The Impact of Human Platelet Antigen Allele on Antiplatelet Antibodies and Cryoglobulins in Patients with Primary Immune Thrombocytopenia and Hepatitis C Virus-Associated Immune Thrombocytopenia.

IF 2 4区医学 Q3 HEMATOLOGY

Mediterranean Journal of Hematology and Infectious Diseases Pub Date : 2023-05-01 eCollection Date: 2023-01-01 DOI:10.4084/MJHID.2023.030

Cih-En Huang, Yi-Yang Chen, Jung-Jung Chang, Yu-Ying Wu, Wei-Ming Chen, Ying-Hsuan Wang, Min-Chi Chen, Chang-Hsien Lu, Chung-Sheng Shi, Chih-Cheng Chen

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Abstract

Background and objectives: Human platelet antigens (HPAs) are alloantigens associated with antiplatelet alloantibodies and the risk of immune thrombocytopenia (ITP). However, few studies have investigated associations among HPAs, antiplatelet autoantibodies, and cryoglobulins.

Methods: We enrolled 43 patients with primary ITP, 47 with hepatitis C virus-associated ITP (HCV-ITP), 21 with hepatitis B virus-associated ITP (HBV-ITP), 25 controls with HCV, and 1013 normal controls. We analyzed HPA allele frequencies, including HPA1-6 and 15, antiplatelet antibodies binding to platelet glycoprotein (GP) IIb/IIIa, Ia/IIa, Ib/IX, IV, human leukocyte antigen class I, cryoglobulin IgG/A/M, and their associations with thrombocytopenia.

Results: In the ITP cohort, HPA2ab, rather than HPA2aa, predicted a low platelet count. HPA2b was associated with the risk of developing ITP. HPA15b was correlated with multiple antiplatelet antibodies. In HCV-ITP patients, HPA3b was correlated with anti-GPIIb/IIIa antibodies. HCV-ITP patients with anti-GPIIb/IIIa antibodies had a higher positive rate of cryoglobulin IgG and IgA compared with those without anti-GPIIb/IIIa antibodies. Overlapping detection was also found among other antiplatelet antibodies and cryoglobulins. Like the antiplatelet antibodies, cryoglobulins were associated with clinical thrombocytopenia, implying their close relationship. Finally, we extracted cryoglobulins to confirm the exhibition of cryoglobulin-like antiplatelet antibodies. In contrast, in primary ITP patients, HPA3b was correlated with cryoglobulin IgG/A/M rather than anti-GPIIb/IIIa antibodies.

Conclusion: HPA alleles were associated with antiplatelet autoantibodies and had different impacts in primary ITP and HCV-ITP patients. HCV-ITP was considered to be a symptom of mixed cryoglobulinemia in HCV patients. The pathophysiology may differ between these two groups.

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人血小板抗原等位基因对原发性免疫性血小板减少症和丙型肝炎病毒相关免疫性血小板降低症患者的抗血小板抗体和冷球蛋白的影响。

背景和目的：人血小板抗原（HPAs）是与抗血小板同种抗体和免疫性血小板减少症（ITP）风险相关的同种抗原。然而，很少有研究调查HPA、抗血小板自身抗体和冷球蛋白之间的关系。方法：我们纳入了43例原发性ITP患者、47例丙型肝炎病毒相关性ITP患者、21例乙型肝炎病毒相关性ITP患者、25例HCV对照者和1013例正常对照者。我们分析了HPA等位基因频率，包括HPA1-6和15，与血小板糖蛋白（GP）IIb/IIIa、Ia/IIa、Ib/IX、IV结合的抗血小板抗体，人类白细胞抗原I类，冷冻球蛋白IgG/A/M，以及它们与血小板减少症的关系。结果：在ITP队列中，HPA2ab而不是HPA2aa预测血小板计数较低。HPA2b与发展为ITP的风险相关。HPA15b与多种抗血小板抗体相关。在HCV-ITP患者中，HPA3b与抗GPIIb/IIIa抗体相关。具有抗GPIIb/IIIa抗体的HCV-ITP患者的冷冻球蛋白IgG和IgA阳性率高于没有抗GPIIb/IIIa抗体的患者。在其他抗血小板抗体和冷球蛋白中也发现了重叠检测。与抗血小板抗体一样，冷球蛋白与临床血小板减少症相关，这意味着它们之间的密切关系。最后，我们提取了冷冻球蛋白来证实冷冻球蛋白样抗血小板抗体的表现。相反，在原发性ITP患者中，HPA3b与冷冻球蛋白IgG/A/M相关，而不是与抗GPIIb/IIIa抗体相关。结论：HPA等位基因与抗血小板自身抗体相关，在原发性ITP和HCV-ITP患者中具有不同的影响。HCV ITP被认为是HCV患者混合性冷球蛋白血症的一种症状。这两组患者的病理生理学可能不同。

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

Mediterranean Journal of Hematology and Infectious Diseases Medicine-Hematology

CiteScore

4.20

自引率

6.20%

发文量

113

审稿时长

12 weeks

期刊介绍： Reciprocal interdependence between infectious and hematologic diseases (malignant and non-malignant) is well known. This relationship is particularly evident in Mediterranean countries. Parasitosis as Malaria, Leishmaniosis, B Hookworms, Teniasis, very common in the southeast Mediterranean area, infect about a billion people and manifest prevalently with anemia so that they are usually diagnosed mostly by experienced hematologist on blood or bone marrow smear. On the other hand, infections are also a significant problem in patients affected by hematological malignancies. The blood is the primary vector of HIV infection, which otherwise manifest with symptoms related to a reduction in T lymphocytes. In turn, infections can favor the insurgency of hematological malignancies. The causative relationship between Epstein-Barr virus infection, Helicobacter pylori, hepatitis C virus, HIV and lymphoproliferative diseases is well known.