158V/F plus 158F/F, ( P < 0·01, P < 0·05). Conversely, the CR rate after splenectomy in 158F/F and 158V/F types (64·3% and 54·6%) was higher than in 158V/V (25%). Our results indicate that the polymorphism of FcγRIIIA, but not FcγRIIA, influences the response to treatment in ITP.