Thrombotic Thrombocytopenic Purpura: When Basic Science Meets Clinical Research
Gaëlle Bécel1,2, Sylvia Faict1,2, Adrien Picod1,2
1Centre de Référence des MicroAngiopathies Thrombotiques, Paris, France.
Hamostaseologie
|February 19, 2021
Summary
New targeted therapies are transforming thrombotic thrombocytopenic purpura (TTP) treatment. Research is shifting from empirical to pathophysiology-based approaches, improving patient prognosis in both acute and long-term outcomes.
Area of Science:
- Hematology
- Translational Medicine
- Clinical Research
Background:
- Thrombotic thrombocytopenic purpura (TTP) is a rare hematologic disorder.
- The treatment of TTP has historically relied on empirical approaches.
- Recent advancements in basic science and clinical research have paved the way for new therapeutic strategies.
Purpose of the Study:
- To review the most recent therapeutic findings in TTP.
- To highlight the shift towards pathophysiology-based treatments.
- To demonstrate the improvement in TTP prognosis due to these advancements.
Main Methods:
- Review of recent literature on TTP therapeutics.
- Analysis of national and international collaborative research efforts.
- Synthesis of findings on epidemiology, clinical presentation, prognosis, and long-term outcomes.
Main Results:
- The availability of new targeted therapies is rapidly changing the TTP therapeutic landscape.
- Collaborative research has provided high-quality, practice-changing studies.
- These efforts have improved the understanding and management of TTP.
Conclusions:
- The progressive shift from empiricism to pathophysiology-based treatments exemplifies translational medicine.
- Recent therapeutic findings have significantly improved the prognosis of TTP.
- Continued research efforts are crucial for further enhancing patient outcomes in TTP.
Related Concept Videos
Anticoagulant Drugs: Low-Molecular-Weight Heparins
1.2K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
1.2K
Clot Retraction and Fibrinolysis
7.7K
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
7.7K
Venous Thrombosis I: Introduction
118
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
118
Structure and Function of Platelets
2.4K
The cell fragments known as platelets are disc-shaped, with an average diameter of about 3 μm and a thickness of roughly 1 μm. They play a crucial role in the body's vascular clotting system, which also involves plasma proteins, blood cells, and blood vessel tissues.
Platelets are continually replenished, circulating in the bloodstream for 9-12 days before being removed by phagocytes, primarily in the spleen. A microliter of circulating blood contains between 150,000 and 450,000...
Platelets are continually replenished, circulating in the bloodstream for 9-12 days before being removed by phagocytes, primarily in the spleen. A microliter of circulating blood contains between 150,000 and 450,000...
2.4K
Extrinsic and Intrinsic Pathways of Hemostasis
10.7K
Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
10.7K
Formation of the Platelet Plug
8.1K
The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
8.1K


