CD8+ T cells medicates antibody-indenpendent platelet clearance in mice.pdf

Brief Report TRANSFUSION MEDICINE CD81 T cells mediate antibody-independent platelet clearance in mice Connie M. Arthur,1 Seema R. Patel,1 H. Cliff Sullivan,1 Annie M. Winkler,1 Chris A. Tormey,2 Jeanne E. Hendrickson,2 and Sean R. Stowell1 1Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA; and 2Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT Key Points ? Previous studies suggest that immune-mediated platelet clearance following transfusion represents an antibody-mediated process. ? The results of this study demonstrate that CD81 T cells can mediate platelet clearance independent of anti-platelet alloantibodies. Platelet transfusion provides an important therapeutic intervention in the treatment and prevention of bleeding. However, some patients rapidly clear transfused platelets, preventing thedesired therapeuticoutcome.Althoughplatelet clearancecanoccur through a variety of mechanisms, immune-mediated platelet removal often plays a significant role. Numerousstudiesdemonstrate thatanti-plateletalloantibodiescaninducesignificantplatelet clearance following transfusion. In fact, for nearly 50 years, anti-platelet alloantibodies were considered to be the sole mediator of immune-mediated platelet clearance in platelet- refractory individuals. Although nonimmune mechanisms of platelet clearance can often explain platelet removal in the absence of anti-platelet alloantibodies, many patients experience platelet clearance following transfusion in the absence of a clear mechanism. These results suggest that other processes of antibody-independent platelet clearancemay occur. Our studies demonstrate that CD81 T cells possess the unique ability to induce platelet clearance in the complete absence of anti- platelet alloantibodies. These results suggest a previously unrecognized form of immune-mediated platelet clearance with significant