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REPLY
Helicobacter pylori and Idiopathic Thrombocytopenic Purpura
Francesco Franceschi, MD
16 November 2004 | Volume 141 Issue 10 | Page 820
IN RESPONSE:
In our previous study (1), in 1998, we described improved platelet count in patients with ITP after the eradication of H. pylori infection. A few months later, we investigated the prevalence of CagA-positive strains of H. pylori in the same patients and found that all patients were infected by those strains (2). None of the patients received steroids after eradication of H. pylori infection in 1998 because they maintained high platelet levels.
We used the Dixon test in our previous study (1), and the disappearance of the antiplatelet antibodies was related to the negative results of this test after H. pylori eradication. However, because the Dixon test is unreliable, we also investigated the presence of anti–glycoprotein IIb/IIIa antibodies, which remained unchanged after eradication of H. pylori. The platelet lysates from patients and controls were prepared by following the procedure described in the letter, using fresh platelets.
All of our controls were H. pylori–negative. Of interest, only 1 control showed the 55-kDa band in the platelet lysate, a finding that has been confirmed in all of our experiments. As reported, we also evaluated smooth-muscle cells and normal artery lysates as controls and did not find the 50-kDa or 55-kDa band after blotting with anti-CagA antibodies, a finding consistent with these bands being specific for platelets. Finally, we agree that further studies should specifically try to determine whether these platelet antigens are native to the general population or are specifically expressed in ITP platelets.
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Author and Article Information
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From Catholic University of Rome, 00168 Rome, Italy.
1. Gasbarrini A, Franceschi F, Tartaglione R, Landolfi R, Pola P, Gasbarrini G. Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori [Letter]. Lancet. 1998;352:878 [PMID: 9742983].[Medline]
2. Franceschi F, Gasbarrini A, Tartaglione R, Sanz Totte E, Ojetti V, Candelli M, et al. Healing of autoimmune thrombocytopenia after H. pylori eradication: 1 year of follow up [Abstract]. Gastroenterology. 1999;116:713.
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