Tuesday, September 16, 2014

Is idopathic thrombocytopenic purpura caused by cross-targeting autoimmunity? H.pylori and zika?

Idopathic thrombocytopenic purpura

Cross-targeting:  the layering of 2 different infections on one target causing autoimmune disease.  A viral infection marking the inside of the target then a bacterial, or fungal, or mycobacteria..etc.. infection marking the outside.

In most cases of Idopathic thrombocytopenic purpura, H.pylori marks the outside of the host's platelets.

ITP antibodies to platelets
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1538143/

Eradication of H.pyloir has been shown to help or cure ITP

H. pylori
http://www.ncbi.nlm.nih.gov/pubmed/24505529
http://www.ncbi.nlm.nih.gov/pubmed/21120192
http://www.ncbi.nlm.nih.gov/pubmed/15765778
http://www.ncbi.nlm.nih.gov/pubmed/11157503

note that H. pylori replicates inside of bone marrow derived dendritic cells and it would be a small leap to believe that it could eventually infect other bone marrow derived cells like platelets or in infecting these types of marrow cells accidentally triggering antibodies toward platelets

The question I have : do other spirochetes infect the bone marrow? Does syphillis' t. pallidum or  lyme's b.burgdorferi or the dog spirochete leptospira???

However other infections can cause ITP...the key is that they generate antibodies against platelets. Here  are examples of mycoplasmas: http://www.ncbi.nlm.nih.gov/pubmed/19474700
http://www.ncbi.nlm.nih.gov/pubmed/19474700 
(the mycoplasma cases would have RA)

More than one virus may be able to cause the necessary cross-targeting on platelets but they must somehow infect or generate antibodies against platelets:

Flaviviruses infect bone marrow and should trigger it
dengue and ITP
http://www.ncbi.nlm.nih.gov/pubmed/24879007
http://www.ncbi.nlm.nih.gov/pubmed/26434084
http://www.ncbi.nlm.nih.gov/pubmed/25728040

Added 4/30/1016 : Zika and ITP
http://www.theguardian.com/world/2016/apr/30/zika-virus-symptoms-american-death-puerto-rico-risks

Hepatitis C and ITP
http://www.ncbi.nlm.nih.gov/pubmed/24457056
http://cid.oxfordjournals.org/content/39/6/790.full

Hepatitis C infecting the bone marrow (which would include platelet cells)
http://www.ncbi.nlm.nih.gov/pubmed/21188328

influenza A and ITP
http://www.ncbi.nlm.nih.gov/pubmed/15614463
http://www.ncbi.nlm.nih.gov/pubmed/21962253

Influenza A absorbed by platelets
http://www.bloodjournal.org/content/28/2/213?sso-checked=true 

Note that there is a strong overlap with Primary biliary cirrhosis (an autoimmune disease of the liver) and ITP
http://www.ncbi.nlm.nih.gov/pubmed/9185750  which makes sense because some of these infections are known to infect liver cells in addition to the fact that the liver filters the blood.

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