1、2023/1/19 特发性血小板减少性紫癜（Idiopathic Thrombocytopenic Idiopathic Thrombocytopenic Purpura,ITPPurpura,ITP）发病机制发病机制2023/1/19发病机制发病机制体液免疫体液免疫 1体液免疫因素体液免疫因素 自身抗体识别的靶抗原几乎涉及血小板膜表面所自身抗体识别的靶抗原几乎涉及血小板膜表面所有分子有分子(抗血小板糖蛋白抗血小板糖蛋白IIb/IIIa、Ib/IX、Ia/IIa、IV、VI和和P-SelP-Sel等等)。结合自身抗体的血小板易被网状内皮系统破坏结合自身抗体的血小板易被网状内皮系统破坏 自身抗体
2、引起获得性血小板功能异常自身抗体引起获得性血小板功能异常 自身抗体结合巨核细胞，干扰巨核细胞分化成自身抗体结合巨核细胞，干扰巨核细胞分化成熟熟 McMillan等发现，等发现，2/3 ITP患者血浆能明显抑制巨患者血浆能明显抑制巨核细胞生成（核细胞生成（2595%）,巨核细胞数量和成熟度均巨核细胞数量和成熟度均受到抑制。受到抑制。Chang等也证实自身抗体明显抑制脐血来等也证实自身抗体明显抑制脐血来源巨核细胞生长源巨核细胞生长 Blood 2004;103:1364-1369Blood 2004;103:1364-1369 Blood 2003;102:887-895 Blood 2003;1
3、02:887-8952023/1/19发病机制发病机制体液免疫体液免疫 1、血小板相关抗体（、血小板相关抗体（platelet-associated immuoglobulin PAIgG）Harrington 等等1951年证实：年证实：27例例ITP患患者的血浆输给正常志愿者，者的血浆输给正常志愿者，16例例PC减少减少 PC CD8+T cells.Trend toward Th1 activation.primarily react with GPIIb/IIIa.Adherent cell(APC)dependent.2023/1/19Approximately 40%of pati
4、ents with chronic AITP have no detectible antibodies on their platelets or in their plasma.Why?How are their platelets being destroyed?2023/1/19TumorcellCTL2023/1/19Anderson et al.Nature Medicine 2003 CD8 cellPlateletLysis(kill)Suggests that a novel therapeutic targeting cell mediated immunity may b
5、enefit some ITP patients.2023/1/19 Disturbed apoptosis of T-cells in patients with active idiopathic thrombocytopenic purpura apoptotic resistance of activated T-lymphocytes in patients with active ITP may lead to defective clearance of autoreactive T-lymphocytes through AICD（activation induced cell
6、 death),which might cause a continued immune destruction of plateletsOlsson B,et al.Thromb Haemost.20052023/1/19发病机制发病机制 3、雌激素、雌激素 4、遗传因素、遗传因素 HLA DRW9 和和HLA DQW3后面内容直接删除就行资料可以编辑修改使用资料可以编辑修改使用资料仅供参考，实际情况实际分析主要经营：课件设计，文档制作，网络软件设计、图文设计制作、发布广告等秉着以优质的服务对待每一位客户，做到让客户满意！致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划案、学习课件、各类模板等方方面面，打造全网一站式需求The user can demonstrate on a projector or computer,or print the presentation and make it into a film to be used in a wider field
