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Glycoprotein IIb/IIIa antagonists: potential induction and detection of drug-dependent antiplatelet antibodies.

Abstract
Development of acute, severe thrombocytopenia has been reported in several patients treated with a chimeric monoclonal antibody fragment to the platelet glycoprotein IIb/IIIa (GPIIb/IIIa) complex. However, the propensity of oral GPIIb/IIIa antagonists to induce antibody-mediated thrombocytopenia or platelet dysfunction with chronic exposure is unknown. There is evidence to suggest that a small percentage of otherwise healthy individuals have preexisting serum antibodies to conformation-dependent epitopes in the GPIIb/IIIa complex that are induced by certain members of this class of compounds that function as mixed agonists/antagonists. Additional studies are needed to identify the epitopes recognized by these antibodies and the requirement for the drug or a drug-metabolite to be present for antibody binding and detection. Detailed immunologic studies of antibodies from patients in whom immune thrombocytopenia develops after receiving oral GPIIb/IIIa antagonists may also provide insight into the mechanism by which activated platelets are normally cleared from the circulation.
AuthorsD B Cines
JournalAmerican heart journal (Am Heart J) Vol. 135 Issue 5 Pt 2 Su Pg. S152-9 (May 1998) ISSN: 0002-8703 [Print] UNITED STATES
PMID9588394 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S., Review)
Chemical References
  • Antibodies
  • Antibodies, Monoclonal
  • Platelet Glycoprotein GPIIb-IIIa Complex
Topics
  • Animals
  • Antibodies (analysis, immunology)
  • Antibodies, Monoclonal (adverse effects, immunology, therapeutic use)
  • Antibody Formation (drug effects)
  • Antibody Specificity (physiology)
  • Blood Platelets (immunology)
  • Humans
  • Platelet Glycoprotein GPIIb-IIIa Complex (antagonists & inhibitors)
  • Thrombocytopenia (chemically induced)

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