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Helicobacter pylori and Idiopathic Thrombocytopenic Purpura
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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.
Francesco Franceschi, MD
Catholic University of Rome; 00168 Rome, Italy
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
