儿童慢性血小板减少性紫癜的治疗进展(2)
2.6 抗CD40L抗体 (Antova) CD40 是一种表达于B 淋巴细胞膜上的糖蛋白在B 淋巴细胞的生长、发育以及分化等过程中都起着重要作用。而CD40 配体是一种表达在激活的T 淋巴细胞膜上的糖蛋白,在体液免疫中起了重要作用。Antova能够阻止CD154 结合CD40从而抑制B细胞分化和激活,减少自身抗体的产生而治疗ITP。ITP患者存在大量CD4+T细胞,CD40配体可介导活化T细胞依赖的B细胞扩增,所以抗CD40L抗体可能在CITP中具有治療作用,无明显毒副作用。
综上所述,儿童CITP的有效治疗方法有激素、IVIG、anti-D、脾脏切除及免疫抑制剂,免疫抑制剂等可作为新的治疗选择,但在儿童CITP中尚需要进一步循证治疗研究。
参考文献
[1] 中华医学会儿科学分会血液学组,《中华儿科杂志》编辑委员会.儿童原发性免疫性血小板减少症诊疗建议[J].中华儿科杂志,2013, 51(5): 382-384.
[2] Abdel-Hamid SM, Al-Lithy HN. B cell activating factor gene polymorphisms in patients with risk of idiopathic thrombocytopenic purpura[J].The American journal of the medical sciences, 2011,342(1): 9一14. ?
[3] Zilber R,Bortz AP,Yacobovich J,et al. Analysis of health-related quality of life in children with immune thrombocytopenia and their parents using the kids' ITP tools[J]. J Pediatr Hematology Oncology,2012,34(1):2-5.
[4] Klaassen RJ,Blanchette V,Burke TA,et al. Quality of life in childhood immune thrombocytopenia:international validation of the kids' ITP tools[J].Pediatr Blood Cancer,2013,60(1):95-100.
[5] Gudbrandsdottir S,Birgens HS,Frederiksen H,et al. Rituximab and dexamethasone vs dexamethasone monotherapy in newly diagnosed patients with primary immune thrombocytopenia[J].Blood,2013,121(11):1976-1981.
[6] Patel VL, Mahevas M, Lee SY, et al. Outcomes 5 years after response to rituximab therapy119(25):in children and adults with immune thrombocytopenia[J].Blood, 2012:5989-5995.
[7] Choudhary DR, Naithani R, Mahapatra M, et al. Efficacy of cyclosporine as a Single agent therapy in chronic idiopathic thrombocytopenic purpura[J].31 Haematologica, 2008, 93(10): e61-e62.
[8] Gwilliam NR,Lazar DA,Brandt ML,et al.An analysis of out-comes and treatment costs for children undergoing splenectomy for chronic immune thrombocytopenia purpura[J].J Pediatr Surg,2012,47(8):1537-1541., http://www.100md.com(杨青 宋春艳 李娜)
综上所述,儿童CITP的有效治疗方法有激素、IVIG、anti-D、脾脏切除及免疫抑制剂,免疫抑制剂等可作为新的治疗选择,但在儿童CITP中尚需要进一步循证治疗研究。
参考文献
[1] 中华医学会儿科学分会血液学组,《中华儿科杂志》编辑委员会.儿童原发性免疫性血小板减少症诊疗建议[J].中华儿科杂志,2013, 51(5): 382-384.
[2] Abdel-Hamid SM, Al-Lithy HN. B cell activating factor gene polymorphisms in patients with risk of idiopathic thrombocytopenic purpura[J].The American journal of the medical sciences, 2011,342(1): 9一14. ?
[3] Zilber R,Bortz AP,Yacobovich J,et al. Analysis of health-related quality of life in children with immune thrombocytopenia and their parents using the kids' ITP tools[J]. J Pediatr Hematology Oncology,2012,34(1):2-5.
[4] Klaassen RJ,Blanchette V,Burke TA,et al. Quality of life in childhood immune thrombocytopenia:international validation of the kids' ITP tools[J].Pediatr Blood Cancer,2013,60(1):95-100.
[5] Gudbrandsdottir S,Birgens HS,Frederiksen H,et al. Rituximab and dexamethasone vs dexamethasone monotherapy in newly diagnosed patients with primary immune thrombocytopenia[J].Blood,2013,121(11):1976-1981.
[6] Patel VL, Mahevas M, Lee SY, et al. Outcomes 5 years after response to rituximab therapy119(25):in children and adults with immune thrombocytopenia[J].Blood, 2012:5989-5995.
[7] Choudhary DR, Naithani R, Mahapatra M, et al. Efficacy of cyclosporine as a Single agent therapy in chronic idiopathic thrombocytopenic purpura[J].31 Haematologica, 2008, 93(10): e61-e62.
[8] Gwilliam NR,Lazar DA,Brandt ML,et al.An analysis of out-comes and treatment costs for children undergoing splenectomy for chronic immune thrombocytopenia purpura[J].J Pediatr Surg,2012,47(8):1537-1541., http://www.100md.com(杨青 宋春艳 李娜)