Alwan, Ferras; Vendramin, Chiara; Budde, Ulrich; Liesner, Ri; Taylor, Alice; Thomas, Mari; Lämmle, Bernhard; Scully, Marie (2021). Assessing thrombogenesis and treatment response in congenital thrombotic thrombocytopenic purpura. eJHaem, 2(2), pp. 188-195. Wiley 10.1002/jha2.178
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eJHaem_-_2021_-_Alwan_-_Assessing_thrombogenesis_and_treatment_response_in_congenital_thrombotic_thrombocytopenic_purpura.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (967kB) | Preview |
Despite clinical remission and normal platelet counts, congenital TTP (cTTP) is associated with non-overt symptoms. Prophylactic ADAMTS13 replacement therapy such as plasma infusion (PI) prevents acute episodes and improves symptomatology. There is no current method to investigate disease severity or monitor the impact of treatment. We utilize a dynamic high shear flow assay to further understand disease pathophysiology and determine the impact of cTTP on symptomatology and therapy, despite normal platelet counts. Whole blood, under high shear, was run over collagen-coated channels, causing platelet adhesion to von Willebrand factor (VWF) multimers. The resulting surface coverage by platelet-VWF thrombus was assessed. The normal range was 6-39% in 50 controls. Twenty-two cTTP patients with normal platelet counts were evaluated. Median pre-treatment surface coverage was 89%, and PI reduced coverage to a median of 44% (p = 0.0005). Patients taking antiplatelets had further reduced coverage when combined with PI and improved non-overt symptoms such as headache, lethargy, and abdominal pain in 100% of patients compared to 74% with PI alone (p = 0.046). We use a dynamic assay to report increased in vitro platelet adhesion and aggregation and additionally demonstrate significantly decreased thrombi following PI, with levels in the normal range levels achieved in patients taking additional antiplatelet therapy.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory |
UniBE Contributor: |
Lämmle, Bernhard |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2688-6146 |
Publisher: |
Wiley |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
20 Jul 2022 12:17 |
Last Modified: |
05 Dec 2022 16:21 |
Publisher DOI: |
10.1002/jha2.178 |
PubMed ID: |
35845267 |
Uncontrolled Keywords: |
congenital TTP prophylaxis shear flow upshaw schulman syndrome |
BORIS DOI: |
10.48350/171415 |
URI: |
https://boris.unibe.ch/id/eprint/171415 |
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