Immune thrombocytopenia: a review on the pathogenetic role of immune cells.

IF 2.3 4区医学 Q2 HEMATOLOGY

Expert Review of Hematology Pub Date : 2023-07-01 Epub Date: 2023-09-08 DOI:10.1080/17474086.2023.2255750

Forogh Nokhostin, Fatemeh Bakhshpour, Seyed Mohammad Sadegh Pezeshki, Reyhane Khademi, Najmaldin Saki

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引用次数: 0

Abstract

Introduction: Immune thrombocytopenia [ITP] is a common bleeding disorder with an isolated platelet count of less than 100 × 10⁹/L.

Areas covered: Relevant literature from 2003 to 2022 was retrieved and reviewed from the Google Scholar search engine and PubMed database. Antibodies produced by autoreactive B lymphocytes and the phagocytic function of macrophages are considered the most critical factors in platelet destruction. Also, macrophages present the antigen to T lymphocytes and activate them. Follicular helper T-cells [TFH] play a role in stimulating, differentiating, and activating autoreactive B cells, while cluster of differentiation [CD]-8+ T plays a role in platelet destruction through apoptosis. The classical pathway of the complement system also causes platelet destruction. By inhibiting platelet production, low levels of thrombopoietin and an immune response against megakaryocytes in the bone marrow worsen thrombocytopenia.

Expert opinion: T-cell subset changes and an increase in activated autoreactive B cells, in addition to the function of components of the innate immune system [the complement system, dendritic cells, and natural killer cells], play a critical role in the pathogenesis of the ITP. Accurate detection of these changes may lead to developing new therapeutic strategies and identifying better prognostic/diagnostic factors.

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免疫性血小板减少症：免疫细胞致病作用综述。

简介：免疫性血小板减少症是一种常见的出血性疾病，分离的血小板计数低于100 × 109/L。涵盖领域：从谷歌学者搜索引擎和PubMed数据库检索和审查了2003年至2022年的相关文献。自身反应性B淋巴细胞产生的抗体和巨噬细胞的吞噬功能被认为是血小板破坏的最关键因素。此外，巨噬细胞将抗原呈递给T淋巴细胞并激活它们。卵泡辅助性T细胞[TFH]在刺激、分化和激活自身反应性B细胞中发挥作用，而分化簇[CD]-8+T通过凋亡在血小板破坏中发挥作用。补体系统的经典途径也会导致血小板破坏。通过抑制血小板生成，骨髓中低水平的血小板生成素和针对巨核细胞的免疫反应会加重血小板减少症。专家意见：T细胞亚群的变化和活化的自身反应性B细胞的增加，以及先天免疫系统成分[补体系统、树突状细胞和自然杀伤细胞]的功能，在ITP的发病机制中发挥着关键作用。准确检测这些变化可能有助于开发新的治疗策略并确定更好的预后/诊断因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Hematology HEMATOLOGY-

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.