在临床上怀疑VITT患者中对血小板糖蛋白的抗体
Romy T Meier1, Leendert Porcelijn2, Suzanne Hofstede-van Egmond2
1Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, 1066 CX Amsterdam, The Netherlands.
Antibodies (Basel, Switzerland)
|May 28, 2024
概括
血小板抗体与类似HIT的VITT无关,但在一些VITT患者中发现,主要是血小板缩. 对于VITT的诊断和治疗,需要进一步的研究.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 疫苗诱导的血栓性血栓细胞缩 (VITT) 是 COVID-19 疫苗接种的一种罕见,严重的并发症.
- 维特与肝素诱导的血小板缺血 (HIT) 有共同的机制,涉及抗血小板因子4 (PF4) 抗体.
- 其他血小板抗体在VITT病变发生中的作用尚不清楚.
研究的目的:
- 在VITT患者中调查针对特定糖蛋白的血小板抗体的存在和作用.
- 为了确定血小板抗体是否与HIT类VITT或单独的血小板缺血有关.
- 探索疫苗类型与血小板抗体的发展之间的潜在联系.
主要方法:
- 对232名临床怀疑的VITT患者进行了针对GPIIb/IIIa,GPV和GPIb/IX的抗体的血清分析.
- 根据临床怀疑疫苗接种后的血小板缺血和/或血栓形成,对VITT进行分类.
- 与HIT类VITT和非HIT类VITT病例之间的抗体患病率的比较.
主要成果:
- 19%的疑似VITT患者的抗血小板抗体检测呈阳性.
- 对GPIIb/IIIa,GPV和GPIb/IX的抗体分别在39%,32%和86%的阳性病例中被发现.
- 没有类似HIT的VITT患者对血小板抗体呈阳性结果;这些主要与血小板缩有关.
结论:
- 血小板抗体不太可能参与HIT类VITT.
- 血小板抗体在VITT病例中主要与血小板缺血有关.
- 疫苗类型 (腺病毒或mRNA) 与血小板抗体发育之间没有发现相关性,因此需要进一步研究VITT病理生理学.
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