# The glycan fingerprint in immune thrombocytopenia

## TL;DR

This paper reviews how changes in platelet glycans may contribute to immune thrombocytopenia and influence disease severity.

## Contribution

The paper provides a comprehensive review of glycan-mediated mechanisms in ITP and highlights new directions for glycobiology research.

## Key findings

- Antiplatelet glycans and glycans on platelets and megakaryocytes may shape ITP pathophysiology.
- IgG Fc-glycosylation composition may affect platelet clearance in a subset of ITP patients.
- Glycan analysis could indicate ITP disease severity but requires further investigation.

## Abstract

A state-of-the-art lecture titled “Platelet Glycobiology and Immune Thrombocytopenia (ITP)” was presented at the International Society on Thrombosis and Haemostasis (ISTH) congress in 2025. In this review, we summarize the current knowledge on glycan-mediated mechanisms in ITP, including glycan alterations of platelet autoantibodies and on the surface of platelets and megakaryocytes. We discuss how these glycan modifications might contribute to thrombocytopenia, and potentially to an increased risk of bleeding in patients with ITP. We address relevant new data on this topic and emphasize key directions for future ITP glycobiology research.

•Antiplatelet glycans and glycans on platelets and megakaryocytes may shape ITP pathophysiology.•IgG Fc-glycosylation composition may affect platelet clearance in a subset of patients with ITP.•Both anti-GPIb/IX and anti-GPIIb/IIa can induce platelet surface desialylation in ITP.•Glycan analysis could indicate ITP disease severity but warrants more investigation.

Antiplatelet glycans and glycans on platelets and megakaryocytes may shape ITP pathophysiology.

IgG Fc-glycosylation composition may affect platelet clearance in a subset of patients with ITP.

Both anti-GPIb/IX and anti-GPIIb/IIa can induce platelet surface desialylation in ITP.

Glycan analysis could indicate ITP disease severity but warrants more investigation.