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<dc:title xml:lang="en">Immune mechanisms of platelet elimination in HLA Class I platelet transfusion refractoriness</dc:title>
<dcterms:alternative xml:lang="fr">Mécanismes immunitaires d’élimination des plaquettes sanguines lors d’un état réfractaire post-transfusionnel</dcterms:alternative>
<dc:subject xml:lang="fr">État réfractaire post-transfusionnel</dc:subject>
<dc:subject xml:lang="fr">Plaquettes</dc:subject>
<dc:subject xml:lang="fr">HLA de Classe I</dc:subject>
<dc:subject xml:lang="en">Platelet transfusion refractoriness</dc:subject>
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<tef:elementdEntree autoriteExterne="169447111" autoriteSource="Sudoc">Anticorps anti-HLA</tef:elementdEntree>
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<dcterms:abstract xml:lang="fr">La transfusion plaquettaire est vitale pour certains patients. Cependant, la présence d’IgG anti-HLA de classe I circulants chez un receveur peut entraîner une élimination trop rapide des plaquettes transfusées et conduire à une inefficacité thérapeutique appelée état réfractaire aux transfusions plaquettaires (ERTP). L'objectif de ce projet était d'étudier les mécanismes encore mal caractérisés par lesquels le système immunitaire élimine les plaquettes transfusées dans ce contexte. À l'aide d'un modèle murin, j'ai montré que les anticorps sont les médiateurs de l’ERTP. Cependant, l’élimination des plaquettes n’a pu être attribué à un seul mécanisme dépendant des anticorps. Les cellules de Kupffer du foie et les macrophages de la pulpe rouge de la rate ont été identifiés comme les sites d'élimination des plaquettes. Leur déplétion empêche l’élimination des plaquettes transfusées malgré la présence d’allo-anticorps. Ces travaux ouvrent la voie à un nouveau domaine de recherche axé sur les macrophages et l’élimination des plaquettes ainsi qu’à l’exploration de nouvelles thérapies.</dcterms:abstract>
<dcterms:abstract xml:lang="en">Platelet transfusion is vital for certain patients. The presence of circulating anti-HLA class I IgG in the recipients can result in a fast elimination of transfused platelets, leading to a platelet transfusion refractoriness (PTR), a therapeutic failure. The aim of this project was to investigate the mechanisms by which the immune system eliminates platelets in this context, since they remain poorly characterized. Using a murine model, I determined that antibodies mediate PTR. However, not a single antibody-dependent mechanism could be attributed to platelet clearance. Kupffer cells in the liver and splenic red pulp macrophages were identified as the elimination sites of platelets. Depletion of these macrophage populations avoided platelet elimination despite the present alloantibodies. This work opens the path to a novel domain of research on macrophages and platelet elimination, as well as the exploration of new therapies.</dcterms:abstract>
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