Abstract
Although cell-mediated immunity to platelets has been suggested as the possible etiologic factor in patients with ITP, the mechanism by which autologous lymphocytes are stimulated remains obscure. Therefore, lymphocytes from 14 patients with ITP, 4 of whom were post-transfusion, and 13 normal individuals were cultured with autologous, homologous platelets and isolated platelet membrane. Cell-mediated immunity to these antigens was assayed by the migration inhibitory (MI) test. The results of the MI test to homologous platelets varied between 89 and 151% with a mean value of 119% in normal individuals. The mean percentages of migration in patients with ITP and in patients with post-transfusion were 96 and 113%, respectively. The percentage of migration in ITP was decreased significantly from that in normal controls, whereas none of the lymphocytes from patients with post-transfusion produced MIF. Patients with ITP whose MI tests to homologous platelets were positive also reacted positively to autologous platelets as well as to isolated platelet membrane. These results indicate that lymphocytes from patients with ITP can be stimulated by the antigenic determinant on platelet membrane. Close correlation of the percentage of migration with the number of peripheral platelets strongly suggests that cell-mediated immunity to autologous platelets plays some role in the pathogenesis of ITP.
Published Version
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