{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:23:08Z","timestamp":1793330588867,"version":"4.5.0"},"reference-count":108,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["jthjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Thrombosis and Haemostasis"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.jtha.2026.01.011","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T17:15:08Z","timestamp":1770657308000},"page":"1949-1963","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"title":["Immunopathology of immune thrombocytopenia"],"prefix":"10.1016","volume":"24","author":[{"given":"Kirsty","family":"Hillier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor Olmsted","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9412-333X","authenticated-orcid":false,"given":"Thomas","family":"Pincez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jtha.2026.01.011_bib1","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1182\/blood-2008-07-162503","article-title":"Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group","volume":"113","author":"Rodeghiero","year":"2009","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib2","doi-asserted-by":"crossref","first-page":"6511","DOI":"10.1182\/blood-2009-01-129155","article-title":"The ITP syndrome: pathogenic and clinical diversity","volume":"113","author":"Cines","year":"2009","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib3","article-title":"Gut microbiome alterations in immune thrombocytopenia: a systematic review of current evidence","volume":"12","author":"Khiabani","year":"2025","journal-title":"Front Med (Lausanne)"},{"key":"10.1016\/j.jtha.2026.01.011_bib4","doi-asserted-by":"crossref","DOI":"10.1016\/j.autrev.2024.103677","article-title":"Autoimmune effector mechanisms associated with a defective immunosuppressive axis in immune thrombocytopenia (ITP)","volume":"23","author":"Li","year":"2024","journal-title":"Autoimmun Rev"},{"key":"10.1016\/j.jtha.2026.01.011_bib5","doi-asserted-by":"crossref","DOI":"10.1016\/j.blre.2024.101222","article-title":"Immune thrombocytopenia: pathophysiology and impacts of romiplostim treatment","volume":"67","author":"Semple","year":"2024","journal-title":"Blood Rev"},{"key":"10.1016\/j.jtha.2026.01.011_bib6","doi-asserted-by":"crossref","DOI":"10.1016\/j.blre.2023.101141","article-title":"The many facets of immune-mediated thrombocytopenia: principles of immunobiology and immunotherapy","volume":"63","author":"Moulinet","year":"2024","journal-title":"Blood Rev"},{"key":"10.1016\/j.jtha.2026.01.011_bib7","first-page":"1","article-title":"Demonstration of a thrombocytopenic factor in the blood of patients with thrombocytopenic purpura","volume":"38","author":"Harrington","year":"1951","journal-title":"J Lab Clin Med"},{"key":"10.1016\/j.jtha.2026.01.011_bib8","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/j.1749-6632.1965.tb18984.x","article-title":"Similarities between known antiplatelet antibodies and the factor responsible for thrombocytopenia in idiopathic purpura. Physiologic, serologic and isotopic studies","volume":"124","author":"Shulman","year":"1965","journal-title":"Ann N Y Acad Sci"},{"key":"10.1016\/j.jtha.2026.01.011_bib9","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S0037-1963(00)90102-1","article-title":"Autoantibodies and autoantigens in chronic immune thrombocytopenic purpura","volume":"37","author":"McMillan","year":"2000","journal-title":"Semin Hematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib10","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1182\/blood.V59.1.23.23","article-title":"Specificity of autoantibodies in autoimmune thrombocytopenia","volume":"59","author":"van Leeuwen","year":"1982","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib11","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1182\/blood.V70.4.1040.1040","article-title":"Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP","volume":"70","author":"McMillan","year":"1987","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib12","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1182\/blood.V70.6.1722.1722","article-title":"Monoclonal antibody\u2013specific immobilization of platelet antigens (MAIPA): a new tool for the identification of platelet-reactive antibodies","volume":"70","author":"Kiefel","year":"1987","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib13","doi-asserted-by":"crossref","first-page":"7737","DOI":"10.1038\/ncomms8737","article-title":"Desialylation is a mechanism of Fc-independent platelet clearance and a therapeutic target in immune thrombocytopenia","volume":"6","author":"Li","year":"2015","journal-title":"Nat Commun"},{"key":"10.1016\/j.jtha.2026.01.011_bib14","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/bjh.15404","article-title":"Detection of platelet autoantibodies to identify immune thrombocytopenia: state of the art","volume":"182","author":"Porcelijn","year":"2018","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib15","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1182\/blood.V83.4.1024.1024","article-title":"Spectrum of Ig classes, specificities, and titers of serum antiglycoproteins in chronic idiopathic thrombocytopenic purpura","volume":"83","author":"He","year":"1994","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib16","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1001\/jama.1978.03280500056020","article-title":"Antibody against megakaryocytes in idiopathic thrombocytopenic purpura","volume":"239","author":"McMillan","year":"1978","journal-title":"JAMA"},{"key":"10.1016\/j.jtha.2026.01.011_bib17","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1182\/blood-2003-08-2672","article-title":"Suppression of in vitro megakaryocyte production by antiplatelet autoantibodies from adult patients with chronic ITP","volume":"103","author":"McMillan","year":"2004","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib18","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1172\/JCI113060","article-title":"Mechanisms of thrombocytopenia in chronic autoimmune thrombocytopenic purpura. Evidence of both impaired platelet production and increased platelet clearance","volume":"80","author":"Ballem","year":"1987","journal-title":"J Clin Invest"},{"key":"10.1016\/j.jtha.2026.01.011_bib19","doi-asserted-by":"crossref","first-page":"623","DOI":"10.3324\/haematol.2014.115634","article-title":"Immune thrombocytopenia: antiplatelet autoantibodies inhibit proplatelet formation by megakaryocytes and impair platelet production in vitro","volume":"100","author":"Iraqi","year":"2015","journal-title":"Haematologica"},{"key":"10.1016\/j.jtha.2026.01.011_bib20","doi-asserted-by":"crossref","DOI":"10.1016\/j.ebiom.2022.103820","article-title":"Recent advances in the mechanisms and treatment of immune thrombocytopenia","volume":"76","author":"Provan","year":"2022","journal-title":"EBioMedicine"},{"key":"10.1016\/j.jtha.2026.01.011_bib21","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1002\/ajh.27448","article-title":"2025 update on clinical trials in immune thrombocytopenia","volume":"99","author":"Al-Samkari","year":"2024","journal-title":"Am J Hematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib22","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1038\/nm921","article-title":"T-cell-mediated cytotoxicity toward platelets in chronic idiopathic thrombocytopenic purpura","volume":"9","author":"Olsson","year":"2003","journal-title":"Nat Med"},{"key":"10.1016\/j.jtha.2026.01.011_bib23","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1111\/j.1600-0609.2005.00622.x","article-title":"Cell-mediated lysis of autologous platelets in chronic idiopathic thrombocytopenic purpura","volume":"76","author":"Zhang","year":"2006","journal-title":"Eur J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib24","doi-asserted-by":"crossref","first-page":"916","DOI":"10.4049\/jimmunol.1200580","article-title":"Platelets present antigen in the context of MHC class I","volume":"189","author":"Chapman","year":"2012","journal-title":"J Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib25","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1182\/bloodadvances.2017007021","article-title":"Mature murine megakaryocytes present antigen-MHC class I molecules to T cells and transfer them to platelets","volume":"1","author":"Zufferey","year":"2017","journal-title":"Blood Adv"},{"key":"10.1016\/j.jtha.2026.01.011_bib26","first-page":"2417","article-title":"The role of CD8+ T-cell clones in immune thrombocytopenia","volume":"141","author":"Malik","year":"2023","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib27","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1080\/10245332.2016.1155347","article-title":"Lower expression of PD-1 and PD-L1 in peripheral blood from patients with chronic ITP","volume":"21","author":"Zhong","year":"2016","journal-title":"Hematology"},{"key":"10.1016\/j.jtha.2026.01.011_bib28","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1002\/ajh.2830370409","article-title":"Suppressed natural killer cell activity in patients with chronic autoimmune thrombocytopenic purpura","volume":"37","author":"Semple","year":"1991","journal-title":"Am J Hematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib29","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1182\/blood.V82.5.1538.1538","article-title":"Severe chronic autoimmune thrombocytopenic purpura is associated with an expansion of CD56+ CD3- natural killer cells subset","volume":"82","author":"Garcia-Suarez","year":"1993","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib30","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1182\/blood.V83.3.870.870","article-title":"Natural killer cell numbers and activity in patients with chronic autoimmune thrombocytopenic purpura","volume":"83","author":"Semple","year":"1994","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib31","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.hemonc.2017.01.001","article-title":"Study of CD4+, CD8+, and natural killer cells (CD16+, CD56+) in children with immune thrombocytopenic purpura","volume":"10","author":"El-Rashedi","year":"2017","journal-title":"Hematol Oncol Stem Cell Ther"},{"key":"10.1016\/j.jtha.2026.01.011_bib32","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/cei.12279","article-title":"Alterations in immune cell subsets and their cytokine secretion profile in childhood idiopathic thrombocytopenic purpura (ITP)","volume":"176","author":"Talaat","year":"2014","journal-title":"Clin Exp Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib33","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1182\/bloodadvances.2025017536","article-title":"Azathioprine or mycophenolate mofetil for pediatric autoimmune cytopenia: a propensity score-matched study","volume":"10","author":"Pincez","year":"2025","journal-title":"Blood Adv"},{"key":"10.1016\/j.jtha.2026.01.011_bib34","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1182\/blood.2020008477","article-title":"Low-dose decitabine modulates T-cell homeostasis and restores immune tolerance in immune thrombocytopenia","volume":"138","author":"Han","year":"2021","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib35","article-title":"Contributions of T lymphocyte abnormalities to therapeutic outcomes in newly diagnosed patients with immune thrombocytopenia","volume":"10","author":"Zhao","year":"2015","journal-title":"PLoS One"},{"key":"10.1016\/j.jtha.2026.01.011_bib36","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1046\/j.1365-2141.2003.04509.x","article-title":"The IgG subclasses of platelet-associated autoantibodies directed against platelet glycoproteins IIb\/IIIa in patients with idiopathic thrombocytopenic purpura","volume":"122","author":"Chan","year":"2003","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib37","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1182\/bloodadvances.2021006864","article-title":"Safety and efficacy of classical complement pathway inhibition with sutimlimab in chronic immune thrombocytopenia","volume":"7","author":"Broome","year":"2023","journal-title":"Blood Adv"},{"key":"10.1016\/j.jtha.2026.01.011_bib38","doi-asserted-by":"crossref","DOI":"10.1080\/09537104.2022.2159019","article-title":"Complement activation negatively affects the platelet response to thrombopoietin receptor agonists in patients with immune thrombocytopenia: a prospective cohort study","volume":"34","author":"Akesson","year":"2023","journal-title":"Platelets"},{"key":"10.1016\/j.jtha.2026.01.011_bib39","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1016\/j.addr.2011.05.010","article-title":"Advances in assay of complement function and activation","volume":"63","author":"Harboe","year":"2011","journal-title":"Adv Drug Deliv Rev"},{"key":"10.1016\/j.jtha.2026.01.011_bib40","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1080\/09537104.2016.1235686","article-title":"Antibodies against complement-regulatory proteins on platelets in immune thrombocytopenia","volume":"28","author":"Unterberger","year":"2017","journal-title":"Platelets"},{"key":"10.1016\/j.jtha.2026.01.011_bib41","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/09537100701777311","article-title":"Expression of complement components and inhibitors on platelet microparticles","volume":"19","author":"Yin","year":"2008","journal-title":"Platelets"},{"key":"10.1016\/j.jtha.2026.01.011_bib42","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1111\/cei.13475","article-title":"Complement activation in patients with immune thrombocytopenic purpura according to phases of disease course","volume":"201","author":"Castelli","year":"2020","journal-title":"Clin Exp Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib43","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1002\/rth2.12388","article-title":"Serum complement levels in immune thrombocytopenia: Characterization and relation to clinical features","volume":"4","author":"Cheloff","year":"2020","journal-title":"Res Pract Thromb Haemost"},{"key":"10.1016\/j.jtha.2026.01.011_bib44","first-page":"201","article-title":"Platelet associated immunoglobulins and complement in idiopathic thrombocytopenic purpura","volume":"53","author":"Winiarski","year":"1983","journal-title":"Clin Exp Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib45","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/nm.3770","article-title":"The Ashwell-Morell receptor regulates hepatic thrombopoietin production via JAK2-STAT3 signaling","volume":"21","author":"Grozovsky","year":"2015","journal-title":"Nat Med"},{"key":"10.1016\/j.jtha.2026.01.011_bib46","article-title":"The role of platelet desialylation as a biomarker in primary immune thrombocytopenia: mechanisms and therapeutic perspectives","volume":"15","author":"Zhang","year":"2024","journal-title":"Front Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib47","doi-asserted-by":"crossref","first-page":"4537","DOI":"10.1172\/JCI57850","article-title":"The maternal immune response to fetal platelet GPIbalpha causes frequent miscarriage in mice that can be prevented by intravenous IgG and anti-FcRn therapies","volume":"121","author":"Li","year":"2011","journal-title":"J Clin Invest"},{"key":"10.1016\/j.jtha.2026.01.011_bib48","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1182\/blood.2020008238","article-title":"Immune cells surveil aberrantly sialylated O-glycans on megakaryocytes to regulate platelet count","volume":"138","author":"Lee-Sundlov","year":"2021","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib49","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/fcp.12213","article-title":"Unexpected platelets elevation in a patient with idiopathic thrombocytopenia treated with oseltamivir for influenza infection","volume":"30","author":"Bigot","year":"2016","journal-title":"Fundam Clin Pharmacol"},{"key":"10.1016\/j.jtha.2026.01.011_bib50","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1007\/s11239-022-02651-3","article-title":"Oseltamivir as rescue therapy for persistent, chronic, or refractory immune thrombocytopenia: a case series and review of the literature","volume":"54","author":"Colunga-Pedraza","year":"2022","journal-title":"J Thromb Thrombolysis"},{"key":"10.1016\/j.jtha.2026.01.011_bib51","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1080\/09537104.2020.1714576","article-title":"Evaluating the effects of oseltamivir phosphate on platelet counts: a retrospective review","volume":"31","author":"Shaim","year":"2020","journal-title":"Platelets"},{"key":"10.1016\/j.jtha.2026.01.011_bib52","doi-asserted-by":"crossref","first-page":"e289","DOI":"10.1016\/S2352-3026(21)00030-2","article-title":"Dexamethasone plus oseltamivir versus dexamethasone in treatment-naive primary immune thrombocytopenia: a multicentre, randomised, open-label, phase 2 trial","volume":"8","author":"Sun","year":"2021","journal-title":"Lancet Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib53","doi-asserted-by":"crossref","first-page":"2948","DOI":"10.1021\/jm301892f","article-title":"Identification of selective inhibitors for human neuraminidase isoenzymes using C4,C7-modified 2-deoxy-2,3-didehydro-N-acetylneuraminic acid (DANA) analogues","volume":"56","author":"Zhang","year":"2013","journal-title":"J Med Chem"},{"issue":"Suppl 2","key":"10.1016\/j.jtha.2026.01.011_bib54","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1002\/stem.5530160719","article-title":"Endogenous TPO (eTPO) levels in health and disease: possible clues for therapeutic intervention","volume":"16","author":"Nichol","year":"1998","journal-title":"Stem Cells"},{"key":"10.1016\/j.jtha.2026.01.011_bib55","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/j.1365-2141.2009.07717.x","article-title":"Pathogenesis of chronic immune thrombocytopenia: increased platelet destruction and\/or decreased platelet production","volume":"146","author":"Nugent","year":"2009","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib56","doi-asserted-by":"crossref","first-page":"3235","DOI":"10.3390\/cells10113235","article-title":"Platelets in ITP: victims in charge of their own fate?","volume":"10","author":"Nelson","year":"2021","journal-title":"Cells"},{"key":"10.1016\/j.jtha.2026.01.011_bib57","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.tmrv.2020.09.005","article-title":"The immune nature of platelets revisited","volume":"34","author":"Maouia","year":"2020","journal-title":"Transfus Med Rev"},{"key":"10.1016\/j.jtha.2026.01.011_bib58","doi-asserted-by":"crossref","first-page":"4245","DOI":"10.1182\/blood.V87.10.4245.bloodjournal87104245","article-title":"Differences in serum cytokine levels in acute and chronic autoimmune thrombocytopenic purpura: relationship to platelet phenotype and antiplatelet T-cell reactivity","volume":"87","author":"Semple","year":"1996","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib59","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.3324\/haematol.2009.007823","article-title":"Elevated profile of Th17, Th1 and Tc1 cells in patients with immune thrombocytopenic purpura","volume":"94","author":"Zhang","year":"2009","journal-title":"Haematologica"},{"key":"10.1016\/j.jtha.2026.01.011_bib60","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.thromres.2006.09.008","article-title":"Reduced Cd4+Cd25+ T cells in patients with idiopathic thrombocytopenic purpura","volume":"120","author":"Sakakura","year":"2007","journal-title":"Thromb Res"},{"key":"10.1016\/j.jtha.2026.01.011_bib61","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1182\/blood-2007-12-129262","article-title":"Analysis of regulatory T-cell changes in patients with idiopathic thrombocytopenic purpura receiving B cell-depleting therapy with rituximab","volume":"112","author":"Stasi","year":"2008","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib62","doi-asserted-by":"crossref","DOI":"10.1155\/2012\/925135","article-title":"CD4(+)T cells: differentiation and functions","volume":"2012","author":"Luckheeram","year":"2012","journal-title":"Clin Dev Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib63","doi-asserted-by":"crossref","first-page":"2645","DOI":"10.1182\/blood-2003-07-2268","article-title":"Adult chronic idiopathic thrombocytopenic purpura (ITP) is the manifestation of a type-1 polarized immune response","volume":"103","author":"Panitsas","year":"2004","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib64","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1034\/j.1600-0609.2003.00138.x","article-title":"High Th1\/Th2 ratio in patients with chronic idiopathic thrombocytopenic purpura","volume":"71","author":"Ogawara","year":"2003","journal-title":"Eur J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib65","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1182\/blood.V78.10.2619.2619","article-title":"Increased antiplatelet T helper lymphocyte reactivity in patients with autoimmune thrombocytopenia","volume":"78","author":"Semple","year":"1991","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib66","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.imlet.2013.08.006","article-title":"Correction of abnormal T cell subsets by high-dose dexamethasone in patients with chronic idiopathic thrombocytopenic purpura","volume":"154","author":"Li","year":"2013","journal-title":"Immunol Lett"},{"key":"10.1016\/j.jtha.2026.01.011_bib67","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1182\/blood-2013-03-491415","article-title":"Preferential splenic CD8(+) T-cell activation in rituximab-nonresponder patients with immune thrombocytopenia","volume":"122","author":"Audia","year":"2013","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib68","first-page":"493","article-title":"Assessment of Th17\/Treg cells and Th cytokines in an improved immune thrombocytopenia mouse model","volume":"22","author":"Zhang","year":"2017","journal-title":"Hematology"},{"key":"10.1016\/j.jtha.2026.01.011_bib69","first-page":"85","article-title":"Alteration in frequency and function of CD4+CD25+FOXP3+ regulatory T cells in patients with immune thrombocytopenic purpura","volume":"13","author":"Arandi","year":"2014","journal-title":"Iran J Allergy Asthma Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib70","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1097\/MOH.0000000000000447","article-title":"Pathophysiology of immune thrombocytopenia","volume":"25","author":"Li","year":"2018","journal-title":"Curr Opin Hematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib71","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1111\/j.1600-0609.2006.00780.x","article-title":"Abnormality of CD4(+)CD25(+) regulatory T cells in idiopathic thrombocytopenic purpura","volume":"78","author":"Liu","year":"2007","journal-title":"Eur J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib72","doi-asserted-by":"crossref","first-page":"178","DOI":"10.3345\/kjp.2015.58.5.178","article-title":"Association of CD4(+)CD25(+)FoxP3(+) regulatory T cells with natural course of childhood chronic immune thrombocytopenic purpura","volume":"58","author":"Son","year":"2015","journal-title":"Korean J Pediatr"},{"key":"10.1016\/j.jtha.2026.01.011_bib73","doi-asserted-by":"crossref","first-page":"2858","DOI":"10.1182\/blood-2014-03-563445","article-title":"Splenic TFH expansion participates in B-cell differentiation and antiplatelet-antibody production during immune thrombocytopenia","volume":"124","author":"Audia","year":"2014","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib74","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1182\/blood-2008-01-135335","article-title":"Defective circulating CD25 regulatory T cells in patients with chronic immune thrombocytopenic purpura","volume":"112","author":"Yu","year":"2008","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib75","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1182\/blood-2012-02-413526","article-title":"Thymic retention of CD4+CD25+FoxP3+ T regulatory cells is associated with their peripheral deficiency and thrombocytopenia in a murine model of immune thrombocytopenia","volume":"120","author":"Aslam","year":"2012","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib76","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/j.1600-0609.2007.00917.x","article-title":"Circulating dendritic cells subsets and CD4+Foxp3+ regulatory T cells in adult patients with chronic ITP before and after treatment with high-dose dexamethasome","volume":"79","author":"Ling","year":"2007","journal-title":"Eur J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib77","doi-asserted-by":"crossref","first-page":"4639","DOI":"10.1182\/blood-2010-04-281717","article-title":"Improved regulatory T-cell activity in patients with chronic immune thrombocytopenia treated with thrombopoietic agents","volume":"116","author":"Bao","year":"2010","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib78","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.immuni.2009.11.009","article-title":"CD19(+)CD24(hi)CD38(hi) B cells exhibit regulatory capacity in healthy individuals but are functionally impaired in systemic lupus erythematosus patients","volume":"32","author":"Blair","year":"2010","journal-title":"Immunity"},{"key":"10.1016\/j.jtha.2026.01.011_bib79","doi-asserted-by":"crossref","first-page":"3318","DOI":"10.1182\/blood-2012-05-432575","article-title":"Defective regulatory B-cell compartment in patients with immune thrombocytopenia","volume":"120","author":"Li","year":"2012","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib80","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/bjh.13567","article-title":"Splenic lymphocyte subtypes in immune thrombocytopenia: increased presence of a subtype of B-regulatory cells","volume":"173","author":"Aslam","year":"2016","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib81","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/bjh.12480","article-title":"Cellular immune dysfunction in immune thrombocytopenia (ITP)","volume":"163","author":"McKenzie","year":"2013","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib82","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1080\/16078454.2019.1622292","article-title":"The imbalance between regulatory memory B cells reveals possible pathogenesis involvement in pediatric immune thrombocytopenia","volume":"24","author":"Fang","year":"2019","journal-title":"Hematology"},{"key":"10.1016\/j.jtha.2026.01.011_bib83","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1038\/nri2506","article-title":"Myeloid-derived suppressor cells as regulators of the immune system","volume":"9","author":"Gabrilovich","year":"2009","journal-title":"Nat Rev Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib84","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1182\/blood-2015-10-674531","article-title":"High-dose dexamethasone corrects impaired myeloid-derived suppressor cell function via Ets1 in immune thrombocytopenia","volume":"127","author":"Hou","year":"2016","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib85","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1182\/blood-2016-01-692160","article-title":"Move over Tregs, MDSCs are here","volume":"127","author":"Semple","year":"2016","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib86","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/bjh.14542","article-title":"Intravenous immunoglobulin treatment of spleen cells from patients with immune thrombocytopenia significantly increases the percentage of myeloid-derived suppressor cells","volume":"181","author":"Aslam","year":"2018","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib87","doi-asserted-by":"crossref","DOI":"10.1016\/j.bcmd.2020.102529","article-title":"Myeloid-derived suppressor cells anticipate sustained treatment response in newly-diagnosed and persistent primary immune thrombocytopenia","volume":"87","author":"Elsaied","year":"2021","journal-title":"Blood Cells Mol Dis"},{"key":"10.1016\/j.jtha.2026.01.011_bib88","doi-asserted-by":"crossref","first-page":"2818","DOI":"10.1182\/blood.2022016029","article-title":"Low-dose decitabine modulates myeloid-derived suppressor cell fitness via LKB1 in immune thrombocytopenia","volume":"140","author":"Ni","year":"2022","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib89","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1182\/blood.2023022738","article-title":"Platelet-derived TGF-beta1 induces functional reprogramming of myeloid-derived suppressor cells in immune thrombocytopenia","volume":"144","author":"Wang","year":"2024","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib90","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/j.jaci.2016.12.978","article-title":"Autoimmune and inflammatory manifestations occur frequently in patients with primary immunodeficiencies","volume":"140","author":"Fischer","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"10.1016\/j.jtha.2026.01.011_bib91","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1002\/ajh.26900","article-title":"Impact of age at diagnosis, sex, and immunopathological manifestations in 886 patients with pediatric chronic immune thrombocytopenia","volume":"98","author":"Pincez","year":"2023","journal-title":"Am J Hematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib92","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1182\/bloodadvances.2024014639","article-title":"The role of genetic sequencing in the diagnostic workup for chronic immune thrombocytopenia","volume":"9","author":"Joshi","year":"2025","journal-title":"Blood Adv"},{"key":"10.1016\/j.jtha.2026.01.011_bib93","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.3324\/haematol.2011.050799","article-title":"Newly diagnosed immune thrombocytopenia in children and adults: a comparative prospective observational registry of the Intercontinental Cooperative Immune Thrombocytopenia Study Group","volume":"96","author":"Kuhne","year":"2011","journal-title":"Haematologica"},{"key":"10.1016\/j.jtha.2026.01.011_bib94","doi-asserted-by":"crossref","first-page":"3710","DOI":"10.1182\/bloodadvances.2023009949","article-title":"Deciphering the genetic basis of immune thrombocytopenia: current evidence for genetic predisposition in adult ITP","volume":"7","author":"Georgi","year":"2023","journal-title":"Blood Adv"},{"key":"10.1016\/j.jtha.2026.01.011_bib95","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/7531876","article-title":"A pooling genome-wide association study identifies susceptibility loci and signaling pathways of immune thrombocytopenia in Chinese Han population","volume":"2020","author":"Xu","year":"2020","journal-title":"Int J Genomics"},{"key":"10.1016\/j.jtha.2026.01.011_bib96","doi-asserted-by":"crossref","first-page":"5529","DOI":"10.1182\/bloodadvances.2024012776","article-title":"Genetic variants in canonical Wnt signaling pathway associated with pediatric immune thrombocytopenia","volume":"8","author":"Kim","year":"2024","journal-title":"Blood Adv"},{"key":"10.1016\/j.jtha.2026.01.011_bib97","doi-asserted-by":"crossref","DOI":"10.1016\/j.bvth.2025.100107","article-title":"Ubiquitous dysregulation of the Wnt pathway in immune thrombocytopenia genetic susceptibility","volume":"2","author":"Lecluze","year":"2025","journal-title":"Blood Vessels Thromb Hemost"},{"key":"10.1016\/j.jtha.2026.01.011_bib98","doi-asserted-by":"crossref","first-page":"3308","DOI":"10.1182\/blood-2014-05-578336","article-title":"Epidemiology of incident immune thrombocytopenia: a nationwide population-based study in France","volume":"124","author":"Moulis","year":"2014","journal-title":"Blood"},{"key":"10.1016\/j.jtha.2026.01.011_bib99","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1001\/archinternmed.2008.576","article-title":"Risk of immune thrombocytopenic purpura and autoimmune hemolytic anemia among 120 908 US veterans with hepatitis C virus infection","volume":"169","author":"Chiao","year":"2009","journal-title":"Arch Intern Med"},{"key":"10.1016\/j.jtha.2026.01.011_bib100","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/j.1365-2141.2009.07714.x","article-title":"Cytomegalovirus can make immune thrombocytopenic purpura refractory","volume":"146","author":"DiMaggio","year":"2009","journal-title":"Br J Haematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib101","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3934\/microbiol.2021018","article-title":"Helicobacter pylori induced immune thrombocytopenic purpura and perspective role of Helicobacter pylori eradication therapy for treating immune thrombocytopenic purpura","volume":"7","author":"Ihtesham","year":"2021","journal-title":"AIMS Microbiol"},{"key":"10.1016\/j.jtha.2026.01.011_bib102","doi-asserted-by":"crossref","DOI":"10.1016\/j.blre.2024.101252","article-title":"The intestinal flora: the key to unraveling heterogeneity in immune thrombocytopenia?","volume":"69","author":"Schoenaker","year":"2025","journal-title":"Blood Rev"},{"key":"10.1016\/j.jtha.2026.01.011_bib103","doi-asserted-by":"crossref","DOI":"10.3389\/fmicb.2023.1190866","article-title":"Causal relationship between gut microbiota and immune thrombocytopenia: a Mendelian randomization study of two samples","volume":"14","author":"Guo","year":"2023","journal-title":"Front Microbiol"},{"key":"10.1016\/j.jtha.2026.01.011_bib104","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s12185-024-03777-1","article-title":"Mendelian randomization reveals association of gut microbiota with Henoch-Schonlein purpura and immune thrombocytopenia","volume":"120","author":"Jiang","year":"2024","journal-title":"Int J Hematol"},{"key":"10.1016\/j.jtha.2026.01.011_bib105","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2021-002055","article-title":"Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study","volume":"8","author":"Adami","year":"2022","journal-title":"RMD Open"},{"key":"10.1016\/j.jtha.2026.01.011_bib106","first-page":"1141","article-title":"Air pollution, residential greenspace, and the risk of incident immune thrombocytopenic purpura: a prospective cohort study of 356,482 participants","volume":"110","author":"Luo","year":"2025","journal-title":"Haematologica"},{"key":"10.1016\/j.jtha.2026.01.011_bib107","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2022.837101","article-title":"Prenatal exposure to air pollution and immune thrombocytopenia: a nationwide population-based cohort study","volume":"10","author":"Yen","year":"2022","journal-title":"Front Pediatr"},{"key":"10.1016\/j.jtha.2026.01.011_bib108","first-page":"1217","article-title":"Heat exposure and pediatric immune thrombocytopenia in Japan from 2011 to 2022: a nationwide space-time-stratified case-crossover study","volume":"110","author":"Nawa","year":"2025","journal-title":"Haematologica"}],"container-title":["Journal of Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1538783626000668?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1538783626000668?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:14:04Z","timestamp":1781525644000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1538783626000668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":108,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["S1538783626000668"],"URL":"https:\/\/doi.org\/10.1016\/j.jtha.2026.01.011","relation":{},"ISSN":["1538-7836"],"issn-type":[{"value":"1538-7836","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Immunopathology of immune thrombocytopenia","name":"articletitle","label":"Article Title"},{"value":"Journal of Thrombosis and Haemostasis","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jtha.2026.01.011","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}