人类血小板分子免疫学研究进展  

Progress of Studies on Molecular Immunology of Human Pletelets——Editorial

作　　者：侯明[1] 彭军[1] 

机构地区：[1]山东大学齐鲁医院血液科,济南250012

出　　处：《中国实验血液学杂志》2004年第5期553-557,共5页Journal of Experimental Hematology

基　　金：国家自然科学基金资助项目 ( 3 0 3 0 0 3 12 ) ;教育部优秀青年教师基金资助项目;山东省优秀中青年科学家奖励基金资助项目( 973 744 2 8)

摘　　要：自身免疫性血小板减少性紫癜 (AITP)中血小板自身抗体通过其Fab段特异性结合血小板膜GP ,CD5 + 和CD5 - B细胞共同参与AITP发病过程 ,慢性AITP患者自身抗原决定簇的数量有限 ,部分患者GP特异性自身抗体源于寡克隆B淋巴细胞增生。在AITP中通过阻断共刺激信号能够诱导血小板抗原特异性T细胞免疫耐受 ,其耐受机制为T细胞免疫无能。霉酚酸酯治疗激素耐药AITP的有效性与其对患者细胞和体液免疫功能的有效调节有关。血浆TPO水平测定有助于鉴别血小板破坏增多、骨髓增生低下或严重受抑所致的血小板生成减少 ,且对难治性贫血与慢性再生障碍性贫血的鉴别诊断具有重要意义。TPO检测可作为原发性与继发性血小板增多的实验室鉴别诊断指标。奎宁和肝素能够诱导药物相关自身抗体 ,引起血小板减少。PCR SSP方法可用于新生儿HPA基因的产前检测及大规模研究不同人群HAP的基因分型。人类血小板糖蛋白上存在红细胞A、B、H血型抗原 ,A2亚型血小板可以作为O型血小板输注而不致引起抗血型A免疫反应。生物素可干扰标记血小板的功能。In autoimmune thrombocytopenic purpura (AITP) specific autoantibodies bind plate let GP via their Fab fragments. Both splenic CD5+ B and CD5-B cells produce plat elet glycoprotein-specific antibodies. There is limited number of antigenic det erminants, and the GP-specific autoantibodies are derived from a restricted num ber of B-cell clones in chronic AITP. Blocking co-stimulatory signals could in duce platelet-specific T cell anergy. MMF could be used as a second line agent for the treatment of steroid-resistant AITP. Detection of plasma thrombopoietin levels play an important role in the differentiation of thrombocytopenic states caused by platelet destruction or due to bone marrow hypoplasia. Endogenous TPO level is also important on the differential diagnosis of ET and RT. Quinine- or heparin-dependent antibodies could induce thrombocytopenia. PCR-SSP is usef ul for the genotyping of the platelet-specific alloantigen HPA. Biotinylated pl atelets have an impaired response to agonists as evidenced by in vitro plate let aggregation tests.

关 键 词：血小板 分子免疫学 自身免疫性血小板减少性紫癜 

分 类 号：R331.143[医药卫生—人体生理学] R554.6[医药卫生—基础医学]