Role of complement in patients with autoimmune hemolytic anemia and platelet transfusion refractoriness

Transfus Clin Biol. 2019 Sep;26(3):152-154. doi: 10.1016/j.tracli.2019.06.232. Epub 2019 Jun 19.

Abstract

The complement is a key player of the innate immune response. It provides defense mechanisms that are not specific, but very efficient at neutralizing any invader, accounting for 4% of the proteins in the peripheral blood. Nevertheless, there is a dark side to the complement system, as it may activate its machinery against healthy cells such as peripheral blood red blood cells and platelets resulting in undesired hemolysis and thrombocytopenia, respectively. Understanding and identifying the role of complement in these settings allow physicians to adjust their diagnostic and therapeutic modalities accordingly. The role of complement in the pathophysiology and management of autoimmune hemolytic anemia and of alloimmune-mediated thrombocytopenia is under investigation and discussed.

Keywords: Auto-immune; Autoimmune; Complement; Complément; Hemolysis; Hémolyse; Platelet transfusion refractoriness; Thrombopénie réfractaire.

Publication types

  • Review

MeSH terms

  • Anemia, Hemolytic, Autoimmune / immunology*
  • Anemia, Hemolytic, Autoimmune / therapy
  • Antibody Specificity
  • Antigens, Human Platelet / immunology
  • Antilymphocyte Serum / blood
  • Antilymphocyte Serum / immunology
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Complement System Proteins / immunology*
  • Humans
  • Immunity, Innate / immunology*
  • Immunoglobulin G / immunology
  • Immunoglobulin M / immunology
  • Platelet Transfusion*

Substances

  • Antigens, Human Platelet
  • Antilymphocyte Serum
  • Autoantibodies
  • Immunoglobulin G
  • Immunoglobulin M
  • Complement System Proteins