Involvement of Fc gamma receptor polymorphism in the therapeutic response of idiopathic thrombocytopenic purpura.

Abstract

Clearance of autoantibody-sensitized platelets through Fc gamma receptors on phagocytic cells is one of the main mechanisms of thrombocytopenia in idiopathic thrombocytopenic purpura (ITP). We examined the Fc gamma RIIA-131R/H and Fc gamma RIIIA-158V/F polymorphisms in 104 adult chronic ITP patients, and in 59 healthy control subjects using polymerase chain reaction-based allele-specific restriction analysis. The frequency of Fc gamma RIIA genotypes (131H/H, H/R, R/R) was not significantly different between patients and controls, and did not correlate with the responsiveness to treatment. In contrast, among Fc gamma RIIIA genotypes, frequency of 158F/F homotype was smaller in ITP (P < 0.05). Furthermore, in Fc gamma RIIIA-158V/V homotype, the complete remission (CR) rate with medication (treatment with corticosteroid or other immunosuppressive agents) was significantly higher (60%) than that in 158V/F (10%) or 158V/F plus 158F/F, (P < 0.01, P < 0.05). Conversely, the CR rate after splenectomy in 158F/F and 158V/F types (64.3% and 54.6%) was higher than in 158V/V (25%). Our results indicate that the polymorphism of Fc gamma RIIIA, but not Fc gamma RIIA, influences the response to treatment in ITP.

• Authors: T T Fujimoto, M Inoue, T Shimomura, K Fujimura
• Journal: British journal of haematology (Br J Haematol) Vol. 115 Issue 1 Pg. 125-30 (Oct 2001) ISSN: 0007-1048 [Print] England
• PMID: 11722422 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• Platelet Glycoprotein GPIIb-IIIa Complex
• Platelet Glycoprotein GPIb-IX Complex
• Receptors, IgG

Topics

• Adult
• Autoantibodies (analysis)
• Case-Control Studies
• Chi-Square Distribution
• Female
• Genotype
• Humans
• Male
• Middle Aged
• Patient Selection
• Platelet Glycoprotein GPIIb-IIIa Complex (immunology)
• Platelet Glycoprotein GPIb-IX Complex (immunology)
• Polymerase Chain Reaction (methods)
• Polymorphism, Genetic
• Purpura, Thrombocytopenic, Idiopathic (immunology, therapy)
• Receptors, IgG (genetics)
• Remission Induction
• Retrospective Studies
• Statistics, Nonparametric