Specificities of platelet autoantibodies in patients with lupus anticoagulants in primary antiphospholipid syndrome

Panzer, Simon; Gschwandtner, Michael E.; Hütter, D.; Spitzauer, Susanne; Pabinger, Ingrid

doi:10.1007/s002770050291

Cited by 35 publications

(21 citation statements)

References 26 publications

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“…Based on monoclonal antibody immobilization of platelet antigens (MAIPA) assays [35][36][37][38][39], antibodies directed against GP on the cell wall of platelets (GPIIb/IIIa, GPIb/IX, GPIa/IIa, and GPIV) have been identified in 40-70 % of thrombocytopenic patients with APS. Severe thrombocytopenia in APS correlates more closely with antiplatelet-GP antibodies than aPL [35,36,39].…”

Section: Increased Platelet Activation and Destructionmentioning

confidence: 99%

“…The prevalence of these antibodies in APS patients with no thrombocytopenia, however, is approximately 10 % [36,37]. Although some investigators suggested a link between thrombocytopenia and presence of these antibodies in patients with APS [35][36][37], some studies did not support these findings [38]. Interestingly, immunosuppressive therapies may decrease the titers of anti-platelet antibodies and increase the platelet count in APS with thrombocytopenia but do not reduce the titers of aPL [40].…”

Section: Increased Platelet Activation and Destructionmentioning

confidence: 99%

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The Significance and Management of Thrombocytopenia in Antiphospholipid Syndrome

2015

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The association between antiphospholipid antibodies (aPL) and clinical problems goes beyond what is stated in the antiphospholipid syndrome (APS) classification criteria, namely thrombosis and pregnancy morbidity, and thrombocytopenia is the most common non-criteria hematologic manifestation of aPL with a frequency ranging from 20 to 50 %. Thrombocytopenia is rarely severe, and hemorrhage is far less common than thrombosis. However, when anticoagulation is considered, it may constitute a clinical problem with increased bleeding risk. Furthermore, thrombocytopenia represents a risk factor for thrombosis in aPL-positive patients. Therefore, it is important to understand the pathogenesis and the clinical associations of thrombocytopenia to build the right medical approach in aPL-positive patients. In this paper, we review the literature on aPL/APS-associated thrombocytopenia and briefly discuss the other conditions that can result in thrombocytopenia as they have commonalities with APS and their recognition is important to establish the most appropriate treatment strategy.

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Section: Increased Platelet Activation and Destructionmentioning

confidence: 99%

Section: Increased Platelet Activation and Destructionmentioning

confidence: 99%

The Significance and Management of Thrombocytopenia in Antiphospholipid Syndrome

2015

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“…In one study, 27 of 68 sera with aPL antibodies were found to react to the same glycoproteins [28]. In a different report, antiplatelet glycoprotein antibodies were detected in 15 of 22 plasmas containing LA activity [29]. Antibodies to platelet glycoproteins do not appear to select patients with a history of thrombosis, although there seems to be a significant correlation with thrombocytopenia [28,29].…”

Section: Platelets As Phospholipid Templates and Regulators Of Hemostmentioning

confidence: 94%

“…Antiphospholipid antibodies are known to bind to platelet membrane structures [14,[28][29][30][31][32], which may result in thrombocytopenia or hemostatic activation [14]. In addition, an association between aPL antibodies and immunemediated thrombocytopenia (ITP) has been established [28].…”

Section: Platelets As Phospholipid Templates and Regulators Of Hemostmentioning

confidence: 99%

What causes the antiphospholipid syndrome?

Merrill

2001

Curr Rheumatol Rep

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The antiphospholipid syndrome (APS) is characterized by unpredictable, sporadic, thrombotic events. The cause of the thrombosis is probably multifactorial and may involve disparate effects of the autoantibodies associated with the syndrome, which are known to interfere with various protein regulators of hemostasis. An integrated theory of pathogenesis that accounts for the diversity of autoantibodies and their effects suggests that cellular inflammation or apoptosis within the vasculature may lead to oxidation or turnover in phospholipid membranes. Thus, normally cryptic, functionally important epitopes of phospholipid-binding proteins are subjected to increased exposure to immune surveillance.

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“…These antibodies can target specific platelet glycoproteins (GP), human leucocyte antigen (HLA) class I antigens or phospholipids (Kurata et al, 1993;Alcorta et al, 1996;Macchi et al, 1996Macchi et al, , 1997Cuadrado et al, 1997;Panzer et al, 1997;Kiefel et al, 2001;Ranasinghe et al, 2001;Cines & Blanchette, 2002). The detection of these antibodies with high sensitivity and characterization of their specificity is important for diagnosis and specific therapy.…”

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confidence: 99%

A novel method for simultaneous analysis of specific platelet antibodies: SASPA

et al. 2004

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Anti-platelet antibodies cause several thrombocytopenic disorders such as autoimmune or alloimmune thrombocytopenia, post-transfusion purpura, drug-induced thrombocytopenia and refractoriness to platelet transfusion by eliminating platelets from the circulation. These antibodies can target specific platelet glycoproteins (GP), human leucocyte antigen (HLA) class I antigens or phospholipids (Kurata et al, 1993;Alcorta et al, 1996;Macchi et al, 1996Macchi et al, , 1997Cuadrado et al, 1997;Panzer et al, 1997;Kiefel et al, 2001;Ranasinghe et al, 2001;Cines & Blanchette, 2002). The detection of these antibodies with high sensitivity and characterization of their specificity is important for diagnosis and specific therapy.The platelet immunofluorescence test (PIFT) has been widely used as a screening method for the detection of platelet antibodies (von dem Borne et al, 1978;Christopoulos et al, 1993;Porcelijn and von dem Borne, 1998;Hagenström et al, 2000). In order to differentiate the detected antibodies, the monoclonal antibody-specific immobilization of platelet antigen (MAIPA) assay has been mostly used as the reference assay (Kiefel et al, 1987). Several other antibody-detection systems, such as immunoblotting, solid-phase radioimmunoassay and modified antigen-capture enzyme-linked immunosorbent assay (MACE), have been reported (Tijhuis et al, 1991;Hou et al, 1995). However, the drawbacks of these tests SummaryGlycoprotein (GP)-specific platelet antibodies can cause allo-immune and auto-immune thrombocytopenia. The specific detection of relevant antibodies is a prerequisite for diagnosis and treatment. Here, we describe an improved method based on simultaneous detection of various plateletspecific immunoglobulin G (IgG) and IgM antibodies. Bead populations with distinct fluorescence intensities, coated with monoclonal antibodies specific for mouse heavy chain isotypes, were used for the simultaneous immobilization of platelet-GP [IIb/IIIa, Ib/IX, human leucocyte antigen (HLA) class I, or Ia/IIa, CD32, GPIV or CD109, Ib/IX, HLA class I]. In order to detect human IgG and IgM antibodies simultaneously, phycoerythrin-and fluorescein isotiocyanate-conjugated goat anti-human IgG and IgM were added. On this basis, the abundance of six distinct antibodies (three anti-GP, each with subclasses IgG and IgM) were simultaneously analysed without cross-reaction by flow cytometry. For evaluation, sera and platelets from 169 patients with platelet-binding and/or platelet-associated antibodies were investigated. The monoclonal antibody-specific immobilization of platelet antigen (MAIPA) assay was performed in parallel as reference test. The simultaneous analysis of platelet-specific antibodies (SASPA) assay was able to detect all platelet-specific IgG and IgM that were also recognized by MAIPA with a comparable sensitivity. SASPA proved to be a rapid and reliable assay that required less platelets than other methods. This method has the potential to pave the way for new investigations of platelet-specific antibodies.

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Specificities of platelet autoantibodies in patients with lupus anticoagulants in primary antiphospholipid syndrome

Cited by 35 publications

References 26 publications

The Significance and Management of Thrombocytopenia in Antiphospholipid Syndrome

The Significance and Management of Thrombocytopenia in Antiphospholipid Syndrome

What causes the antiphospholipid syndrome?

A novel method for simultaneous analysis of specific platelet antibodies: SASPA

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