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Blood, 1 October 2000, Vol. 96, No. 7, pp. 2520-2527
IMMUNOBIOLOGY
Identification of critical antigen-specific mechanisms in the
development of immune thrombocytopenic purpura in mice
Bernhard Nieswandt,
Wolfgang Bergmeier,
Kirsten Rackebrandt,
J. Engelbert Gessner, and
Hubert Zirngibl
From the Department of Molecular Oncology, General
Surgery, University of Witten-Herdecke, Wuppertal, Germany; and
Department of Clinical Immunology, Hannover Medical School, Hannover,
Germany.
The pathogenic effects of antiplatelet antibodies were investigated
in mice. Monoclonal antibodies (mAbs) of different immunoglobulin G
subclass directed against mouse GPIIbIIIa, GPIIIa, GPIb , GPIb-IX, GPV, and CD31 were generated and characterized biochemically. MAbs
against GPIb-IX, GPV, CD31, and linear epitopes on GPIIIa had mild and
transient effects on platelet counts and induced no spontaneous
bleeding. Anti-GPIb mAbs induced profound irreversible thrombocytopenia (< 3% of normal) by Fc-independent mechanisms but
only had minor effects on hematocrits. In contrast, injection of intact
mAbs, but not F(ab)2 fragments, against conformational epitopes on GPIIbIIIa, induced irreversible thrombocytopenia, acute
systemic reactions, hypothermia, decreased hematocrits, and a
paradoxical loss of surface GPIIbIIIa on platelets in vivo, the latter
suggesting the formation of platelet-derived microparticles. Blockage
of platelet-activating factor receptors inhibited the acute reactions,
but not thrombocytopenia, loss of GPIIbIIIa, and decreases in
hematocrits. Repeated injections of low doses of anti-GPIIbIIIa
antibodies resulted in profound thrombocytopenia and bleeding, whereas
no acute systemic reactions were observed. These data strongly suggest
that the identity of the target antigen recognized by antiplatelet
antibodies determines the mechanisms of platelet destruction and the
severity of bleeding in mice, the latter depending on previously
unrecognized anti-GPIIbIIIa-specific inflammatory mechanisms.

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