Antibody-independent thrombocytopenia in lactate dehydrogenase-elevating virus-infected mice.

Previously we demonstrated that antibody-mediated thrombocytopenia is strongly enhanced by lactate dehydrogenase-elevating virus (LDV) infection. Here we report that mice infected with LDV develop a moderate thrombocytopenia, even in the absence of immunoglobulins or Fc receptors. A similar decrease of platelet counts was observed after mouse hepatitis virus infection. LDV-induced type I interferon-independent thrombocytopenia was partly suppressed by treatment with clodronate-containing liposomes. Therefore, we conclude that the thrombocytopenia results from increased phagocytosis of nonopsonized platelets by macrophages.

Two-step mechanism of virus-induced autoimmune hemolytic anemia.

Viruses are associated with the development of autoantibody-mediated blood autoimmune diseases. A two-step mechanism could explain virus involvement in the development of experimental hemolytic anemia. Immunization of normal mice with rat erythrocytes results in an autoantibody production that could be enhanced by viral infection, without erythrocyte destruction. Inoculation of the same virus when autoantibodies are at high levels triggers clinical anemia. This results from macrophage activation by gamma-interferon, leading to exacerbated erythrophagocytosis. Thus the development of anemia during the course of viral infection may require two independent stimuli, in which the first triggers autoantibody production and the second enhances the pathogenicity of these autoantibodies.

Enhancement of autoantibody pathogenicity by viral infections in mouse models of anemia and thrombocytopenia.

Viral infections are involved in the pathogenesis of blood autoimmune diseases such as hemolytic anemia and thrombocytopenia. Although antigenic mimicry has been proposed as a major mechanism by which viruses could trigger the development of such diseases, it is not easy to understand how widely different viruses might induce these blood autoimmune diseases by this sole mechanism. In mice infected with lactate dehydrogenase-elevating virus (LDV), or mouse hepatitis virus, and treated with anti-erythrocyte or anti-platelet monoclonal autoantibodies at a dose insufficient to induce clinical disease by themselves, the infection sharply enhances the pathogenicity of autoantibodies, leading to severe anemia or thrombocytopenia. This effect is observed only with antibodies that induce disease through phagocytosis. Moreover, the phagocytic activity of macrophages from infected mice is increased and the enhancing effect of infection on autoantibody-mediated pathogenicity is strongly suppressed by treatment of mice with clodronate-containing liposomes. Finally, the disease induced by LDV after administration of autoantibodies is largely suppressed in animals deficient for gamma-interferon receptor. Together, these observations suggest that viruses may trigger autoantibody-mediated anemia or thrombocytopenia by activating macrophages through gamma-interferon production, a mechanism that may account for the pathogenic similarities of multiple infectious agents.

Exacerbation of autoantibody-mediated thrombocytopenic purpura by infection with mouse viruses.

Antigenic mimicry has been proposed as a major mechanism by which viruses could trigger the development of immune thrombocytopenic purpura (ITP). However, because antigenic mimicry implies epitope similarities between viral and self antigens, it is difficult to understand how widely different viruses can be involved by this sole mechanism in the pathogenesis of ITP. Here, we report that in mice treated with antiplatelet antibodies at a dose insufficient to induce clinical disease by themselves, infection with lactate dehydrogenase-elevating virus (LDV) was followed by severe thrombocytopenia and by the appearance of petechiae similar to those observed in patients with ITP. A similar exacerbation of antiplatelet-mediated thrombocytopenia was induced by mouse hepatitis virus. This enhancement of antiplatelet antibody pathogenicity by LDV was not observed with F(ab')2 fragments, suggesting that phagocytosis was involved in platelet destruction. Treatment of mice with clodronate-containing liposomes and with total immunoglobulin G (IgG) indicated that platelets were cleared by macrophages. The increase of thrombocytopenia triggered by LDV after administration of antiplatelet antibodies was largely suppressed in animals deficient for gamma-interferon receptor. Together, these results suggest that viruses may exacerbate autoantibody-mediated ITP by activating macrophages through gamma-interferon production, a mechanism that may account for the pathogenic similarities of multiple infectious agents.

New model of transient strain-dependent autoimmune thrombocytopenia in mice immunized with rat platelets.

OBJECTIVE: The aim of this study was to develop a new experimental model of antiplatelet autoimmune disease in the mouse. MATERIALS AND METHODS: Mice were immunized with rat platelets. Anti-mouse platelet autoantibody responses were analyzed by enzyme-linked immunosorbent assay, Western blots, and flow cytometry. RESULTS: Immunization of CBA/Ht mice with rat platelets was followed by a transient thrombocytopenia. Platelets were opsonized by autoantibodies that recognized both rat and mouse normal platelets and (then) destroyed by phagocytosis. Absorption experiments indicated that these autoantibodies reacted with epitope(s) shared by rat and mouse platelets. In contrast, BALB/C mice similarly immunized with rat platelets did not develop thrombocytopenia. The ability of BALB/C mice to produce anti-rat platelet antibodies and to eliminate antibody-coated platelets was comparable with that of CBA/Ht animals. However, the specificity of the antibody response elicited in these two mouse strains differed markedly, with a 145- to 155-kDa mouse platelet antigen corresponding to platelet glycoprotein Ib recognized in CBA/Ht, but not in BALB/C, animals. CONCLUSION: This immunization protocol may serve as a model of antiplatelet autoimmune response, especially of posttransfusion purpura.