PMID- 37038316
OWN - NLM
STAT- MEDLINE
DCOM- 20230613
LR  - 20230624
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 63
IP  - 6
DP  - 2023 Jun
TI  - HLA antibodies in fetal and neonatal alloimmune thrombocytopenia.
PG  - 1141-1149
LID - 10.1111/trf.17342 [doi]
AB  - BACKGROUND: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is caused by 
      antibodies against human platelet antigens (HPA). However, in many cases that 
      meet clinical criteria for the condition, maternal sera do not have HPA 
      antibodies. In studies examining whether human leukocyte antigen (HLA) antibodies 
      cause FNAIT, the results are limited and inconclusive. This study sought to 
      examine whether clinically suspected FNAIT cases with absent maternal HPA 
      antibodies had different HLA antibody strength and specificity compared to 
      controls. STUDY DESIGN AND METHODS: A retrospective case-control study assessed 
      class I HLA antibody strength and specificity in cases submitted for testing to 
      Versiti, Wisconsin. There were 813 cases that met initial screening criteria, but 
      written consent could only be obtained for 50. After review of medical records 
      and expert panel review, 31 cases with clinical criteria of FNAIT and maternal 
      HLA but not HPA antibodies were included. Each case was matched for maternal age, 
      gestational age at delivery, parity, and race/ethnicity to two controls from 
      unaffected pregnancies that had maternal serum HLA antibodies. RESULTS: FNAIT 
      cases were found to have both significantly higher HLA antibody strength, 
      measured by mean fluorescence index (MFI), and broader HLA antibody specificity 
      at antigen epitope level, compared to matched controls (p < .001). p-values 
      remained significant after controlling for parity and gestational age at 
      delivery. DISCUSSION: Additional studies are needed to further examine whether 
      the strong HLA antibodies identified in HPA-antibody-negative cases directly 
      cause neonatal thrombocytopenia and whether prenatal treatment may be warranted 
      in select cases to prevent recurrence.
CI  - (c) 2023 AABB.
FAU - Colvin, Zachary A
AU  - Colvin ZA
AUID- ORCID: 0000-0003-3643-0195
AD  - Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, 
      Wisconsin, USA.
FAU - Schiller, Jennifer
AU  - Schiller J
AD  - Platelet & Neutrophil Immunology Lab and Blood Research Institute, Versiti 
      Wisconsin, Milwaukee, Wisconsin, USA.
AD  - Histocompatibility & Immunogenetics Lab, Versiti Wisconsin, Milwaukee, Wisconsin, 
      USA.
FAU - Tsaih, Shirng-Wern
AU  - Tsaih SW
AUID- ORCID: 0000-0002-9836-4659
AD  - Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, 
      Wisconsin, USA.
FAU - Sharma, Ruchika
AU  - Sharma R
AUID- ORCID: 0000-0002-3157-2445
AD  - Platelet & Neutrophil Immunology Lab and Blood Research Institute, Versiti 
      Wisconsin, Milwaukee, Wisconsin, USA.
AD  - Division Hematology/Oncology/BMT, Department of Pediatrics, Medical College of 
      Wisconsin, Milwaukee, Wisconsin, USA.
FAU - Grace, Rachael F
AU  - Grace RF
AUID- ORCID: 0000-0001-7302-0449
AD  - Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical 
      School, Boston, Massachusetts, USA.
FAU - McIntosh, Jennifer J
AU  - McIntosh JJ
AUID- ORCID: 0000-0002-0299-9589
AD  - Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, 
      Wisconsin, USA.
FAU - Curtis, Brian R
AU  - Curtis BR
AUID- ORCID: 0000-0001-9553-9081
AD  - Platelet & Neutrophil Immunology Lab and Blood Research Institute, Versiti 
      Wisconsin, Milwaukee, Wisconsin, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230410
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Antigens, Human Platelet)
SB  - IM
MH  - Pregnancy
MH  - Female
MH  - Infant, Newborn
MH  - Humans
MH  - *Thrombocytopenia, Neonatal Alloimmune
MH  - Retrospective Studies
MH  - Case-Control Studies
MH  - Prenatal Care
MH  - Antibodies
MH  - HLA Antigens
MH  - *Antigens, Human Platelet
OTO - NOTNLM
OT  - FNAIT
OT  - HLA
OT  - antibodies
OT  - neonatal
OT  - pregnancy
OT  - thrombocytopenia
EDAT- 2023/04/12 06:00
MHDA- 2023/06/13 06:42
CRDT- 2023/04/11 01:02
PHST- 2023/03/10 00:00 [revised]
PHST- 2022/12/28 00:00 [received]
PHST- 2023/03/13 00:00 [accepted]
PHST- 2023/06/13 06:42 [medline]
PHST- 2023/04/12 06:00 [pubmed]
PHST- 2023/04/11 01:02 [entrez]
AID - 10.1111/trf.17342 [doi]
PST - ppublish
SO  - Transfusion. 2023 Jun;63(6):1141-1149. doi: 10.1111/trf.17342. Epub 2023 Apr 10.