{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T10:43:44Z","timestamp":1698403424965},"reference-count":25,"publisher":"Akademiai Kiado Zrt.","issue":"38","license":[{"start":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T00:00:00Z","timestamp":1663459200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2022,9,18]]},"abstract":"<jats:p>T\u00f6bb mint 20 \u00e9ve k\u00f6vetkezett be a m\u00e1sodik szeml\u00e9letv\u00e1lt\u00e1s a kr\u00f3nikus feln\u0151ttkori\n                    idiopathi\u00e1s thrombocytopeni\u00e1s purpura (immunthrombocytopenia) kezel\u00e9s\u00e9ben,\n                    amikor felismert\u00e9k az am\u00fagy megakaryocyt\u00e1s, de a fokozott thrombocytapusztul\u00e1st\n                    m\u00e9gsem el\u00e9gg\u00e9 ellens\u00falyoz\u00f3 csontvel\u0151i thrombocytak\u00e9pz\u00e9s serkent\u00e9s\u00e9nek\n                    fontoss\u00e1g\u00e1t. A thrombopoetinanal\u00f3gok bel\u00e9ptek a klinikai alkalmaz\u00e1sba, gyorsan\n                    \u00e1t\u00edrt\u00e1k az algoritmust, a splenectomia m\u00e1ra a harmadik vonalba ker\u00fclt. Ezen\n                    paradigmav\u00e1lt\u00e1st az egyik szerz\u0151 20 \u00e9ve ebben a foly\u00f3iratban is ismertette.\n                    Id\u0151k\u00f6zben sok tapasztalat gy\u0171lt \u00f6ssze a thrombopoetinanal\u00f3gok alkalmaz\u00e1s\u00e1val,\n                    nagy el\u0151nyeivel, de azzal is, hogy m\u00e9g ezek sem oldanak meg minden ter\u00e1pi\u00e1s\n                    gondot. Ez az \u00fatkeres\u00e9s visszakanyarodott az eredeti antitestinduk\u00e1lt\n                    immunthrombocytopenia ir\u00e1nyba, azaz az immunmodul\u00e1ns k\u00f6zel\u00edt\u00e9sm\u00f3dra. Ebben 3 f\u0151\n                    ir\u00e1nyzat l\u00e1tszik olyan m\u00e9rt\u00e9kben \u00edg\u00e9retesnek, hogy a k\u00f6zelj\u00f6v\u0151ben be fognak\n                    \u00e9p\u00fclni a klinikai gyakorlatban a szteroid\/TPO-anal\u00f3g refrakter vagy m\u00e1s,\n                    nehezebb idiopathi\u00e1s thrombocytopeni\u00e1s purpura esetek ell\u00e1t\u00e1si rendj\u00e9be. Ezen\n                    ir\u00e1nyok: (1) szelekt\u00edv IgG-anyagcsere (clearance)-gyors\u00edt\u00f3k, (2)\n                    komplementm\u00f3dos\u00edt\u00e1s a thrombocytafelsz\u00edni immunglobulin-k\u00f6t\u0151d\u00e9s cs\u00f6kkent\u00e9s\u00e9re,\n                    (3) ezen immunfolyamat jel\u00e1tviteli \u00fatj\u00e1nak megv\u00e1ltoztat\u00e1sa tirozin-kin\u00e1z-\n                    (els\u0151sorban l\u00e9p-tirozin-kin\u00e1z- \u00e9s Bruton-tirozin-kin\u00e1z-) g\u00e1tl\u00e1ssal. Ezen elemek\n                    egymagukban, egy\u00fctt, illetve a jelen modalit\u00e1sokhoz kapcsol\u00f3d\u00f3an \u00e1trajzolhatj\u00e1k\n                    az idiopathi\u00e1s thrombocytopeni\u00e1s purpura kezel\u00e9si algoritmusait a k\u00f6zelj\u00f6v\u0151ben,\n                    amire ez a k\u00f6zlem\u00e9ny k\u00edv\u00e1nja felh\u00edvni a figyelmet. Orv Hetil. 2022; 163(38):\n                    1514\u20131519.<\/jats:p>","DOI":"10.1556\/650.2022.32549","type":"journal-article","created":{"date-parts":[[2022,11,19]],"date-time":"2022-11-19T02:45:14Z","timestamp":1668825914000},"page":"1514-1519","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":0,"title":["Meg\u00fajul\u00f3 szeml\u00e9let \u00e9s immunmodul\u00e1ci\u00f3s t\u00f6rekv\u00e9sek a feln\u0151ttkori idiopathi\u00e1s immunthrombocytopenia ter\u00e1pi\u00e1j\u00e1ban"],"prefix":"10.1556","volume":"163","author":[{"given":"Mikl\u00f3s","family":"Udvardy","sequence":"first","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Belgy\u00f3gy\u00e1szati Int\u00e9zet, Hematol\u00f3gia Tansz\u00e9k Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lajos","family":"Gergely","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Belgy\u00f3gy\u00e1szati Int\u00e9zet, Hematol\u00f3gia Tansz\u00e9k Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1rp\u00e1d","family":"Ill\u00e9s","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Belgy\u00f3gy\u00e1szati Int\u00e9zet, Hematol\u00f3gia Tansz\u00e9k Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","unstructured":"1 Harrington WJ, Minnich V, Hollingsworth JW, et al. 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