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Publication : Desialylation is a mechanism of Fc-independent platelet clearance and a therapeutic target in immune thrombocytopenia.

First Author  Li J Year  2015
Journal  Nat Commun Volume  6
Pages  7737 PubMed ID  26185093
Mgi Jnum  J:224451 Mgi Id  MGI:5662309
Doi  10.1038/ncomms8737 Citation  Li J, et al. (2015) Desialylation is a mechanism of Fc-independent platelet clearance and a therapeutic target in immune thrombocytopenia. Nat Commun 6:7737
abstractText  Immune thrombocytopenia (ITP) is a common bleeding disorder caused primarily by autoantibodies against platelet GPIIbIIIa and/or the GPIb complex. Current theory suggests that antibody-mediated platelet destruction occurs in the spleen, via macrophages through Fc-FcgammaR interactions. However, we and others have demonstrated that anti-GPIbalpha (but not GPIIbIIIa)-mediated ITP is often refractory to therapies targeting FcgammaR pathways. Here, we generate mouse anti-mouse monoclonal antibodies (mAbs) that recognize GPIbalpha and GPIIbIIIa of different species. Utilizing these unique mAbs and human ITP plasma, we find that anti-GPIbalpha, but not anti-GPIIbIIIa antibodies, induces Fc-independent platelet activation, sialidase neuraminidase-1 translocation and desialylation. This leads to platelet clearance in the liver via hepatocyte Ashwell-Morell receptors, which is fundamentally different from the classical Fc-FcgammaR-dependent macrophage phagocytosis. Importantly, sialidase inhibitors ameliorate anti-GPIbalpha-mediated thrombocytopenia in mice. These findings shed light on Fc-independent cytopenias, designating desialylation as a potential diagnostic biomarker and therapeutic target in the treatment of refractory ITP.
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