血小板凋亡与免疫性血小板减少症关系的研究进展

Research progress of the relationship between platelet apoptosis and immune thrombocytopenia

免疫性血小板减少症(immune thrombocytopenia,ITP)是一种获得性、高度异质性的自身免疫介导的血液系统疾病。ITP的发病机制中同时存在血小板的破坏增多和生成不足。血小板自身抗体的形成在其中发挥着重要作用。既往认为抗体引起的血小板破坏主要是依赖于网状内皮系统Fc受体介导的吞噬作用。目前研究发现,ITP还存在Fc-非依赖性血小板清除途径,如血小板自身抗体引起的血小板凋亡和血小板的去唾液酸化等[1-3]。

Immune thrombocytopenia(ITP)is an acquired autoimmune-mediated thrombocytopenia.The majority of children ITP show self-limiting process,while few undergo prolonged and recurrent natural history,similar to the majority of adults ITP,who bear heavy burden of treatment and poor prognosis.ITP is highly heterogeneous in clinical outcomes with complex mechanisms that have yet to be discovered.In recent years,it has been found that platelet apoptosis may be one of the mechanisms of chronic ITP in adults and acute ITP in children.Intravenous immunoglobulin and recombinant human thrombopoietin may affect the process of platelet apoptosis,to achieve the therapeutic purpose.In this paper,we review the role of platelet apoptosis in the pathogenesis and treatment of ITP.