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Article Dans Une Revue Autoimmunity Reviews Année : 2017

Pathogenesis of immune thrombocytopenia

Matthieu Mahévas
  • Fonction : Auteur
Maxime Samson
  • Fonction : Auteur
Bertrand Godeau
  • Fonction : Auteur
Bernard Bonnotte
  • Fonction : Auteur

Résumé

Immune thrombocytopenia (ITP) is a rare autoimmune disease due to an abnormal T cell response, notably supported by splenic T follicular helper cells, that stimulates the proliferation and differentiation of autoreactive B cells. The antiplatelet autoantibodies they produce facilitate platelet phagocytosis by macrophages, essentially in the spleen. Macrophages contribute to the perpetuation of the auto-immune response as the main antigenpresenting cell during ITP. CD8 + T cells also participate to thrombocytopenia by increasing platelet apoptosis. Besides this peripheral platelet destruction, inappropriate bone marrow production also exacerbates thrombocytopenia, due to an immune response against megakaryocytes. Moreover, the level of circulating thrombopoietin, the main growth factor of megakaryocytes, is low during ITP. In this review, the major mechanisms leading to thrombocytopenia, the role of the different immune cells and the different targets of treatments are described.

Mots clés

HCV hepatitis C virus HIV human immunodeficiency virus IDO 3-dioxygenase ITP immune thrombocytopenia MDS myelodysplastic syndrome MHC major histocompatibility complex moDC monocyte-derived dendritic cells MSC mesenchymal stromal cells RTX rituximab TCR T cell receptor TIMP-3 tissue inhibitor of metalloproteinase 3 TFH T follicular helper cells TLR toll-like receptor TPO thrombopoietin TPO-RA thrombopoietin receptor agonists TRAP thrombin receptor activating peptide Treg Immune thrombocytopenia Platelets Pathogenesis T cells B cells Macrophages Dendritic cells Regulatory cells ADP adenosine diphosphate AID autoimmune diseases AML acute myeloid leukemia APRIL a proliferation inducing ligand BAFF B cell activating factor Breg regulatory B cells CMV cytomegalovirus DC dendritic cells EBV Epstein Barr virus FcγR Fcγ receptor GP glycoproteins HCV hepatitis C virus HIV human immunodeficiency virus IDO indoleamine 2 3-dioxygenase ITP immune thrombocytopenia MDS myelodysplastic syndrome MHC major histocompatibility complex moDC monocyte-derived dendritic cells MSC mesenchymal stromal cells RTX rituximab TCR T cell receptor TIMP-3 tissue inhibitor of metalloproteinase 3 TFH T follicular helper cells TLR toll-like receptor TPO thrombopoietin TPO-RA thrombopoietin receptor agonists TRAP thrombin receptor activating peptide Treg regulatory T cells adenosine diphosphate AID autoimmune diseases AML acute myeloid leukemia APRIL a proliferation inducing ligand BAFF B cell activating factor Breg regulatory B cells CMV cytomegalovirus DC dendritic cells EBV Epstein Barr virus FcγR Fcγ receptor GP glycoproteins
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Dates et versions

hal-04242234 , version 1 (16-10-2023)

Identifiants

Citer

Sylvain Audia, Matthieu Mahévas, Maxime Samson, Bertrand Godeau, Bernard Bonnotte. Pathogenesis of immune thrombocytopenia. Autoimmunity Reviews, 2017, 16 (6), pp.620 - 632. ⟨10.1016/j.autrev.2017.04.012⟩. ⟨hal-04242234⟩

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