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Ann Hematol. 2018 Apr;97(4):641-654. doi: 10.1007/s00277-017-3215-3. Epub 2017 Dec 29.

Diminished expression of β2-GPI is associated with a reduced ability to mitigate complement activation in anti-GPIIb/IIIa-mediated immune thrombocytopenia.

Zhu X1,2,3, Zhang J1,2,3, Wang Q1,2, Fu H1,2, Chang Y1,2,3, Kong Y1,2,3, Lv M1,2, Xu L1,2,3, Liu K1,2,3, Huang X1,2,3, Zhang X4,5,6.

Author information

1
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China.
2
Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 100044, China.
3
Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China.
4
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China. zhangxh100@sina.com.
5
Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 100044, China. zhangxh100@sina.com.
6
Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China. zhangxh100@sina.com.

Abstract

Anti-GPIIb/IIIa-mediated complement activation has been reported to be important in the pathogenesis of immune thrombocytopenia (ITP). However, the role of the complement system and the involved regulatory mechanism remain equivocal. Beta2-glycoprotein I (β2-GPI), known as the main target for antiphospholipid autoantibodies, has been demonstrated as a complement regulator. Here, we investigated the complement-regulatory role of β2-GPI in anti-GPIIb/IIIa-mediated ITP. Plasma complement activation and enhanced complement activation capacity (CAC) were found in ITP patients with anti-GPIIb/IIIa antibodies in vivo and in vitro. Diminished plasma levels of β2-GPI were shown in patients of this group, which was inversely correlated with C5b-9 deposition. C5b-9 generation was inhibited by approximate physiological concentrations of β2-GPI, in a dose-dependent manner. Inhibition of C3a generation by β2-GPI and the existence of β2-GPI/C3 complexes in plasma indicated a regulation on the level of the C3 convertase. Furthermore, β2-GPI down-regulated the phosphorylation levels of c-Jun N-terminal kinase (JNK) and cleavage of BH3 interacting domain death agonist (Bid) and ultimately harbored platelet lysis. Our findings may provide a novel link between diminished plasma levels of β2-GPI and enhanced complement activation, indicating β2-GPI as a potential diagnostic biomarker and therapeutic target in the treatment of anti-GPIIb/IIIa-mediated ITP.

KEYWORDS:

Beta2-glycoprotein I (β2-GPI); Bid; Complement; Immune thrombocytopenia (ITP); JNK

PMID:
29350259
DOI:
10.1007/s00277-017-3215-3
[Indexed for MEDLINE]

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