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Platelet E-News – November 17, 2003


  • Fluoroquinolone-Based Treatment May be Superior for H.pylori Eradication
  • Biotech Drugs Target Autoimmune Diseases
  • FDA to Issue Guidelines for Personalized Medicine
  • Injured Cells My Trigger Immunity
  • Integrated Therapy Addresses Platelet Defects
  • NHLBI Launches New Web Site
  • Buy from Amazon? Help PDSA by Clicking Through Our Site
  • How much time does your intravenous (IV) therapy take? (advertisement)
  • Herbal Treatment (advertisement)



In an open-label trial of more than 100 patients, H.pylori was cleared in 92% of patients with gatifloxacin (a fluoroquinolone), amoxicillin and rabeprazole. This compares to eradication rates of 80% to 85% with conventional treatment consisting of a proton pump inhibitor, clarithromycin and either amoxicillin or metronidazole. The new regimen is a 7 day treatment with a much lower number of pills. The switch to fluoroquinolone is important because clarithromycin is no longer effective for a growing portion of the population.

Medscape News

(Note: Eradication of H.pylori has been reported to lead to an increased platelet count for some patients with ITP who have an associated H.pylori infection.)


“Expensive, hard-to-make (bioengineered) drugs are now at the center of one of the drug industry’s hottest new markets: treatments for autoimmune diseases”, reports the Wall Street Journal. In the past year Amgen, Abbott Laboratories, Biogen, Inc, and Genentech, Inc. have launched drugs targeting autoimmune diseases. Abbott estimates the market could reach $14 billion by 2010.

The FDA has already approved the following genetically engineered drugs for treating autoimmune disorders: Enbrel (Amgen) Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis; Remicide (Johnson & Johnson Centocor) Rheumatoid arthritis, Crohn’s disease; Humira (Abbott) Rheumatoid arthritis; Amevive (Biogen) Psoriasis; Raptiva (Genentech) Psoriasis.

“New Battleground for Biotech Drugs: Autoimmune Ills” David P. Hamilton, Wall Street Journal, November 5, 2003

(Note: Many drugs, although developed for one autoimmune disease are tried in others, including ITP. Enbrel, in a limited clinical trial, has been shown to help patients with ITP. See


Medications affect people differently depending on their genetic makeup. Now the Food and Drug Administration (FDA) plans to issue draft guidelines outlining when drug companies must submit information on how medicines affect people with different genetic profiles. This lays the groundwork for tailoring the drugs prescribed to a patient’s individual genetic signature. This type of “personalized medicine” could lead to prescribing drugs to only those who stand to benefit from the treatment and reducing serious side-effects. Already the FDA has begun approving some new drugs with labeling that contains genetic test information.

“FDA Will Issue Rules on New Era of ‘Personalized Medicine’, Anna Wilde Mathews, The Wall Street Journal, November 3, 1003.


Usually scientists describe the immune system as something that distinguishes self from non-self and autoimmune diseases as an error in that process. An alternative theory, proposed by Polly Matzinger, PhD, a researcher at the NIH, suggests that the immune system reacts only to injured cells after they release danger signals. For example, autoimmunity may be triggered by defects in the target cells (such as platelets). Now researchers at the University of Massachusetts report that injured or dying cells release uric acid which activates immune cells. They found that cells damaged by heat, chemicals or radiation increase production of uric acid and it stimulates an immune response to those cells.

“Danger, danger, cry injured cells” Science News, October 18, 2003

Shi, Y., J.E. Evans, and K.L. Rock. 2003. Molecular identification of a danger signal that alerts the immune system to dying cells. Nature 425(Oct. 2):516-521. Abstract available at

The danger model of immunity:

(Note: This may help explain the success of some alternative therapies that are designed to improve tissue health)


The National Heart, Lung and Blood Institute, a part of the National Institutes of Health, recently launched a new web site. One of the features on the site is a section on ITP. See to access the new site.