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Transcript of John FreedmanJohn W SempleAlan H Lazarus Valery LeytinHeyu Ni Margaret L RandVictor S Blanchette...
John Freedman John W Semple Alan H Lazarus
Valery Leytin Heyu Ni
Margaret L Rand Victor S Blanchette
HSC CBSSMH
ITP
Idiopathic thrombocytopenic purpura Immune thrombocytopenic purpura
From Hippocrates to Bussel
(and a few side-trips in between)
immune
thrombocytopenia
purpura
Greco-Roman: Hippocrates, Galen –
life based on four elements: Fire, air, earth, water
Blood was one of the four ‘humors’ (air): made in liver, sloshed around through heart where mixed with air
Brew of willow tree leaves (salicylates) as analgesic and antipyretic
Spleen: source of black bile; “organ full of mystery”
Hippocrates
460-377 BCE
Galen
CE 129-circa 210
[Juliana Anicia Ms, CE 487]
Red “eminences”/spots associated with pestilential fevers (plague).
Porphyra
Gastropod mollusc janthina janthina
Purpura
πορφυρα
C10th: Avicenna (Canon) --- chronic purpura
Amatus Lusitanus (Joo Rodrigues de Castelo Branco)[1511-1568]
Physician, researcher in anatomy, internal medicine, dermatology, mental illness.
Peripatetic Converso who fled from Salamanca to Portugal, Ferrara, Ancona, Dubrovnik, Salonika, but was nonetheless physician to several monasteries and to Pope Julius III.
Between 1541 and 1561 wrote seven centuriae: each 100 case histories, their treatment, results and pathology, accompanied by learned explanations.
1658
X 300
1632-1723
Anton van Leeuwenhoek
1735
linguist physician
composerpoet
1775
1808
The Englishman, William Hewson (1739-1774) was probably the first to observe some platelets.
Joseph Lister, Lord
1827-1912
Founder of aseptic surgery
Joseph Jackson Lister
1786-1869
Wine merchant
1828
1842
+ Foucault = daguerrotype
Alfred Donne (1801-1878)
Child care; breastfeeding
1840s to 1860s:
Gulliver, Addison: independently made what are probably the first drawings of platelets
Zimmerman: ‘elementary bodies’ which came from lymphatics and were precursors of red blood cells;(Hematoblasts)
Jones, Beale, Simon, Schultze: platelets were fibrin clots (? derived from leukocytes)
Schmidt in Estonia: ? A cell between erythrocyte and leukocyte
Addison 1842
Brewer DB: Br J Haematol 133:251-258, 2006
Professor of Anatomy, Bonn
1874
Aequanimitas
Osler
“It must still be confessed that we know nothing about the origin or destiny of these corpuscles”
1882
“The existence of a constant blood particle, differing from red and white blood cells, has been suspected by several authors for some time”
Despite the work’s title (“…et sur son importance dans la trombose et dans la coagulation”), Bizzozero did not focus on the hemostatic or hemorrhagic role of platelets, and appears not to have recognized platelets as a factor in purpura.
rbc
platelets
Georges Hayem (1841-1935):
A founder of haematology.
Small elements in blood; tendency to clump and to change shape;in 1883, coined term platelet.
Hôpital Tenon; St Antoine: several anemias, digestion, stomach, rbc counting, cholera
In 1884, Krauss related purpura hemorrhagica to a decrease in circulating platelets
1887
1895
1890
Relation of megakaryocytes to platelets
proplatelets JCB9909028.V1.movTake off full screen
1915: Frank (Breslau) recognized that megakaryocytopoiesis was normal in ITP
1915
1916 Minot Failure of transfusion in ITP
1916 Minot Platelet destruction due to “some reaction”
1916 Kaznelson Spleen site of platelet destruction?(Prague) Splenectomy in ITP
Other treatments at this time included irradiation by mercury vapor lamps, snake venom, splenic irradiation.
1938 Troland & Lee ‘Thrombocytopen’ from ITP splenic extracts
Pla
tele
t cou
nt
1940 Wiseman Clinical diagnostic criteria for ITP
1946 Curtis Failure of splenectomy due to accessory spleen
Damashek & Miller, however, continued to argue that ITP was due to a fundamental abnormality of the spleen which ‘exerts an unusual effect on the production of platelets from the megakaryocytes in the marrow’
Harrington et al, J Lab Clin Med 38:1, 1951
1951
plasma
Passive transfer of ITP with ITP plasma
Carl V Moore
1951 Evans Plasma factor = anti-platelet antibody
1951 Damashek Distinction of acute versus chronic ITP
1951 Wintrobe Use of corticosteroids in ITP
Maxwell WintrobeWilliam Damashek
1972 --- Sartorius, Am J Ped Hematol Oncol 6:165, 1984
1984: First randomized trial of steroids in ITP
Lien
1970s
1975 Dixon Measurement of PA-IgG
1981 Imbach IVIG in ITP
1983 Salama Anti-D in ITP
1970s – 1990s Humoral immunity in ITP; antibody specificity New drugs for refractory patients
1990s - Dysregulation of cellular immunity in ITP
Literature on history of plateletsJones HW, Tocantins LM: The history of pupura hemorrhagica. Ann Med Hist 5:349-359, 1933.
Robb-Smith AHT: How the platelets were discovered. Br J Haematol 13:618-639, 1967.
Blanchette M, Freedman J: The history of idiopathic thrombocytopenic purpura (ITP). Transfus Sci 19:231-236, 1998.
Freedman J, Blanchette M: Idiopathic thrombocytopenic purpura (ITP): a historical odyssey. Acta Paediatr Suppl 424:3-6, 1998.
Mustard JF, Kinlough-Rathbone RL, Packham MA: History of platelets. In: Platelets in thrombotic and nonthrombotic disorders: pathophysiology, pharmacology and therapeutics . Gresele P, Page C, Fuster V, Vermylen J, eds. Cambridge University Press, Cambridge, 2002.
Imbach P, Kuhne T, Signer E: Historical aspects and present knowledge of idiopathic thrombocytopenic purpura. Br J Haematol 119:894-900, 2002.
Izaguirre-Avila R: El descubrimiento de las plaquetas. Revista Biomedica Vol 8, 1997.