ArticleThe Journal of clinical investigation2022
High-affinity autoreactive plasma cells disseminate through multiple organs in patients with immune thrombocytopenic purpura.
Article in The Journal of clinical investigation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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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.
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Who cites it
19 citing papers in PubMed, 31 citations in OpenAlex.
- Low-dose oral nicotinamide mononucleotide for immune thrombocytopenia: a phase 1/2 trial.Nature medicine · 2026Trial
- Anti-CD38 monoclonal antibody CM313 for primary immune thrombocytopenia: multicentre, randomised, placebo controlled, phase 2 trial.BMJ (Clinical research ed.) · 2025Trial
- Quantitative and qualitative differences in anti-Envelope IgG-secreting cells distinguish subclinical and hospitalized dengue in a Cambodian pediatric cohort.PLoS pathogens · 2026Article
- Lymph node microenvironment remodeling unlocks local antibody-mediated B cell depletion.Science advances · 2026Article
- Daratumumab in patients with immune thrombocytopenia: a single-center, open-label, phase 2 trial.EClinicalMedicine · 2026Article
- Roads and detours for CAR T cell therapy in autoimmune diseases.Nature reviews. Drug discovery · 2026Review
- When the victim becomes the villain: Platelets as drivers of immune dysregulation in ITP.Journal of translational autoimmunity · 2025Review
- Review
- GPIbα CAAR T cells function like a Trojan horse to eliminate autoreactive B cells to treat immune thrombocytopenia.Haematologica · 2024Article
- Antigen-specific Fab profiling achieves molecular-resolution analysis of human autoantibody repertoires in rheumatoid arthritis.Nature communications · 2024Article
- The role of platelet desialylation as a biomarker in primary immune thrombocytopenia: mechanisms and therapeutic perspectives.Frontiers in immunology · 2024Review
- Deep learning enabled label-free microfluidic droplet classification for single cell functional assays.Frontiers in bioengineering and biotechnology · 2024Article
- Pathogenesis of refractory ITP: Overview.British journal of haematology · 2023Review
- Qualitative monitoring of SARS-CoV-2 mRNA vaccination in humans using droplet microfluidics.JCI insight · 2023Article
- Article
- Regulation of CD8 T cell by B-cells: A narrative review.Frontiers in immunology · 2023Review
- Rituximab resistance in ITP and beyond.Frontiers in immunology · 2023Review
- Antibodies as drugs-a Keystone Symposia report.Annals of the New York Academy of Sciences · 2023Article
- Aligning payer and provider strategies with the latest evidence to optimize clinical outcomes for patients with neuromyelitis optica spectrum disorder.Journal of managed care & specialty pharmacy · 2022Review
Corrections and comments
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Authors and funding
21 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The major therapeutic goal for immune thrombocytopenic purpura (ITP) is to restore normal platelet counts using drugs to promote platelet production or by interfering with mechanisms responsible for platelet destruction. Eighty percent of patients with ITP possess anti-integrin αIIbβ3 IgG autoantibodies that cause platelet opsonization and phagocytosis. The spleen is considered the primary site of autoantibody production by autoreactive B cells and platelet destruction. The immediate failure in approximately 50% of patients to recover a normal platelet count after anti-CD20 rituximab-mediated B cell depletion and splenectomy suggests that autoreactive, rituximab-resistant, IgG-secreting B cells (IgG-SCs) reside in other anatomical compartments. We analyzed more than 3,300 single IgG-SCs from spleen, bone marrow, and/or blood of 27 patients with ITP, revealing high interindividual variability in affinity for αIIbβ3, with variations over 3 logs. IgG-SC dissemination and range of affinities were, however, similar for each patient. Longitudinal analysis of autoreactive IgG-SCs upon treatment with the anti-CD38 mAb daratumumab demonstrated variable outcomes, from complete remission to failure with persistence of high-affinity anti-αIIbβ3 IgG-SCs in the bone marrow. This study demonstrates the existence and dissemination of high-affinity autoreactive plasma cells in multiple anatomical compartments of patients with ITP that may cause the failure of current therapies.
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Registered trials
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.