{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:21:42Z","timestamp":1780503702957,"version":"3.54.1"},"reference-count":139,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NSW Ministry of Health Ph.D. Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Immune thrombocytopenia (ITP) is an autoimmune disease in which platelet autoantibodies play a significant role in its pathogenesis. Regulatory T cell dysfunction and T cell-mediated cytotoxicity also contribute to thrombocytopenia. Current therapies are directed towards immune suppression and modulation as well as stimulation of platelet production with thrombopoietin receptor agonists. Additional mechanisms of the pathogenesis of ITP have been suggested by recent experimental data. One of these processes, known as desialylation, involves antibody-induced removal of terminal sialic acid residues on platelet surface glycoproteins, leading to hepatic platelet uptake and thrombocytopenia. Apoptosis, or programmed platelet death, may also contribute to the pathogenesis of ITP. The extent of the impact of desialylation and apoptosis on ITP, the relative proportion of patients affected, and the role of antibody specificity are still the subject of investigation. This review will discuss both historical and new evidence of the influence of desialylation and apoptosis in the pathogenesis of ITP, with an emphasis on the clinical implications of these developments. Further understanding of both platelet desialylation and apoptosis might change current clinical practice and improve patient outcomes.<\/jats:p>","DOI":"10.3390\/cimb46110709","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T05:47:33Z","timestamp":1729748853000},"page":"11942-11956","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Desialylation and Apoptosis in Immune Thrombocytopenia: Implications for Pathogenesis and Treatment"],"prefix":"10.3390","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7346-0994","authenticated-orcid":false,"given":"Shiying Silvia","family":"Zheng","sequence":"first","affiliation":[{"name":"Haematology Research Unit, St. George and Sutherland Clinical Campuses, School of Medicine & Health, University of New South Wales, Kogarah, NSW 2217, Australia"},{"name":"Department of Haematology, St. George Hospital, Kogarah, NSW 2217, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Sail","family":"Perdomo","sequence":"additional","affiliation":[{"name":"Haematology Research Group, Central Clinical School, Faculty Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"ref_1","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":"ref_2","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.hoc.2013.02.003","article-title":"Drug-induced immune thrombocytopenia","volume":"27","author":"Chong","year":"2013","journal-title":"Hematol. 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