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Vial G, Rivière E, Raymond AA, James C, Di-Tommaso S, Dugot-Senant N, Dupuy JW, Yacoub M, Parrens M, Saltel F, Viallard JF. Antigenic Mimicry in Paraneoplastic Immune Thrombocytopenia. Front Immunol 2019; 10:523. [PMID: 30967864 PMCID: PMC6439352 DOI: 10.3389/fimmu.2019.00523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/26/2019] [Indexed: 01/25/2023] Open
Abstract
The association of immune thrombocytopenia (ITP) with cancer has been reported, but the causality of tumor cells in paraneoplastic ITP pathogenesis and maintenance has never been established. We analyzed the unusual case of refractory ITP and coincident urothelial tumor of the kidney with circulating high titer anti-GPIIBIIIA autoantibodies. Intriguingly, after nephrectomy, the patient recovered fully and her anti-GPIIBIIIA autoantibodies disappeared. Proteomic and immunohistochemistry analyses revealed erratic GPIIB expression by the tumor cells, suggesting possible antigenic mimicry chronically stimulating the immune system and leading to this patient's refractory ITP. Such previously unreported findings provide proof-of-concept that requires further confirmation with the prospective study of a larger number of patients.
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Affiliation(s)
- Guillaume Vial
- Internal Medicine and Infectious Diseases Department, Haut Lévêque Hospital, University Hospital Centre of Bordeaux, Pessac, France
| | - Etienne Rivière
- Internal Medicine and Infectious Diseases Department, Haut Lévêque Hospital, University Hospital Centre of Bordeaux, Pessac, France.,INSERM, Biology of Cardiovascular Diseases, U1034, Pessac, France.,Biology of Cardiovascular Diseases, U1034, University of Bordeaux, Pessac, France
| | | | - Chloé James
- INSERM, Biology of Cardiovascular Diseases, U1034, Pessac, France.,Biology of Cardiovascular Diseases, U1034, University of Bordeaux, Pessac, France.,Laboratory of Hematology, University Hospital Centre of Bordeaux, Pessac, France
| | | | | | - Jean-William Dupuy
- Centre de Génomique Fonctionnelle, Plateforme Protéome, Université de Bordeaux, Bordeaux, France
| | - Mokrane Yacoub
- Pathology Department, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Marie Parrens
- Pathology Department, Haut Lévêque Hospital, University Hospital Centre of Bordeaux, Pessac, France
| | - Fréderic Saltel
- INSERM U1053, Oncoprot, Bordeaux University, Bordeaux, France
| | - Jean-François Viallard
- Internal Medicine and Infectious Diseases Department, Haut Lévêque Hospital, University Hospital Centre of Bordeaux, Pessac, France.,INSERM, Biology of Cardiovascular Diseases, U1034, Pessac, France.,Biology of Cardiovascular Diseases, U1034, University of Bordeaux, Pessac, France
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