Immunological platelet transfusion refractoriness: current insights from mechanisms to therapeutics

Although there have been tremendous improvements in the production and storage of platelets, platelet transfusion refractoriness (PTR) remains a serious clinical issue that may lead to various severe adverse events. The burden of supplying platelets is worsened by rising market demand and limited do...

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Main Authors: Xiaoyu Chen, Yuhong Zhao, Yan Lv, Jue Xie
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Platelets
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/09537104.2024.2306983
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author Xiaoyu Chen
Yuhong Zhao
Yan Lv
Jue Xie
author_facet Xiaoyu Chen
Yuhong Zhao
Yan Lv
Jue Xie
author_sort Xiaoyu Chen
collection DOAJ
description Although there have been tremendous improvements in the production and storage of platelets, platelet transfusion refractoriness (PTR) remains a serious clinical issue that may lead to various severe adverse events. The burden of supplying platelets is worsened by rising market demand and limited donor pools of compatible platelets. Antibodies against platelet antigens are known to activate platelets through FcγR-dependent or complement-activated channels, thereby rapidly eliminating foreign platelets. Recently, other mechanisms of platelet clearance have been reported. The current treatment strategy for PTR is to select appropriate and compatible platelets; however, this necessitates a sizable donor pool and technical assistance for costly testing. Consolidation of these mechanisms should be of critical significance in providing insight to establish novel therapeutics to target immunological platelet refractoriness. Therefore, the purposes of this review were to explore the modulation of the immune system over the activation and elimination of allogeneic platelets and to summarize the development of alternative approaches for treating and avoiding alloimmunization to human leukocyte antigen or human platelet antigen in PTR.
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series Platelets
spelling doaj-art-fbcfcf7f577647d8b40e29f14f5ca3552025-08-20T02:12:19ZengTaylor & Francis GroupPlatelets0953-71041369-16352024-12-0135110.1080/09537104.2024.2306983Immunological platelet transfusion refractoriness: current insights from mechanisms to therapeuticsXiaoyu Chen0Yuhong Zhao1Yan Lv2Jue Xie3Department of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Blood Transfusion, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaAlthough there have been tremendous improvements in the production and storage of platelets, platelet transfusion refractoriness (PTR) remains a serious clinical issue that may lead to various severe adverse events. The burden of supplying platelets is worsened by rising market demand and limited donor pools of compatible platelets. Antibodies against platelet antigens are known to activate platelets through FcγR-dependent or complement-activated channels, thereby rapidly eliminating foreign platelets. Recently, other mechanisms of platelet clearance have been reported. The current treatment strategy for PTR is to select appropriate and compatible platelets; however, this necessitates a sizable donor pool and technical assistance for costly testing. Consolidation of these mechanisms should be of critical significance in providing insight to establish novel therapeutics to target immunological platelet refractoriness. Therefore, the purposes of this review were to explore the modulation of the immune system over the activation and elimination of allogeneic platelets and to summarize the development of alternative approaches for treating and avoiding alloimmunization to human leukocyte antigen or human platelet antigen in PTR.https://www.tandfonline.com/doi/10.1080/09537104.2024.2306983AntibodiesCD8+ T cellsHLAHPAplatelet transfusion refractorinesstherapeutics
spellingShingle Xiaoyu Chen
Yuhong Zhao
Yan Lv
Jue Xie
Immunological platelet transfusion refractoriness: current insights from mechanisms to therapeutics
Platelets
Antibodies
CD8+ T cells
HLA
HPA
platelet transfusion refractoriness
therapeutics
title Immunological platelet transfusion refractoriness: current insights from mechanisms to therapeutics
title_full Immunological platelet transfusion refractoriness: current insights from mechanisms to therapeutics
title_fullStr Immunological platelet transfusion refractoriness: current insights from mechanisms to therapeutics
title_full_unstemmed Immunological platelet transfusion refractoriness: current insights from mechanisms to therapeutics
title_short Immunological platelet transfusion refractoriness: current insights from mechanisms to therapeutics
title_sort immunological platelet transfusion refractoriness current insights from mechanisms to therapeutics
topic Antibodies
CD8+ T cells
HLA
HPA
platelet transfusion refractoriness
therapeutics
url https://www.tandfonline.com/doi/10.1080/09537104.2024.2306983
work_keys_str_mv AT xiaoyuchen immunologicalplatelettransfusionrefractorinesscurrentinsightsfrommechanismstotherapeutics
AT yuhongzhao immunologicalplatelettransfusionrefractorinesscurrentinsightsfrommechanismstotherapeutics
AT yanlv immunologicalplatelettransfusionrefractorinesscurrentinsightsfrommechanismstotherapeutics
AT juexie immunologicalplatelettransfusionrefractorinesscurrentinsightsfrommechanismstotherapeutics