(Adnkronos) - "La piastrinopenia immune è una condizione patologica nella quale la conta piastrinica si riduce drasticamente, raggiungendo livelli che possono determinare dei sanguinamenti. Sotto il profilo clinico, ci si accorge di essere affetti da Itp perché, in maniera abbastanza improvvisa, si possono verificare degli episodi emorragici, soprattutto dei sanguinamenti a carico della cute e delle mucose. Quindi sangue dal naso, epistassi, sangue dalle gengive, petecchie ed ecchimosi sul corpo”. Lo afferma Mariasanta Napolitano, professoressa di Ematologia presso l'università degli studi di Palermo e responsabile Uos emostasi e trombosi, Aoup “P. Giaccone” di Palermo, in occasione del 51° congresso nazionale Sie - Società italiana di ematologia, in svolgimento al MiCo di Milano dal 23 al 25 settembre e al quale è presente anche Sobi, azienda biofarmaceutica con focus su malattie ematologiche rare o poco conosciute, e oncoematologia.
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00:00What is the effect of immune piastinopenia?
00:04Immune piastinopenia is a pathological condition
00:08in which the piastrinic count is drastically reduced
00:12to levels that can determine bleeding.
00:16So, under the clinical profile,
00:18we realize that we are affected by ATP
00:21because, quite suddenly,
00:24hemorrhagic episodes can be verified,
00:27especially bleeding caused by the cuticle and the mucosa,
00:31so blood from the nose, the pistachios,
00:33blood from the gums, hemorrhagic gums,
00:35pimples and chemosis on the body.
00:37The pathogenic mechanism responsible for ATP
00:41is an immunological mechanism.
00:43In fact, several factors intervene,
00:47both biomoral and cellular,
00:49to destroy the piastrines,
00:51both circulating piastrines,
00:53so these elements deriving from the medullary megakaryocytes,
00:57both in charge of the progenitors in the middle bone.
01:01Consequently, the treatments we have available today
01:06are mainly focused on two components.
01:10The first is the lowering of this excessive,
01:15the control of this excessive immune response,
01:18so the lowering, the reduction of the antibody level.
01:21The second, which is a more recent approach,
01:27is to stimulate the medullary precursors
01:33to produce, to a greater extent,
01:36piastrines to be put in a circle
01:38and also interfering with the destruction mechanisms,
01:44so at the level, for example, of the myeloma
01:46and, in general, of what is called the endothelial reticulum system,
01:50which recognizes the piastrines
01:52covered by these auto-antibodies
01:55and destroys them.
01:57National and international efforts
02:00are now aimed at trying to define
02:04what are the optimal treatment strategies
02:08and their timing,
02:10so what to use in the first place
02:14in the patient who arrives with a bleeding
02:17and with an extremely low piastrine count,
02:19for example 1,000 piastrines per cubic millimetre,
02:22and what to administer in the subsequent phases,
02:27so if the disease becomes a persistent or chronic disease.
02:32The Italian Society of Hematology
02:35is reviewing the national guidelines
02:39to update all the available therapeutic guidelines
02:44and recommendations
02:46regarding their administration
02:48in terms of timing and expected results.
02:52Certainly, the main need of the immune piastinopenia
02:57is its chronicity,
03:00in a non-negligible percentage of patients.
03:03In fact, after a first episode of immune piastinopenia,
03:08after the resolution of this first event,
03:12there are recidives,
03:14so the disease returns,
03:17and precisely on the prevention of recidives,
03:20so on the early action,
03:22avoiding that the disease returns,
03:24and then on the management of these recidives,
03:27scientific efforts are being focused
03:30and also pharmaceutical companies
03:33in the pharmaceutical research,
03:35because clearly having a chronic pathology
03:40with the risk of having hemorrhages
03:43and also fatigue,
03:45so tiredness,
03:46which is a very common symptom
03:49referred to by patients with immune piastinopenia,
03:52means living a bad daily life,
03:55living with the thought
03:57of having to undergo periodically
04:00and in a fairly close way
04:02hemochromia,
04:03sometimes to check the piastrinic count,
04:05to have to modify,
04:07modulate the treatments
04:09compared to the piastrinic count
04:11and also to have the weight
04:13of those that are possible,
04:15long-term management
04:17of the effects related to the treatment.