Chronic idiopathic thrombocytopenic purpura (ITP): molecular mechanisms and implications for therapy.

• Chronic idiopathic thrombocytopenic purpura (ITP) is an immune-mediated disorder in which platelets are prematurely destroyed in the reticuloendothelial system by platelet autoantibodies. However, it is becoming clear that the pivotal process of the humoral immune response in the pathogenesis of the disorder is a complex interaction between antigen-presenting cells, T cells and B cells. Furthermore, it is increasingly evident that regulatory T cells play an important role and that T-cell-mediated cytotoxicity contributes to the destruction of platelets in ITP. Different new approaches to immunotherapy in chronic ITP have been explored, including use of anti-CD20, anti-CD154 and anti-CD52 antibodies. So far, these therapies have been antigen-nonspecific and the risk of general immunosuppression is a concern. Thus, improving our understanding of the interaction and relative contribution of humoral and cell-mediated mechanisms is essential for developing antigen-specific immunotherapies for the treatment of this disorder. This review aims to elucidate the current status of knowledge of the cellular and humoral immune components of chronic ITP, together with the implications of this knowledge for therapy.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

Adult

Antibodies

Monoclonal

immunology

therapeutic use

Antigen-Presenting Cells

immunology

Antigens

CD

immunology

Antigens

Human Platelet

immunology

Autoantibodies

immunology

Blood Platelets

immunology

Child

Humans

Immune Tolerance

drug effects

Immunosuppressive Agents

therapeutic use

Immunotherapy

methods

Lymphocyte Subsets

immunology

Purpura

Thrombocytopenic

Idiopathic

blood

diagnosis

immunology

therapy

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)