Evidence map›Paper›PMID 30309891›Full record

ArticleBlood2018

Polyreactive IgM initiates complement activation by PF4/heparin complexes through the classical pathway.

Sanjay Khandelwal, Joann Ravi, Lubica Rauova, Alexandra Johnson, Grace M Lee, Jennifer B Gilner, Sreenivasulu Gunti, Abner L Notkins, Maragatha Kuchibhatla, Michael Frank and 3 more

Open access · bronzeAbstract read
In one paragraph

Article in Blood, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 48 citations in OpenAlex.

  1. Methods to Examine Complement Activation by HIT Immune Complexes.Methods in molecular biology (Clifton, N.J.) · 2026
    Article
  2. Heparin: Over 100 Years of Anticoagulation.Handbook of experimental pharmacology · 2026
    Review
  3. Article
  4. Article
  5. Divergent host humoral innate immune response to the smooth-to-rough adaptation ofFrontiers in cellular and infection microbiology · 2025
    Article
  6. Article
  7. Thrombotic anti-PF4 immune disorders: HIT, VITT, and beyond.Hematology. American Society of Hematology. Education Program · 2023
    Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Pathogenesis of heparin-induced thrombocytopenia.Translational research : the journal of laboratory and clinical medicine · 2020
    Review
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 1 country.

Sanjay KhandelwalDivision of Hematology, Duke University Medical Center, Durham, NC.ORCID 0000-0002-5661-3856
Joann RaviDivision of Hematology, Duke University Medical Center, Durham, NC.
Lubica RauovaChildren's Hospital of Philadelphia, Philadelphia, PA.
Alexandra JohnsonDivision of Hematology, Duke University Medical Center, Durham, NC.
Grace M LeeDivision of Hematology, Duke University Medical Center, Durham, NC.ORCID 0000-0002-0051-2466
Jennifer B GilnerObstetrics & Gynecology, Duke University Medical Center, Durham, NC.
Sreenivasulu GuntiExperimental Medicine Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD.
Abner L NotkinsExperimental Medicine Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD.
Maragatha KuchibhatlaDepartment of Biostatistics and Bioinformatics and.
Michael FrankDepartment of Pediatrics, Duke University Medical Center, Durham, NC; and.
Mortimer PonczChildren's Hospital of Philadelphia, Philadelphia, PA.
Douglas B CinesDepartment of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Gowthami M ArepallyDivision of Hematology, Duke University Medical Center, Durham, NC.ORCID 0000-0003-0496-5064
Duke Medical Center · USChildren's Hospital of Philadelphia · USNational Institutes of Health · USUniversity of Pennsylvania · US

Funding

Subcellular Mechanisms pf Platelet ActivationP01HL040387 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI PONCZ, MORTIMER · 1988 to 2018
$35.5M
Insulin-Dependent Diabetes MellitusZIADE000423 · NIDCR · NATIONAL INSTITUTE OF DENTAL & CRANIOFACIAL RESEARCH · PI NOTKINS, ABNER L. · 2009 to 2020
$16.9M
Protein CoreP01HL110860 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI RAUOVA, LUBICA · 2012 to 2016
$11.4M
Structure-based Design of Rational PF4 Inhibitors in HITR01HL142122 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI CINES, DOUGLAS BROCK, PONCZ, MORTIMER · 2018 to 2021
$2.3M
Complement and CR2/CD21 in the Immune Pathogenesis of HITR01HL136512 · NHLBI · DUKE UNIVERSITY · PI AREPALLY, GOWTHAMI M · 2018 to 2021
$2.1M
Structural analysis of the HIT immune complexR01HL128895 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI ZHANG, HONGTAO · 2015 to 2019
$2.0M
Role of the Endothelium and Neutrophils in the Prothrombotic Nature of HITR01HL139448 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI PONCZ, MORTIMER · 2018 to 2020
$1.4M
Biological Significance of Protamine/Heparin AntibodiesK08HL127183 · NHLBI · DUKE UNIVERSITY · PI LEE, GRACE MING · 2015 to 2019
$637k
NHLBI NIH HHS K08 HL127183NHLBI NIH HHS P01 HL040387NHLBI NIH HHS P01 HL110860NHLBI NIH HHS R01 HL128895NHLBI NIH HHS R01 HL136512NHLBI NIH HHS R01 HL139448NHLBI NIH HHS R01 HL142122
6 · The paper itself

Abstract

The mechanisms by which exposure to heparin initiates antibody responses in many, if not most, recipients are poorly understood. We recently demonstrated that antigenic platelet factor 4 (PF4)/heparin complexes activate complement in plasma and bind to B cells. Here, we describe how this process is initiated. We observed wide stable variation in complement activation when PF4/heparin was added to plasma of healthy donors, indicating a responder "phenotype" (high, intermediate, or low). Proteomic analysis of plasma from these healthy donors showed a strong correlation between complement activation and plasma immunoglobulin M (IgM) levels (

Indexed as

Lymphocyte ActivationB-LymphocytesComplement C3cComplement Pathway, ClassicalHeparinHumansImmunoglobulin MPlatelet Factor 4ProteomicsComplement C3cHeparinImmunoglobulin MPlatelet Factor 4

Identifiers

PMID30309891
PMCPMC6284214
OpenAlexW2895919399

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.