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Blood, 15 February 2005, Vol. 105, No. 4, pp. 1546-1548.
Prepublished online as a Blood First Edition Paper on October 12, 2004; DOI 10.1182/blood-2004-05-1886.


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HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY
Brief report

Monoclonal antibodies that mimic the action of anti-D in the amelioration of murine ITP act by a mechanism distinct from that of IVIg

Seng Song, Andrew R. Crow, Vinayakumar Siragam, John Freedman, and Alan H. Lazarus

From the Transfusion Medicine Research, St Michael's Hospital; The Canadian Blood Services; and The Toronto Platelet Immunobiology Group, Toronto, ON, Canada.

The mechanism of action of intravenous immunoglobulin (IVIg) and polyclonal anti-D–mediated reversal of immune thrombocytopenia (ITP) is still unclear. However, in a murine model of ITP, the therapeutic effect of IVIg appears to be wholly dependent upon the expression of the inhibitory Fc receptor, Fc{gamma}RIIB. We previously demonstrated that, similar to anti-D in humans, 2 erythrocyte-reactive monoclonal antibodies (TER119 and M1/69) ameliorated murine ITP and inhibited reticuloendothelial system (RES) function at doses that protected against thrombocytopenia. The current study evaluated the involvement of the inhibitory and activating Fc receptors, Fc{gamma}RIIB and Fc{gamma}RIIIA, respectively, in the TER119 and M1/69-mediated inhibition of thrombocytopenia. In contrast to IVIg, in Fc{gamma}RIIB-deficient mice, both monoclonal antibodies ameliorated ITP and both significantly down-regulated the level of expression of the activating Fc{gamma}RIIIA in splenic macrophages. These results indicate that anti-erythrocyte antibodies that ameliorate ITP act independently of Fc{gamma}RIIB expression but are dependent upon the activating Fc{gamma}RIIIA.


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