Antiplatelet Antibodies Do Not Predict the Response to Intravenous Immunoglobulins during Immune Thrombocytopenia
Immune thrombocytopenia (ITP) is a rare autoimmune disease due to autoantibodies targeting platelet glycoproteins (GP). The mechanism of platelet destruction could differ depending on the specificity of antiplatelet antibodies: anti-GPIIb/IIIa antibodies lead to phagocytosis by splenic macrophages,...
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MDPI AG
2020-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/6/1998 |
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| author | Thomas Rogier Maxime Samson Guillaume Mourey Nicolas Falvo Nadine Magy-Bertrand Sethi Ouandji Jean-Baptiste Picque Hélène Greigert Christelle Mausservey Arthur Imbach Thibault Ghesquière Laurent Voillat Denis Caillot Eric Deconinck Bernard Bonnotte Sylvain Audia |
| author_facet | Thomas Rogier Maxime Samson Guillaume Mourey Nicolas Falvo Nadine Magy-Bertrand Sethi Ouandji Jean-Baptiste Picque Hélène Greigert Christelle Mausservey Arthur Imbach Thibault Ghesquière Laurent Voillat Denis Caillot Eric Deconinck Bernard Bonnotte Sylvain Audia |
| author_sort | Thomas Rogier |
| collection | DOAJ |
| description | Immune thrombocytopenia (ITP) is a rare autoimmune disease due to autoantibodies targeting platelet glycoproteins (GP). The mechanism of platelet destruction could differ depending on the specificity of antiplatelet antibodies: anti-GPIIb/IIIa antibodies lead to phagocytosis by splenic macrophages, in a Fcγ receptor (FcγR)-dependent manner while anti-GPIb/IX antibodies induce platelet desialylation leading to their destruction by hepatocytes after binding to the Ashwell–Morell receptor, in a FcγR-independent manner. Considering the FcγR-dependent mechanism of action of intravenous immunoglobulins (IVIg), we assumed that the response to IVIg could be less efficient in the presence of anti-GPIb/IX antibodies. We conducted a multicentric, retrospective study including all adult ITP patients treated with IVIg who had antiplatelet antibodies detected between January 2013 and October 2017. Among the 609 identified, 69 patients were included: 17 had anti-GPIb/IX antibodies and 33 had anti-GPIIb/IIIa antibodies. The response to IVIg was not different between the patients with or without anti-GPIb/IX (88.2% vs. 73.1%). The response to IVIg was better in the case of newly diagnosed ITP (odds ratio (OR) = 5.4 (1.2–24.7)) and in presence of anti-GPIIb/IIIa (OR = 4.82 (1.08–21.5)), while secondary ITP had a poor response (OR = 0.1 (0.02–0.64)). In clinical practice, the determination of antiplatelet antibodies is therefore of little value to predict the response to IVIg. |
| first_indexed | 2024-03-10T18:53:12Z |
| format | Article |
| id | doaj.art-50c9ea0574ed49f4b15b4a5b43858577 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T18:53:12Z |
| publishDate | 2020-06-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-50c9ea0574ed49f4b15b4a5b438585772023-11-20T04:56:47ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0196199810.3390/jcm9061998Antiplatelet Antibodies Do Not Predict the Response to Intravenous Immunoglobulins during Immune ThrombocytopeniaThomas Rogier0Maxime Samson1Guillaume Mourey2Nicolas Falvo3Nadine Magy-Bertrand4Sethi Ouandji5Jean-Baptiste Picque6Hélène Greigert7Christelle Mausservey8Arthur Imbach9Thibault Ghesquière10Laurent Voillat11Denis Caillot12Eric Deconinck13Bernard Bonnotte14Sylvain Audia15Service de Médecine Interne et Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-immunes de l’adulte, Centre Hospitalo-Universitaire Dijon Bourgogne, Université de Bourgogne Franche Comté, 21000 Dijon, FranceService de Médecine Interne et Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-immunes de l’adulte, Centre Hospitalo-Universitaire Dijon Bourgogne, Université de Bourgogne Franche Comté, 21000 Dijon, FranceLaboratoire d’Hématologie et d’Immunologie Régional, Établissement Français du Sang (EFS) Bourgogne/Franche-Comté, 25000 Besançon, FranceService de Médecine Interne et Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-immunes de l’adulte, Centre Hospitalo-Universitaire Dijon Bourgogne, Université de Bourgogne Franche Comté, 21000 Dijon, FranceService de Médecine Interne, Centre Hospitalo-Universitaire, Université de Bourgogne Franche-Comté, 25000 Besançon, FranceService de Médecine Interne et Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-immunes de l’adulte, Centre Hospitalo-Universitaire Dijon Bourgogne, Université de Bourgogne Franche Comté, 21000 Dijon, FranceService de Médecine Interne, Centre Hospitalier, 89000 Auxerre, FranceService de Médecine Interne et Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-immunes de l’adulte, Centre Hospitalo-Universitaire Dijon Bourgogne, Université de Bourgogne Franche Comté, 21000 Dijon, FranceService de Médecine Interne, Centre Hospitalier William-Morey, 71100 Chalon/Saône, FranceLaboratoire d’Hématologie et d’Immunologie Régional, Établissement Français du Sang (EFS) Bourgogne/Franche-Comté, 25000 Besançon, FranceService de Médecine Interne et Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-immunes de l’adulte, Centre Hospitalo-Universitaire Dijon Bourgogne, Université de Bourgogne Franche Comté, 21000 Dijon, FranceService d’Hématologie et Oncologie, Centre Hospitalier William-Morey, 71100 Chalon/Saône, FranceService d’Hématologie, Centre Hospitalo-Universitaire Dijon Bourgogne, 21000 Dijon, FranceService d’Hématologie, Centre Hospitalo-Universitaire, Université de Bourgogne Franche-Comté, 25000 Besançon, FranceService de Médecine Interne et Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-immunes de l’adulte, Centre Hospitalo-Universitaire Dijon Bourgogne, Université de Bourgogne Franche Comté, 21000 Dijon, FranceService de Médecine Interne et Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-immunes de l’adulte, Centre Hospitalo-Universitaire Dijon Bourgogne, Université de Bourgogne Franche Comté, 21000 Dijon, FranceImmune thrombocytopenia (ITP) is a rare autoimmune disease due to autoantibodies targeting platelet glycoproteins (GP). The mechanism of platelet destruction could differ depending on the specificity of antiplatelet antibodies: anti-GPIIb/IIIa antibodies lead to phagocytosis by splenic macrophages, in a Fcγ receptor (FcγR)-dependent manner while anti-GPIb/IX antibodies induce platelet desialylation leading to their destruction by hepatocytes after binding to the Ashwell–Morell receptor, in a FcγR-independent manner. Considering the FcγR-dependent mechanism of action of intravenous immunoglobulins (IVIg), we assumed that the response to IVIg could be less efficient in the presence of anti-GPIb/IX antibodies. We conducted a multicentric, retrospective study including all adult ITP patients treated with IVIg who had antiplatelet antibodies detected between January 2013 and October 2017. Among the 609 identified, 69 patients were included: 17 had anti-GPIb/IX antibodies and 33 had anti-GPIIb/IIIa antibodies. The response to IVIg was not different between the patients with or without anti-GPIb/IX (88.2% vs. 73.1%). The response to IVIg was better in the case of newly diagnosed ITP (odds ratio (OR) = 5.4 (1.2–24.7)) and in presence of anti-GPIIb/IIIa (OR = 4.82 (1.08–21.5)), while secondary ITP had a poor response (OR = 0.1 (0.02–0.64)). In clinical practice, the determination of antiplatelet antibodies is therefore of little value to predict the response to IVIg.https://www.mdpi.com/2077-0383/9/6/1998immune thrombocytopeniaantiplatelet antibodiesIVIg |
| spellingShingle | Thomas Rogier Maxime Samson Guillaume Mourey Nicolas Falvo Nadine Magy-Bertrand Sethi Ouandji Jean-Baptiste Picque Hélène Greigert Christelle Mausservey Arthur Imbach Thibault Ghesquière Laurent Voillat Denis Caillot Eric Deconinck Bernard Bonnotte Sylvain Audia Antiplatelet Antibodies Do Not Predict the Response to Intravenous Immunoglobulins during Immune Thrombocytopenia Journal of Clinical Medicine immune thrombocytopenia antiplatelet antibodies IVIg |
| title | Antiplatelet Antibodies Do Not Predict the Response to Intravenous Immunoglobulins during Immune Thrombocytopenia |
| title_full | Antiplatelet Antibodies Do Not Predict the Response to Intravenous Immunoglobulins during Immune Thrombocytopenia |
| title_fullStr | Antiplatelet Antibodies Do Not Predict the Response to Intravenous Immunoglobulins during Immune Thrombocytopenia |
| title_full_unstemmed | Antiplatelet Antibodies Do Not Predict the Response to Intravenous Immunoglobulins during Immune Thrombocytopenia |
| title_short | Antiplatelet Antibodies Do Not Predict the Response to Intravenous Immunoglobulins during Immune Thrombocytopenia |
| title_sort | antiplatelet antibodies do not predict the response to intravenous immunoglobulins during immune thrombocytopenia |
| topic | immune thrombocytopenia antiplatelet antibodies IVIg |
| url | https://www.mdpi.com/2077-0383/9/6/1998 |
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