Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Between Bedside and Bench
  • Published:

Boosting platelet production

Nature Medicine volume 14, pages 917–918 (2008)Cite this article

Few clinical situations generate as much anxiety amongst physicians and surgeons as uncontrolled bleeding, particularly in patients with platelet abnormalities, such as reduced platelet number (thrombocytopenia). One of the most common causes of thrombocytopenia, immune thrombocytopenic purpura (ITP), can cause a severe reduction in the circulating platelet count, with a subset of affected individuals not responding satisfactorily to medical therapy—a precarious situation that predisposes them to life-threatening bleeding complications, including intracranial hemorrhage.

The long-held view that ITP is predominantly caused by the peripheral clearance of platelets was based on the classic studies performed by Harrington and his colleagues4 in 1951. They showed that plasma or whole blood from individuals with ITP induced rapid thrombocytopenia in healthy volunteers4, and fractionation experiments located the factor to the globulin compartment of plasma. Radiolabeled platelet survival studies cemented the dogma that ITP was primarily due to increased platelet removal by the spleen. Consistent with this idea, platelet transfusion, commonly used in the management of thrombocytopenic disorders, is of limited value in the treatment of ITP, owing to the rapid clearance of infused platelets.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Outwitting autoantibodies in ITP.

Katie Vicari

References

  1. Feudjo-Tepie, M.A. et al. J. Thromb. Haemost. 6, 711–712 (2008).

    Article  CAS  Google Scholar 

  2. Bussel, J.B. et al. N. Engl. J. Med. 357, 2237–2247 (2007).

    Article  CAS  Google Scholar 

  3. Kuter, D.J. et al. Lancet 371, 395–403 (2008).

    Article  CAS  Google Scholar 

  4. Harrington, W.J. et al. J. Lab. Clin. Med. 38, 1–10 (1951).

    CAS  PubMed  Google Scholar 

  5. Kojouri, K. et al. Blood 104, 2623–2634 (2004).

    Article  CAS  Google Scholar 

  6. Ballem, P.J. et al. J. Clin. Invest. 80, 33–40 (1987).

    Article  CAS  Google Scholar 

  7. Pisciotta, A.V., Stefanini, M. & Dameshek, W. Blood 8, 703–723 (1953).

    CAS  PubMed  Google Scholar 

  8. Chang, M. et al. Blood 102, 887–895 (2003).

    Article  CAS  Google Scholar 

  9. Kosugi, S. et al. Br. J. Haematol. 93, 704–706 (1996).

    Article  CAS  Google Scholar 

  10. Li, J. et al. Blood 98, 3241–3248 (2001).

    Article  CAS  Google Scholar 

  11. Gurney, A.L. et al. Science 265, 1445–1447 (1994).

    Article  CAS  Google Scholar 

  12. Bussel, J.B. et al. N. Engl. J. Med. 355, 1672–1681 (2006).

    Article  CAS  Google Scholar 

  13. McHutchinson, J.G. et al. N. Engl. J. Med. 357, 2227–2236 (2007).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Andrew Wei and Shaun P. Jackson are at the Australian Centre for Blood Diseases, Monash University, Alfred Medical Research and Education Precinct, 89 Commercial Road, Melbourne, Victoria 3004, Australia. Shaun.Jackson@med.monash.edu.au,

    Andrew Wei & Shaun P Jackson

Authors
  1. Andrew Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shaun P Jackson
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wei, A., Jackson, S. Boosting platelet production. Nat Med 14, 917–918 (2008). https://doi.org/10.1038/nm0908-917

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nm0908-917

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing