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Blood, 1 October 2004, Vol. 104, No. 7, pp. 2102-2106.
Prepublished online as a Blood First Edition Paper on June 17, 2004; DOI 10.1182/blood-2004-01-0310.
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Submitted January 28, 2004
Accepted May 6, 2004
Exacerbation of autoantibody-mediated thrombocytopenic purpura by infection with mouse viruses
Andrei Musaji, Francoise Cormont, Gaetan Thirion, Cesar L Cambiaso, and Jean-Paul Coutelier*
Unit of Experimental Medicine, Institute for Cellular Pathology, Universite catholique de Louvain, Brussels, Belgium
Ludwig Institute for Cancer Research, Institute for Cellular Pathology, Universite catholique de Louvain, Brussels, Belgium
* Corresponding author; email: coutelier{at}mexp.ucl.ac.be.
Antigenic mimicry has been proposed as a major mechanism by which viruses could trigger the development of immune thrombocytopenic purpura (ITP). However, because antigenic mimicry implies epitope similarities between viral and self antigens, it is difficult to understand how widely different viruses can be involved by this sole mechanism in the pathogenesis of ITP. Here we report that in mice treated with anti-platelet antibodies at a dose insufficient to induce clinical disease by themselves, infection with lactate dehydrogenase-elevating virus (LDV) was followed by severe thrombocytopenia and by the appearance of petechiae similar to those observed in patients with ITP. A similar exacerbation of anti-platelet-mediated thrombocytopenia was induced by mouse hepatitis virus. This enhancement of anti-platelet antibody pathogenicity by LDV was not observed with F(ab')2 fragments, suggesting that phagocytosis was involved in platelet destruction. Treatment of mice with clodronate-containing liposomes and with total IgG indicated that platelets were cleared by macrophages. The increase of thrombocytopenia triggered by LDV after administration of anti-platelet antibodies was largely suppressed in animals deficient for gamma-interferon receptor. Together, these results suggest that viruses may exacerbate autoantibody-mediated ITP by activating macrophages through gamma-interferon production, a mechanism that may account for the pathogenic similarities of multiple infectious agents.

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