Drug-dependent clearance of human platelets in the NOD/scid mouse by antibodies from patients with drug-induced immune thrombocytopenia

Blood. 2010 Oct 21;116(16):3033-8. doi: 10.1182/blood-2010-03-277764. Epub 2010 Jun 29.

Abstract

Drug-induced immune thrombocytopenia (DITP) is a relatively common and sometimes life-threatening condition caused by antibodies that bind avidly to platelets only when drug is present. How drug-dependent antibodies (DDAbs) are induced and how drugs promote their interaction with platelets are poorly understood, and methods for detecting DDAbs are suboptimal. A small animal model of DITP could provide a new tool for addressing these and other questions concerning pathogenesis and diagnosis. We examined whether the nonobese diabetic/severe combined immunodeficient (NOD/scid) mouse, which lacks xenoantibodies and therefore allows infused human platelets to circulate, can be used to study drug-dependent clearance of platelets by DDAbs in vivo. In this report, we show that the NOD/scid model is suitable for this purpose and describe studies to optimize its sensitivity for drug-dependent human antibody detection. We further show that the mouse can produce metabolites of acetaminophen and naproxen for which certain drug-dependent antibodies are specific in quantities sufficient to enable these antibodies to cause platelet destruction. The findings indicate that the NOD/scid mouse can provide a unique tool for studying DITP pathogenesis and may be particularly valuable for identifying metabolite-specific antibodies capable of causing immune thrombocytopenia or hemolytic anemia.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Non-Narcotic / immunology
  • Animals
  • Anti-Infective Agents / immunology
  • Antibodies / adverse effects*
  • Antibodies / immunology
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / immunology
  • Blood Platelets / immunology*
  • Cell Survival
  • Disease Models, Animal
  • Humans
  • Mice
  • Mice, SCID
  • Quinine / immunology
  • Sulfamethoxazole / immunology
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / immunology*

Substances

  • Analgesics, Non-Narcotic
  • Anti-Infective Agents
  • Antibodies
  • Antibodies, Monoclonal
  • Quinine
  • Sulfamethoxazole