PMID- 16861345
OWN - NLM
STAT- MEDLINE
DCOM- 20061005
LR  - 20210206
IS  - 0006-4971 (Print)
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Linking)
VI  - 108
IP  - 3
DP  - 2006 Aug 1
TI  - Patients with quinine-induced immune thrombocytopenia have both "drug-dependent" 
      and "drug-specific" antibodies.
PG  - 922-7
AB  - Immune thrombocytopenia induced by quinine and many other drugs is caused by 
      antibodies that bind to platelet membrane glycoproteins (GPs) only when the 
      sensitizing drug is present in soluble form. In this disorder, drug promotes 
      antibody binding to its target without linking covalently to either of the 
      reacting macro-molecules by a mechanism that has not yet been defined. How drug 
      provides the stimulus for production of such antibodies is also unknown. We 
      studied 7 patients who experienced severe thrombocytopenia after ingestion of 
      quinine. As expected, drug-dependent, platelet-reactive antibodies specific for 
      GPIIb/IIIa or GPIb/IX were identified in each case. Unexpectedly, each of 6 
      patients with GPIIb/IIIa-specific antibodies was found to have a second antibody 
      specific for drug alone that was not platelet reactive. Despite recognizing 
      different targets, the 2 types of antibody were identical in requiring quinine or 
      desmethoxy-quinine (cinchonidine) for reactivity and in failing to react with 
      other structural analogues of quinine. On the basis of these findings and 
      previous observations, a model is proposed to explain drug-dependent binding of 
      antibodies to cellular targets. In addition to having implications for 
      pathogenesis, drug-specific antibodies may provide a surrogate measure of drug 
      sensitivity in patients with drug-induced immune cytopenia.
FAU - Bougie, Daniel W
AU  - Bougie DW
AD  - Blood Research Institute, BloodCenter of Wisconsin, Milwaukee, USA. 
      dan.bougie@bcw.edu
FAU - Wilker, Peter R
AU  - Wilker PR
FAU - Aster, Richard H
AU  - Aster RH
LA  - eng
GR  - R01 HL013629/HL/NHLBI NIH HHS/United States
GR  - HL-13629/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Antibodies)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (Platelet Glycoprotein GPIb-IX Complex)
RN  - 0 (Platelet Membrane Glycoproteins)
RN  - 0 (glycoprotein receptor GPIb-IX)
RN  - A7V27PHC7A (Quinine)
SB  - IM
MH  - Antibodies/*blood
MH  - Humans
MH  - Immunoassay
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/immunology
MH  - Platelet Glycoprotein GPIb-IX Complex/immunology
MH  - Platelet Membrane Glycoproteins/immunology
MH  - Quinine/*adverse effects/analogs & derivatives/*immunology
MH  - Thrombocytopenia/*chemically induced/immunology
PMC - PMC1895854
EDAT- 2006/07/25 09:00
MHDA- 2006/10/06 09:00
PMCR- 2007/08/01
CRDT- 2006/07/25 09:00
PHST- 2006/07/25 09:00 [pubmed]
PHST- 2006/10/06 09:00 [medline]
PHST- 2006/07/25 09:00 [entrez]
PHST- 2007/08/01 00:00 [pmc-release]
AID - S0006-4971(20)52744-4 [pii]
AID - 0922 [pii]
AID - 10.1182/blood-2006-01-009803 [doi]
PST - ppublish
SO  - Blood. 2006 Aug 1;108(3):922-7. doi: 10.1182/blood-2006-01-009803.