ITP Research funded or supported by the Association
Since 2000 the ITP Support Association has been funding much needed research
into ITP, as there is no state funding for this disease. The steady flow
of donations from ITP sufferers, families and friends, in addition to
general fundraising at the local level, and contributions from The Charity
Shop in Great Yarmouth, has been not only heart warming and sometimes
astonishing, but also inspiring because of the continuing sacrifice so
many participants have made in their daily lives. Those of us who man
the ITP Support Association are amazed that this small charity for a rare
disorder has been able to finance so much valuable research. We could
never express enough gratitude for the encouragement and willing dedication
given by so many to achieve our targets. Your donation will help us to
replenish our research fund so that we have the means to support the next
worthwhile ITP research project that will help find the cause or cure
for this frightening disease.
This project involves staining bone marrow trephines to analyse
the interactions of the immune system in the bone marrow. We have found
that patients with ITP have increased T cell interactions with the megakaryocyte
when compared to bone marrows from patients without ITP. We are developing
novel imaging techniques to further characterize these interactions.
We hope that these techniques will allow us to understand what kind
of disease patients have, i.e. antibody, or T cell, or both. This should
allow us to make better decisions on what treatments to use in individual
patients. Also see
Dr Nichola Cooper. December 2013
Is Food intolerance a factor causing ITP
The search for food intolerance in ITP is drawing to a close.
44 patients and 33 controls were screened for tests for possible food
allergy and intolerance. 4 patients tested positive for IgE food antibodies
and 3 of them were started on appropriate diets. The platelet count
remained low in all. 7 who tested strongly positive for IgG food antibodies
were given appropriate diets, but only 1 patient showed an increase
in platelet counts to normal levels. She continues to test foods to
see if any produce a fall in her platelets. The third group was of those
who had abnormal metabolites produced by gut bacteria in their urines.
11 patients were markedly different from the control group and agreed
to live on artificial elemental feed for 4 weeks, thus depriving bacteria
of any nutrients from food residues. This mechanism is known to be responsible
for food intolerance in Crohns disease. In none of the subjects
did platelet counts return to normal and there was no significant increase
over all. All patients were tested for coeliac disease and all were
negative. It thus appears that despite recent reports, food intolerance
is not an important mechanism in producing ITP.
Professor John Hunter. December 2013
We are currently in the collection phase of our data. Since June,
nationally, there have been 51 reports of ITP in pregnancy and we are
continuing to collect every month. The next step is to confirm the cases
by sending data collection forms to each unit reporting a case to complete.
That way we ensure they meet the case definition/criteria set by this
project and obtain a full set of data to analyze for the project. Of
20 data collection forms received so far by the UK Obstetric Surveillance
System (UKOSS) there are 13 confirmed cases, 4 do not meet the criteria,
2 have been reported in error and for 1 the reporting unit at present
do not have the case notes and therefore cannot report.
The surveillance period is currently set to run until May 2014.
We will review the number of cases that we acquire in that time and
if we feel that it is insufficient for analysis we would make a plan
to continue recruiting for an additional period of time. Ideally a minimum
of 100 cases is needed for meaningful analysis.
Dr Angharad Care. December 2013
Dr Cooper and myself advertised for the research position associated
with our ITP Support Association award. We had a promising number of
applicants. We shortlisted 5 candidates for interview and offered the
position to Adrienn Orosz. She is highly capable, meticulous in her
approach and comes from a good lab with a strong background in haemostasis.
During Adrienn's time with us she has already been fundamental to the
successful development of some of the assays that we have been setting
up in the lab looking at ITP patient anti-platelet antibodies. So far
we have successfully achieved the following:
- Developed an assay that can accurately and sensitively identify
those ITP patients that have autoantibodies that recognise their platelets.
This assay is much improved on the commercially available anti platelet
antibody tests in that it is quicker, cheaper and allows detection of
all anti platelet antibodies (rather than just a small subset)
- Collected anti platelet antibodies from a new cohort of patients
attending Nikki's clinic anti categorised them according to treatment,
anti platelet antibody status, platelet count etc
- Developed an assay that will now enable us to identify the platelet
surface proteins to which patient antibodies bind. We have performed
this assay just once so far, but the results are very encouraging. With
further optimisation, this assay will hopefully start to provide new
insights in the near future into the nature of autoimmunity in ITP patients.
- Identified a patient with anti platelet antibodies that, likely
due to the antibodies, has a consequent platelet function deficiency.
We are extremely encouraged by the progress that we have made so
far in getting new assays set up in a comparatively short period of
time and are confident that these approaches will develop our understanding
of the pathogenesis of ITP.
Dr James Crawley. May 2013
The role of bone marrow mesenchymal stromal cells in chronic ITP
Mesenchymal stromal cells (MSC) have been shown to be abnormal in
a number of autoimmune disorders, however, little is known about these
cells in ITP patients. St Georges Hospital received full ethical
approval in July 2013 to compare MSC from individuals with ITP to compare
directly with healthy donors. The Hammersmith Hospital in London is
currently in the process of being approved as an additional research
site for the study and depending on trial recruitment numbers we will
seek additional research sites.
Initial work has focused on growing MSC from ITP and donor bone
marrow in the laboratory and comparing the growth characteristics and
stem cell properties of these cells. MSC from 2 of 3 healthy donors
and 1 of 2 ITP bone marrows grew fully in the laboratory dishes showing
densely packed spindle shaped cells (Figure 1). By microscopy no obvious
differences in the growth ability between patient and healthy donor
MSC were observed and using flow cytometry to confirm their stem cell
nature there were no clear differences in the pattern seen in individuals
with ITP and healthy donors.
We are now repeating these studies on a larger sample size and testing
the ability of the MSC from ITP and healthy donors to support platelet
Figure 1. MSC growing in a laboratory dish.
Click for larger version
Dr Ruth Pettengell and Dr Edita Hamzic. November 2013
The ITP Support Association has recently awarded grants for four new
groundbreaking research projects:
Grants for ongoing projects include:
Past grants awarded include:
In addition the Association has conducted three surveys of its membership
surveys were funded by the ITP Support Association to assist the medical
profession and pharma companies in understanding ITP from the patient
point of view.
- 2000 investigating ITP and diagnosis
- 2007 investigating ITP lifestyle problems
- 2009 collecting data on fatigue in ITP
Your donations and fundraising will enable us to allocate even more money
to research for 2014/15. We will be advertising for research studies to
review in our competitive Grant Round which commences in October 2013,
but we cannot fund ITP research without your continuing generosity. Please
help us increase our research funding to find the cause, cure, or improved
management of this rare autoimmune bleeding disorder.