2．自己抗体の標的抗原―ITPを中心に
特発性血小板減少性紫斑病（ITP）は，血小板が自己抗体により早期に網内系にて破壊される自己免疫疾患である．全身性エリテマトーデス（SLE）が全身性疾患であるのに対し，バセドー病やITPは臓器特異的な自己免疫疾患である．ITPの病態さらにはその成因を解析するためには，ITPにおける自己抗体の標的抗原（＝自己抗原）を明らかにする必要がある．本稿では，ITPにおける標的抗原の詳細を中心に，その病態解析に関する最近の進歩につき概説する．...
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| Published in | 日本内科学会雑誌 Vol. 103; no. 7; pp. 1570 - 1579 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
2014
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.103.1570 |
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| Abstract | 特発性血小板減少性紫斑病（ITP）は，血小板が自己抗体により早期に網内系にて破壊される自己免疫疾患である．全身性エリテマトーデス（SLE）が全身性疾患であるのに対し，バセドー病やITPは臓器特異的な自己免疫疾患である．ITPの病態さらにはその成因を解析するためには，ITPにおける自己抗体の標的抗原（＝自己抗原）を明らかにする必要がある．本稿では，ITPにおける標的抗原の詳細を中心に，その病態解析に関する最近の進歩につき概説する． |
|---|---|
| AbstractList | 特発性血小板減少性紫斑病（ITP）は，血小板が自己抗体により早期に網内系にて破壊される自己免疫疾患である．全身性エリテマトーデス（SLE）が全身性疾患であるのに対し，バセドー病やITPは臓器特異的な自己免疫疾患である．ITPの病態さらにはその成因を解析するためには，ITPにおける自己抗体の標的抗原（＝自己抗原）を明らかにする必要がある．本稿では，ITPにおける標的抗原の詳細を中心に，その病態解析に関する最近の進歩につき概説する． |
| Author | 冨山, 佳昭 |
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| Copyright | 2014 一般社団法人 日本内科学会 |
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| DOI | 10.2169/naika.103.1570 |
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| References | 11) Tomiyama Y, Kosugi S: Autoantigenic epitopes on platelet glycoproteins. Int J Hematol 81: 100-105, 2005. 2) Cines DB, Blanchette VS: Immune thrombocytopenic purpura. N Engl J Med 346: 995-1008, 2002. 7) 冨山佳昭: トロンボポエチン受容体作動薬による難治性ITPの治療. 臨血 52: 627-632, 2011. 19) Yu J, et al: Defective circulating CD25 regulatory T cells in patients with chronic immune thrombocytopenic purpura. Blood 112: 1325-1328, 2008. 13) Tomiyama Y, et al: Demonstration of platelet antigens that bind platelet-associated autoantibodies in chronic ITP by direct immunoprecipitation procedure. Br J Haematol 75: 92-98, 1990. 1) Harrington WJ, et al: Demonstration of a thrombocytopenic factor in the blood of patients with thrombocytopenic purpura. J Lab Clin Med 38: 1-10, 1951. 5) Rodeghiero F, et al: Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood 113: 2386-2393, 2009. 20) Stasi R, et al: Analysis of regulatory T-cell changes in patients with idiopathic thrombocytopenic purpura receiving B cell-depleting therapy with rituximab. Blood 112: 1147-1150, 2008. 18) Semple JW, Provan D: The immunopathogenesis of immune thrombocytopenia: T cells still take center-stage. Curr Opin Hematol 19: 357-362, 2012. 3) McMillan R: The pathogenesis of chronic immune thrombocytopenic purpura. Semin Hematol 44 (Suppl 5): S3-S11, 2007. 9) McMillan R, et al: Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP. Blood 70: 1040-1045, 1987. 15) Fujisawa K, et al: The effect of therapy on platelet-associated autoantibody in chronic immune thrombocytopenic purpura. Blood 81: 2872-2877, 1993. 8) Kelton JG, et al: A prospective study of the usefulness of the measurement of platelet-associated IgG for the diagnosis of idiopathic thrombocytopenic purpura. Blood 60: 1050-1053, 1982. 17) Kuwana M, et al: Autoreactive T cells to platelet GPIIb-IIIa in immune thrombocytopenic purpura: role in production of anti-platelet autoantibody. J Clin Invest 102: 1393-1402, 1998. 10) Kiefel V, et al: Autoantibodies against platelet glycoprotein Ib/IX: a frequent finding in autoimmune thrombocytopenic purpura. Br J Haematol 79: 256-262, 1991. 6) McMillan R, et al: Suppression of in vitro megakaryocyte production by antiplatelet autoantibodies from adult patients with chronic ITP. Blood 103: 1364-1369, 2004. 16) Kiyomizu K, et al: Recognition of highly restricted regions in the β-propeller domain of αIIb by platelet-associated anti-αIIbβ3 autoantibodies in primary immune thrombocytopenia. Blood 120: 1499-1509, 2012. 14) Brighton TA, et al: Prospective evaluation of the clinical usefulness of an antigen-specific assay (MAIPA) in idiopathic thrombocytopenic purpura and other immune thrombocytopenias. Blood 88: 194-201, 1996. 12) McMillan R, et al: Prospective evaluation of the immunobead assay for the diagnosis of adult chronic immune thrombocytopenic purpura (ITP). J Thromb Haemost 1: 485-491, 2003. 4) 冨山佳昭: 特発性血小板減少性紫斑病. 臨血 49: 1298-1305, 2008. |
| References_xml | – reference: 11) Tomiyama Y, Kosugi S: Autoantigenic epitopes on platelet glycoproteins. Int J Hematol 81: 100-105, 2005. – reference: 1) Harrington WJ, et al: Demonstration of a thrombocytopenic factor in the blood of patients with thrombocytopenic purpura. J Lab Clin Med 38: 1-10, 1951. – reference: 20) Stasi R, et al: Analysis of regulatory T-cell changes in patients with idiopathic thrombocytopenic purpura receiving B cell-depleting therapy with rituximab. Blood 112: 1147-1150, 2008. – reference: 13) Tomiyama Y, et al: Demonstration of platelet antigens that bind platelet-associated autoantibodies in chronic ITP by direct immunoprecipitation procedure. Br J Haematol 75: 92-98, 1990. – reference: 19) Yu J, et al: Defective circulating CD25 regulatory T cells in patients with chronic immune thrombocytopenic purpura. Blood 112: 1325-1328, 2008. – reference: 9) McMillan R, et al: Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP. Blood 70: 1040-1045, 1987. – reference: 7) 冨山佳昭: トロンボポエチン受容体作動薬による難治性ITPの治療. 臨血 52: 627-632, 2011. – reference: 12) McMillan R, et al: Prospective evaluation of the immunobead assay for the diagnosis of adult chronic immune thrombocytopenic purpura (ITP). J Thromb Haemost 1: 485-491, 2003. – reference: 18) Semple JW, Provan D: The immunopathogenesis of immune thrombocytopenia: T cells still take center-stage. Curr Opin Hematol 19: 357-362, 2012. – reference: 16) Kiyomizu K, et al: Recognition of highly restricted regions in the β-propeller domain of αIIb by platelet-associated anti-αIIbβ3 autoantibodies in primary immune thrombocytopenia. Blood 120: 1499-1509, 2012. – reference: 4) 冨山佳昭: 特発性血小板減少性紫斑病. 臨血 49: 1298-1305, 2008. – reference: 5) Rodeghiero F, et al: Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood 113: 2386-2393, 2009. – reference: 17) Kuwana M, et al: Autoreactive T cells to platelet GPIIb-IIIa in immune thrombocytopenic purpura: role in production of anti-platelet autoantibody. J Clin Invest 102: 1393-1402, 1998. – reference: 10) Kiefel V, et al: Autoantibodies against platelet glycoprotein Ib/IX: a frequent finding in autoimmune thrombocytopenic purpura. Br J Haematol 79: 256-262, 1991. – reference: 6) McMillan R, et al: Suppression of in vitro megakaryocyte production by antiplatelet autoantibodies from adult patients with chronic ITP. Blood 103: 1364-1369, 2004. – reference: 8) Kelton JG, et al: A prospective study of the usefulness of the measurement of platelet-associated IgG for the diagnosis of idiopathic thrombocytopenic purpura. Blood 60: 1050-1053, 1982. – reference: 2) Cines DB, Blanchette VS: Immune thrombocytopenic purpura. N Engl J Med 346: 995-1008, 2002. – reference: 15) Fujisawa K, et al: The effect of therapy on platelet-associated autoantibody in chronic immune thrombocytopenic purpura. Blood 81: 2872-2877, 1993. – reference: 14) Brighton TA, et al: Prospective evaluation of the clinical usefulness of an antigen-specific assay (MAIPA) in idiopathic thrombocytopenic purpura and other immune thrombocytopenias. Blood 88: 194-201, 1996. – reference: 3) McMillan R: The pathogenesis of chronic immune thrombocytopenic purpura. Semin Hematol 44 (Suppl 5): S3-S11, 2007. |
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| Title | 2．自己抗体の標的抗原―ITPを中心に |
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