Platelet Desialylation Affects Bleeding Tendency in Immune Thrombocytopenic Patients

On Monday, Irene Marini of the University of Tubingen in Tübingen, Germany, and Biotest AG presented results from research that looked to assess the impact of desialylating autoantibodies (AAbs) on the bleeding tendency/manifestations of immune thrombocytopenia (ITP) patients. ITP is a bleeding disorder caused by AAbs against platelet (PLT) glycoproteins. Desialylation, the loss of sialic acid from PLT glycoproteins, has been reported to contribute to increased PLT destruction and reduced PLT formation.

Marini commented that the desialylation ability of 100 well-characterized ITP patients was analyzed by flow cytometry, along with PLT count, bleeding tendency, and PLT adhesion. The median PLT count of the study cohort was 32 × 109/L, with a lower PLT count found in patients with desialylating ITP-AAbs compared with patients with non-desialylating AAbs. Bleeding events were reported in 48 out of 100 patients. Bleeding symptoms were often observed in patients with desialylating AAbs. Specifically, a higher tendency to develop petechiae and hematoma was observed in patients with desialylating AAbs compared with non-desialylating ones. This phenomenon was further analyzed by looking further into the PLT function. Impaired adhesion to fibrinogen and von Willebrand factor (VWF) was observed in the presence of desialylating ITP-AAbs, which was significantly improved by pretreatment with a sialidase inhibitor.

Marini concluded that the work demonstrated a correlation between ITP patients with desialylating AAbs and their reduced PLT count and bleeding tendency, suggesting a potential clinical relevance of PLT desialylation as a target for diagnostic tools and therapeutic approaches in the treatment of ITP.

Read the full abstract here.
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