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Shad GA, Ghasemi A, Zadsar M, Shaeigan M, Samiee S, Zare A. PLT antigen discrepancy pattern among couples with recurrent abortion. Front Med (Lausanne) 2024; 11:1291779. [PMID: 38651057 PMCID: PMC11033322 DOI: 10.3389/fmed.2024.1291779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
Background Recurrent abortion refers to a condition of two or more consecutive pregnancies without known etiology affected by miscarriage before the completion of the 20th week of gestational age. However, several hypotheses have been proposed, but not much data are available concerning the relationship between human platelet antigens (HPAs) polymorphisms and recurrent abortion. This study was conducted to evaluate the genetic differences between HPA-1, -2, -3, -5, and - 15 in Iranian couples with a history of recurrent abortion. Methods In this cross-sectional study, a total of 74 couples with at least 2 recurrent abortions without any known specified reasons enrolled in the study. HPA polymorphisms genotyping was performed by single-specific primer PCR. Genotype frequency was calculated using the Hardy-Weinberg equation. Results A total of 39 couples (52.7%) had HPA genotyping partial mismatches. The most common partial mismatch pairs were found concomitantly on both HPA-15a and HPA-15b in three couples (4%), followed by two (2.7%) on HPA-3a and one (1.3%) in each HPA-2b and HPA-5b. There was a deviation from the Hardy-Weinberg equilibrium in the HPA-2 and -5 systems. Conclusion The present study declared that partial mismatches of HPA-3 and -15 genotypes were common among Iranian couples due to the history of recurrent abortion and approximately half of the couples carried at least one HPA gene that was absent in their partners. Further studies might be helpful to clarify the association between HPA polymorphisms and recurrent abortion, such as an investigation into the alloantibodies against HPAs.
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Affiliation(s)
| | - Ali Ghasemi
- Department of Biochemistry and Hematology, Faculty of Medicine Semnan University of Medical Sciences, Semnan, Iran
| | - Maryam Zadsar
- Infectious Disease Specialist, Blood Transfusion Research Center/High Institute for Research & Education in Transfusion Medicine/Microbiology Department, Tehran, Iran
| | - Mojgan Shaeigan
- Immunology, Blood Transfusion Research Center /High Institute for Research & Education in Transfusion Medicine, Immunohematology Department, Tehran, Iran
| | - Shahram Samiee
- Biochemistry, Iranian Blood Transfusion Organization Research Center, Tehran, Iran
| | - Ahad Zare
- Sarem Fertility and Infertility Research Center, Sarem Cell Research Center, Sarem Hospital, Tehran, Iran
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2
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Kuroishi A, Takihara Y, Hirayama F. Current understanding and future perspectives for anti-human platelet antigen-15 antibodies in patients with alloimmune thrombocytopenia: History, laboratory testing, and clinical impact. Transfusion 2022; 62:1128-1141. [PMID: 35266549 DOI: 10.1111/trf.16845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 02/02/2022] [Accepted: 02/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ayumu Kuroishi
- Laboratory, Japanese Red Cross Kinki Block Blood Center, Ibaraki-shi, Osaka, Japan
| | | | - Fumiya Hirayama
- Japanese Red Cross Kinki Block Blood Center, Ibaraki-shi, Osaka, Japan
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3
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Nedberg NH, Turowski G, Guz K, Przytuła E, Uhrynowska M, Roald B, Husebekk A, Sitras V, Nystad M, Dębska M, Brojer E, Tiller H. Platelet alloimmunization is associated with low grade chronic histiocytic intervillositis - A new link to a rare placental lesion? Placenta 2021; 112:89-96. [PMID: 34329972 DOI: 10.1016/j.placenta.2021.07.291] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/01/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Maternal alloimmunization against human platelet antigen (HPA)-1a has been implied to mediate both reduced birth weight and chronic placental inflammation. Fetal growth restriction is associated with different types of chronic inflammation in the placenta, mainly chronic histiocytic intervillositis and chronic villitis. The aim of this prospective study was to do a systematic examination of placentas from HPA-1a alloimmunized pregnancies, with focus on the histopathological and immunohistochemical diagnosis of variants of chronic inflammation. MATERIAL AND METHODS In a Polish-Norwegian study, 48 placentas were examined. The histopathology of placentas from 27 HPA-1a immunized women was compared with 21 placentas from non-immunized HPA-1a negative women (controls). In the group of alloimmunized women, ten received antenatal intravenous immunoglobulin G (IVIg). Tissue sections from formalin fixed paraffin embedded placental tissue were stained with hematoxylin and eosin and microscopically examined with focus on various types of chronic placental inflammations. RESULTS Chronic histiocytic intervillositis was observed in 40.7% of placentas from HPA-1a alloimmunized pregnancies, compared to none in the control group (p = 0.001). Chronic villitis of unknown etiology was more frequently found in the alloimmunized group, however this difference was not statistically significant. Maternal administration of IVIg did not seem to protect against chronic inflammatory lesions. DISCUSSION Placentas with detectable maternal anti-HPA-1a antibodies are associated with highly increased risk of low-grade chronic histiocytic intervillositis.
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Affiliation(s)
- Nora Hersoug Nedberg
- Immunology Research Group, Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Gitta Turowski
- Department of Pathology, Center for Perinatal and Pregnancy-Related Pathology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Katarzyna Guz
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Ewa Przytuła
- Department of Pathology, Centre of Medical Postgraduate Education, Warsaw, Poland
| | - Małgorzata Uhrynowska
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Borghild Roald
- Department of Pathology, Center for Perinatal and Pregnancy-Related Pathology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne Husebekk
- Immunology Research Group, Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vasilis Sitras
- Department of Fetal Medicine, Oslo University Hospital, Oslo, Norway
| | - Mona Nystad
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway
| | - Marzena Dębska
- Department of Obstetrics and Gynecology, Centre of Medical Postgraduate Education, Warsaw, Poland
| | - Ewa Brojer
- Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Heidi Tiller
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway
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4
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Human platelet antigen 1-6, 9 and 15 in the Iranian population: An anthropological genetic analysis. Sci Rep 2020; 10:7442. [PMID: 32366900 PMCID: PMC7198494 DOI: 10.1038/s41598-020-64469-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 04/15/2020] [Indexed: 11/09/2022] Open
Abstract
Human platelet antigens (HPAs) are membranous glycoproteins considered as alloantigens due to their polymorphisms. HPA-incompatibility in multiple pregnancies or blood transfusion can induce the development of alloantibodies leading to thrombocytopenia. The frequency of HPAs varies among populations, so that deep knowledge of HPA frequencies will help us to reduce those incompatibilities. Herein, we studied the allele and genotype frequencies of HPA1-6, HPA9, and HPA15 among the Iranians with intra- and inter-populations analyses on 36 worldwide populations with diverse ethnicities. The analysis shows that the HPA2 and HPA5 have the greatest differences in genotype distribution between the Iranians and other nations, although similar to other populations, the sole allele found in HPA4, 6, and 9 is “a”. Despite other HPAs, the most frequent allele in HPA15 is “b”, which is also abundant in HPA3. Hierarchical clustering indicates the highest degree of global similarity in HPA genotype frequency among Iranian, Argentinian, Brazilian, and German Turkish populations. Our findings can be applied to decrease the risk of alloimmunizations and platelet disorders, especially in neonates.
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5
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Eyada TK, Amin DG, Samih I, Khedr SM. Human platelet antigen 1, 2 and 5 gene polymorphisms in Egyptians and their potential association with susceptibility to immune thrombocytopenic purpura in Egyptian patients. ACTA ACUST UNITED AC 2017; 23:111-116. [PMID: 28823219 DOI: 10.1080/10245332.2017.1365435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study determined the incidence of HPA1, HPA2 and HPA5 polymorphisms in 120 Egyptian immune thrombocytopenic purpura (ITP) patients and 120 healthy Egyptian subjects. METHODS Human platelet antigen (HPA) genotyping was done using the polymerase chain reaction-restriction fragment length polymorphism. RESULTS The frequency of HPA1 allele a and b was 78.75 and 21.25% in controls, 80.8 and 19.2% in ITP, respectively. HPA2 allele a and b frequency was 86.25 and 13.75% in controls and of 74.6 and 25.4% in patients, respectively. HPA5 allele a and b frequency was 87.5 and 12.5% in controls, in patients it was 85 and 15%, respectively. With the exception of HPA2, no other significant difference was encountered in HPA allele frequency between controls and ITP patients. DISCUSSION Egyptian HPA profile is closely linked to Middle East and neighboring Arabs. The current study noted that in all the studied HPA systems 1, 2 and 5, the 'a' allele is more prevalent than the b allele; the most frequent genotype was the homozygous a/a genotype. HPA2b frequency, homo- and hetero-zygous HPA2b genotype frequencies were significantly higher in ITP patients compared to controls. CONCLUSION HPA 2b are 2.37 times more likely to develop ITP compared to those without this allele. The relatively high allele frequency of the HPA-1b in the Egyptian population suggests that this ethnic group has a higher risk of alloimmunization.
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Affiliation(s)
- Tayssir Kamel Eyada
- a Clinical and Chemical Pathology, Faculty of Medicine , Cairo University , Cairo , Egypt
| | - Dalia Gamil Amin
- b Clinical and Chemical Pathology, The BMT Unit, Faculty of Medicine , Cairo University , Cairo , Egypt
| | - Ihab Samih
- c Department of Internal Medicine, Faculty of Medicine , Cairo University , Cairo , Egypt
| | - Salwa Mohamed Khedr
- a Clinical and Chemical Pathology, Faculty of Medicine , Cairo University , Cairo , Egypt
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6
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Reiher VS, Hönger G, Infanti L, Passweg JR, Hösli I, Frey BM, Gassner C, Meyer S, Buser AS, Holbro A, Schaub S. Human platelet antigen antibody induction in uncomplicated pregnancy is associated with HLA sensitization. Transfusion 2017; 57:1272-1279. [DOI: 10.1111/trf.14053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/15/2016] [Accepted: 12/21/2016] [Indexed: 12/16/2022]
Affiliation(s)
| | - Gideon Hönger
- Transplantation Immunology and Nephrology, University Hospital Basel
| | - Laura Infanti
- Regional Blood Transfusion Service; Swiss Red Cross
- Division of Hematology; University Hospital Basel
| | | | - Irene Hösli
- Department for Obstetrics and Fetomaternal Medicine; University Hospital Basel; Basel Switzerland
| | - Beat M. Frey
- Regional Blood Transfusion Service; Swiss Red Cross Zürich Switzerland
| | - Christoph Gassner
- Regional Blood Transfusion Service; Swiss Red Cross Zürich Switzerland
| | - Stefan Meyer
- Regional Blood Transfusion Service; Swiss Red Cross Zürich Switzerland
| | - Andreas S. Buser
- Regional Blood Transfusion Service; Swiss Red Cross
- Division of Hematology; University Hospital Basel
| | - Andreas Holbro
- Regional Blood Transfusion Service; Swiss Red Cross
- Division of Hematology; University Hospital Basel
| | - Stefan Schaub
- Transplantation Immunology and Nephrology, University Hospital Basel
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7
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Phuangtham R, Romphruk A, Puapairoj C, Leelayuwat C, Romphruk AV. Human platelet antigens in Burmese, Karen and north-eastern Thais. Transfus Med 2016; 27:60-65. [PMID: 27696677 DOI: 10.1111/tme.12362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/29/2016] [Accepted: 09/03/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES A comparative study of allele frequencies at HPA-1 to -6 and HPA-15 in Burmese and Karen populations as well as at HPA-15 in north-eastern Thais (NET) is presented. BACKGROUND Human platelet antigens (HPAs) are clinically important in several immune platelet disorders, including foetal and neonatal alloimmune thrombocytopenia (FNAIT), post-transfusion purpura (PTP) and platelet transfusion refractoriness (PTR). The knowledge of antigen frequencies in a population is essential for the evaluation of patients suffering from immune-mediated platelet disorders. METHODS A total of 285 unrelated, healthy Burmese, 242 Karen and 300 NET were recruited to this study. Genotype and allele frequencies of HPA-1 to -6 and HPA-15 were defined using polymerase chain reaction sequence-specific primers (PCR-SSP) RESULTS: No individuals homozygous for HPA-1bb, -2bb, -4bb, -5bb and -6bb were detected. HPA-1a, -2a, -4a, -5a and -6a were present in all samples of Burmese and Karen origin. HPA-1b, -2b, -4b, -5b and -6b were rare in these populations. The frequencies of HPA-3a/-3b were 60·4/39·6% in Burmese and 55·8/44·2% in Karen, respectively. Frequencies of HPA-15a/-15b were 57·2/42·8% in Burmese, 52·5/47·5% in Karen and 49·8/50·2% in NET. CONCLUSIONS The frequencies of HPA genotypes in our study indicates that HPA-1a, -2a, -4a, -5a and -6a are unlikely involved in FNAIT, PTP and PTR in Burmese and Karen populations. However, HPA-1b, -2b, -3a, -3b, -4b, -5b, -6b, -15a and -15b may likely stimulate alloantibodies in these populations.
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Affiliation(s)
- R Phuangtham
- Biomedical Sciences Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
| | - A Romphruk
- The Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Department of Clinical Immunology and Transfusion Sciences, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - C Puapairoj
- Blood Transfusion Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - C Leelayuwat
- The Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Department of Clinical Immunology and Transfusion Sciences, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - A V Romphruk
- The Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Blood Transfusion Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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8
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Portela CN, Schriefer A, Albuquerque SRL, Perdomo RT, Parente AFA, Weber SS. The human platelet alloantigen profile in blood donors from Amazonas, Brazil. Transfus Med 2016; 26:448-456. [DOI: 10.1111/tme.12338] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 05/28/2016] [Accepted: 07/23/2016] [Indexed: 11/29/2022]
Affiliation(s)
- C. N. Portela
- Pós-Graduação em Ciências Aplicadas à Hematologia; Universidade do Estado do Amazonas e Fundação de Hematologia e Hemoterapia do Amazonas; Manaus Brazil
| | - A. Schriefer
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia; Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde; Instituto de Ciência e Tecnologia em Doenças Tropicais; Salvador Brazil
| | - S. R. L. Albuquerque
- Pós-Graduação em Ciências Aplicadas à Hematologia; Universidade do Estado do Amazonas e Fundação de Hematologia e Hemoterapia do Amazonas; Manaus Brazil
- Laboratório de Imunohematologia Molecular; Fundação de Hematologia e Hemoterapia do Amazonas; Manaus Brazil
| | - R. T. Perdomo
- Centro de Ciências Biológicas e da Saúde; Universidade Federal do Mato Grosso do Sul; Campo Grande Brazil
| | - A. F. A. Parente
- Departamento de Ciências Fisiológicas; Instituto de Ciências Biológicas, Universidade Federal do Amazonas; Manaus Brazil
| | - S. S. Weber
- Instituto de Ciências Exatas e Tecnologia; Universidade Federal do Amazonas; Itacoatiara Brazil
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9
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Al-Ouda SK, Al-Banyan AA, Abdel Gader AGM, Bayoumy NM, Al-Gahtani FH. Gene frequency of human platelet alloantigens-1 to -6 and -15 in Saudi blood donors. Transfus Med 2016; 26:220-4. [PMID: 27019315 DOI: 10.1111/tme.12297] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 01/15/2016] [Accepted: 02/27/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human platelet antigens (HPAs) are involved in the pathogenesis of several clinical conditions, such as platelet transfusion purpura (PTP), refractoriness to platelet transfusion and neonatal alloimmune thrombocytopenia (NAITP). Typing of HPA (1-6 and 15) has not been carried on the Saudi population. This is the first study of all the seven HPA systems on Arabs. The aim of this prospective study was to determine the frequency of HPA (1-6 and 15) in Saudis. STUDY DESIGN AND METHODS A total of 100 randomly selected Saudi blood donor samples were genotyped using the polymerase chain reaction with sequence-specific primers (PCR-SSP). RESULTS The most common HPA genotypes among Saudis were HPA-1 a + b- (75%), HPA-2 a + b- (62%), HPA-3 a + b- (51·5%), HPA-4 a + b- (99%), HPA-5 a + b- (76·5%), HPA-6 a + b- (100%) and HPA-15 a + b + (50%). The prevalent allele among the HPA systems was (a), except in the HPA-15 system where the (b) allele was found in 52% of the subjects. Comparisons with other ethnic populations uncovered marked differences in the distribution of HPA alleles. CONCLUSION Studying the prevalence of HPA antigens in Saudi population will help in the understanding of its role in platelet-related disorders. It will also enable the blood bank to establish an HPA-based donor registry that will be a valuable source of compatible platelet-therapeutic products to alloimmunised patients. This will also enhance the safety and efficacy of platelet transfusion. This data obtained will form an addition to the existing body of literature in transfusion research.
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Affiliation(s)
- S K Al-Ouda
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - A A Al-Banyan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - A G M Abdel Gader
- Department of Basic Medical Science, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - N M Bayoumy
- Department of Physiology, King Saud University, Riyadh, Saudi Arabia
| | - F H Al-Gahtani
- Transfusion Medicine Unit, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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10
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Mangerona CMB, Garcia FB, Moraes-Souza H. Frequency of human platelet antigens (HPA)-1, -2, -5 and -15 in Brazilian blood donors and establishment of a panel of HPA-typed donors. Transfus Med 2015; 25:189-94. [PMID: 26033262 DOI: 10.1111/tme.12210] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/08/2015] [Accepted: 05/03/2015] [Indexed: 11/30/2022]
Affiliation(s)
- C. M. B. Mangerona
- Discipline of Hematology and Hemotherapy; Universidade Federal do Triângulo Mineiro
| | - F. B. Garcia
- Discipline of Hematology and Hemotherapy; Universidade Federal do Triângulo Mineiro
- Regional Blood Center of Uberaba; HEMOMINAS Foundation; Uberaba Brazil
| | - H. Moraes-Souza
- Discipline of Hematology and Hemotherapy; Universidade Federal do Triângulo Mineiro
- Regional Blood Center of Uberaba; HEMOMINAS Foundation; Uberaba Brazil
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11
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Veldhuisen B, Porcelijn L, Ellen van der Schoot C, de Haas M. Molecular typing of human platelet and neutrophil antigens (HPA and HNA). Transfus Apher Sci 2014; 50:189-99. [PMID: 24685245 DOI: 10.1016/j.transci.2014.02.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Genotyping is an important tool in the diagnosis of disorders involving allo-immunisation to antigens present on the membranes of platelets and neutrophils. To date 28 human platelet antigens (HPAs) have been indentified on six polymorphic glycoproteins on the surface of platelets. Antibodies against HPAs play a role in foetal and neonatal alloimmune thrombocytopenia (FNAIT), post-transfusion purpura (PTP) and refractoriness to donor platelets. The 11 human neutrophil antigens (HNAs) described to date have been indentified on five polymorphic proteins on the surface of granulocytes. Antibodies to HNAs are implicated with foetal and neonatal alloimmune neutropenia (FNAIN), autoimmune neutropenia (AIN) and transfusion related acute lung injury (TRALI). In this report, we will review the molecular basis and techniques currently available for the genotyping of human platelet and neutrophil antigens.
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Affiliation(s)
- Barbera Veldhuisen
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands; Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Leendert Porcelijn
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands
| | - C Ellen van der Schoot
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Masja de Haas
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands
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12
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Matsuhashi M, Tsuno NH, Sone S, Mishima Y, Nagura Y, Watanabe-Okochi N, Ikeda T, Kashiwase K, Fukuda S, Iriyama T, Hyodo H, Yamashita T, Kamei Y, Arai S, Minami M, Fujii T, Kurokawa M, Tozuka M, Takahashi K, Santoso S. The role of alloantibodies against human platelet antigen-15 in multiply platelet transfused patients. Transfusion 2013; 54:1093-9. [DOI: 10.1111/trf.12455] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 08/05/2013] [Accepted: 08/07/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Mika Matsuhashi
- Department of Transfusion Medicine; The University of Tokyo; Giessen Germany
- Analytical Laboratory Chemistry, Graduate School of Health Care Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Nelson H. Tsuno
- Department of Transfusion Medicine; The University of Tokyo; Giessen Germany
| | - Shinji Sone
- Department of Transfusion Medicine; The University of Tokyo; Giessen Germany
| | - Yuko Mishima
- Department of Transfusion Medicine; The University of Tokyo; Giessen Germany
| | - Yutaka Nagura
- Department of Transfusion Medicine; The University of Tokyo; Giessen Germany
| | | | - Toshiyuki Ikeda
- Department of Transfusion Medicine; The University of Tokyo; Giessen Germany
| | - Koichi Kashiwase
- HLA Laboratory; Japanese Red Cross Kanto-Koshinetsu Block Blood Center; Giessen Germany
| | - Shinya Fukuda
- Department of Obstetrics and Gynecology; The University of Tokyo Hospital; Giessen Germany
| | - Takayuki Iriyama
- Department of Obstetrics and Gynecology; The University of Tokyo Hospital; Giessen Germany
| | - Hironobu Hyodo
- Department of Obstetrics and Gynecology; The University of Tokyo Hospital; Giessen Germany
| | - Takahiro Yamashita
- Department of Obstetrics and Gynecology; The University of Tokyo Hospital; Giessen Germany
| | - Yoshimasa Kamei
- Department of Obstetrics and Gynecology; The University of Tokyo Hospital; Giessen Germany
| | - Shunya Arai
- Department of Hematology & Oncology; The University of Tokyo; Giessen Germany
| | - Mutsuhiko Minami
- HLA Laboratory; Japanese Red Cross Kanto-Koshinetsu Block Blood Center; Giessen Germany
| | - Tomoyuku Fujii
- Department of Obstetrics and Gynecology; The University of Tokyo Hospital; Giessen Germany
| | - Mineo Kurokawa
- Department of Hematology & Oncology; The University of Tokyo; Giessen Germany
| | - Minoru Tozuka
- Analytical Laboratory Chemistry, Graduate School of Health Care Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Koki Takahashi
- Department of Transfusion Medicine; The University of Tokyo; Giessen Germany
| | - Sentot Santoso
- Immunohematology Research Department; Institute for Clinical Immunology and Transfusion Medicine; Giessen Germany
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13
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Development of SYBR Green I based real-time PCR assays for quantitative detection of Rice tungro bacilliform virus and Rice tungro spherical virus. J Virol Methods 2012; 181:86-92. [DOI: 10.1016/j.jviromet.2012.01.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 01/16/2012] [Accepted: 01/24/2012] [Indexed: 11/24/2022]
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14
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Maślanka K, Michur H, Guz K, Wróbel A, Uhrynowska M, Misiak A, Ejduk A, Brojer E, Zupańska B. The relevance of HPA-15 antigen expression for anti-HPA-15 antibody detection. Int J Lab Hematol 2011; 34:65-9. [PMID: 21752233 DOI: 10.1111/j.1751-553x.2011.01358.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The HPA-15 antigen system is characterized by a low antigen expression on platelets. The antibodies against this antigen are implied in fetal/neonatal alloimmune thrombocytopenia (F/NAIT), post-transfusion purpura, and refractoriness to platelet transfusions. Detection of these antibodies appears to be related to the level of HPA-15 expression on the platelets used in the monoclonal antibody-specific immobilization of platelet antigen (MAIPA) assay. METHODS We performed genotyping of 300 healthy blood donors for HPA-15 by TaqMan real-time PCR technology, and the HPA-15 antigen expression was investigated in 13 HPA-15aa and 19 HPA-15bb individuals. We also investigated the relevance of HPA-15 antigen expression on donor platelets used in MAIPA for antibody detection in 223 multitransfused hematological patients and 271 women with suspected F/NAIT. RESULTS In Polish donors, the HPA-15a allele frequencies were lower than the HPA-15b (0.480 vs. 0.515). We identified three HPA-15 expression groups: high (36.7 ± 8.36 MFI - eight cases), medium (19.5 ± 6.2 MFI - 21 cases), and low (6.5 ± 5.9 MFI - three cases). The HPA-15 expression was stable over time. The HPA-15aa and HPA-15bb platelets with high antigen expression were used for anti-HPA-15 antibody detection; anti-HPA-15 antibodies were detected in 4/223 (1.8%) patients receiving multiple transfusions but in none of the 271 women with suspected F/NAIT. Further examination of the four sera by MAIPA with various platelets revealed the optical density in the assay to be closely related to the level of HPA-15 antigen expression. CONCLUSION Anti-HPA-15 antibody detection should be based on carefully selected platelets with high HPA-15 expression level.
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Affiliation(s)
- K Maślanka
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
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15
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Zhou SH, Liu M, An WX, Liang XH, Yu WJ, Gong BL, Piao FY. Genotyping of human platelet antigen-15 by single closed-tube Tm-shift method. Int J Lab Hematol 2011; 34:41-6. [PMID: 21668657 DOI: 10.1111/j.1751-553x.2011.01344.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Genotyping of human platelet antigens (HPA) is useful for the diagnosis and prevention of platelet alloimmune syndromes. HPA-15 might play an important role in the development of platelet alloimmune syndromes. There are several disadvantages in the conventional methods for HPA-15 genotyping. The aim of this study was to develop a new method for HPA-15 genotyping by using single closed-tube melting temperature (T(m))-shift genotyping. METHODS Two GC-rich tails of different lengths were attached to 5'-end of HPA-15 allele-specific PCR primers, such that HPA-15 alleles can be discriminated by the T(m)s of the PCR products. One hundred blood samples were genotyped for HPA-15 by the T(m)-shift and conventional polymerase chain reaction with sequence-specific primers (PCR-SSP). RESULTS The comparison of the PCR-SSP and the T(m)-shift method showed four discordant results in one hundred samples tested. Confirmatory results demonstrated that the PCR-SSP produced several errors, whereas HPA-15 genotyping by T(m)-shift is correct. The retesting results of T(m)-shift method were consistent with those of the initial testing. CONCLUSION The single closed-tube T(m)-shift method for HPA-15 genotyping is high-throughput, rapid, reliable, reproducible and cost-effective and it is superior to conventional PCR-SSP used in routine genotyping of HPA-15.
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Affiliation(s)
- S H Zhou
- Dalian Blood Center, Dalian, China
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16
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17
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Study of 18 functional hemostatic polymorphisms in mucocutaneous bleeding disorders. Ann Hematol 2010; 89:1147-54. [PMID: 20532885 DOI: 10.1007/s00277-010-1000-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 05/17/2010] [Indexed: 10/19/2022]
Abstract
Hereditary disorders of primary hemostasis, characterized by mucocutaneous bleeding (MCB), are highly prevalent in children. Few cases are clearly monogenic, but the overwhelming majority are classified as mild bleeding disorders, with wide clinical and laboratory heterogeneity suggestive of complex polygenic diseases. In this framework, and by homology with venous thrombosis, some functional polymorphisms affecting the hemostatic system should be considered. We evaluated the role of 18 common hemostatic polymorphisms on the occurrence and severity of MCB in a case-control study including 269 patients and 286 matched controls consecutively recruited. FV Leiden was associated with milder bleeding severity, assessed by a standardized bleeding score (p = 0.013). Multivariate analysis revealed that three additional polymorphisms protected against MCB (F13 Leu34, OR = 0.66; 95% CI, 0.47-0.94; p = 0.024; VKORC1 1173T, OR = 0.59; 95% CI, 0.40-0.87; p = 0.009; and non-O blood group alleles, OR = 0.59; 95% CI, 0.41-0.86; p = 0.006). When combined, these polymorphisms showed an additive protection (OR = 0.24; 95% CI, 0.11-0.52), supporting the polygenic nature of MCB. Our data suggest that some common polymorphisms affecting hemostasis-related genes could protect from bleeding.
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18
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[Genotyping applied to platelet immunology: when? How? Limits]. Transfus Clin Biol 2009; 16:164-9. [PMID: 19409829 DOI: 10.1016/j.tracli.2009.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 03/19/2009] [Indexed: 11/21/2022]
Abstract
Platelet alloantigens named Human Platelet Antigens (HPA) are involved in immune conflicts such as post-transfusion purpura, platelet transfusion refractoriness and neonatal alloimmune thrombocytopenia. Biological diagnosis relies on: (1) detection of alloantibodies; (2) identification of the alloantigen involved in the immune conflict. Since the development of methods based on molecular biology, platelet genotyping is preferred to phenotyping. Today, most of the Platelet Immunology Units use PCR-RFLP or PCR-SSP, and few use real-time PCR. An increasing amount of commercial kits based on new technologies is now available, for example microarrays, fluorescent or coloured microbeads, or a combination of both technologies. However, an increasing number of polymorphisms have been discovered that are responsible for erroneous platelet genotypings. Consequently, it would be of interest to develop alternative technologies based on antigen/antibody interaction instead of DNA.
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Martínez C, Antón AI, Corral J, Quiroga T, Panes O, Lozano ML, González-Conejero R, Teruel R, Navarro-Núñez L, Pereira J, Mezzano D, Vicente V, Rivera J. Genotype-phenotype relationship for six common polymorphisms in genes affecting platelet function from 286 healthy subjects and 160 patients with mucocutaneous bleeding of unknown cause. Br J Haematol 2009; 146:95-103. [PMID: 19388931 DOI: 10.1111/j.1365-2141.2009.07713.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Polymorphisms affecting platelet receptors and intracellular proteins have been extensively studied in relation to their potential influence in thrombosis and haemorrhages. However, few reports have addressed their impact on platelet function, with contradictory results. Limitations of these studies include, among others, small number of patients, the platelet functional parameters analyzed and their known variability in the healthy population. We studied the effect of six polymorphisms [ITGB3 1565T > C (HPA-1), GPIBA variable number tandem repeat and 524C > T (HPA-2), ITGA2 807C > T, ADRA2A 1780A > G, and TUBB1 Q43P] on platelet function in 286 healthy subjects and their potential pathogenetic role in 160 patients with hereditary mucocutaneous bleeding of unknown cause. We found no effect of any of these polymorphisms on platelet aggregation, secretion, PFA-100, and thrombin generation in platelet rich plasma. Furthermore, patients and controls showed no significant differences in the frequency of any of these polymorphisms. Thus, our study demonstrated that polymorphisms in genes affecting platelet function do not influence significantly major platelet functions and appear irrelevant in the pathogenesis of bleeding disorders.
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20
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Vongchan P, Nawarawong W, Linhardt RJ. Modification of solid phase red cell adherence assay for the detection of platelet antibodies in patients with thrombocytopenia. Am J Clin Pathol 2008; 130:455-66. [PMID: 18701420 DOI: 10.1309/1qwtqfmf0q9jeagr] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Platelet refractoriness is caused by HLA antibodies and platelet-specific antibodies. Current methods used to detect antiplatelet antibodies have limitations. Solid phase red cell adherence (SPRCA) lacks sensitivity and requires a second assay using chloroquine-treated intact platelets to specify the response due to anti-HLA. We modified SPRCA by using 2 types of antihuman platelet antibodies with different specificities toward platelet lysate and tested samples from 361 patients (69 with unexplained thrombocytopenia and 292 with poor response to platelet transfusions not explicable by alloimmunization or the clinical situation) and 50 from healthy volunteers. Our method compared favorably with platelet suspension direct immunofluorescence. All samples from healthy volunteers were negative; of the samples from the patient population, 240 were positive (147 samples had only antiplatelet and 3 samples had only anti-HLA antibodies). This modified technique had a sensitivity of 98% and a specificity of 91%.
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21
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Fetal/Neonatal Allo-Immune Thrombocytopenia (FNAIT): Past, Present, and Future. Obstet Gynecol Surv 2008; 63:239-52. [DOI: 10.1097/ogx.0b013e31816412d3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Ruan L, Pei B, Li Q. Multicolor real-time polymerase chain reaction genotyping of six human platelet antigens using displacing probes. Transfusion 2007; 47:1637-42. [PMID: 17725728 DOI: 10.1111/j.1537-2995.2007.01335.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several genotyping methods for six clinically relevant human platelet antigens (HPAs) have been reported. A four-color real-time polymerase chain reaction (PCR) method using displacing probes for genotyping of the six HPAs is described. STUDY DESIGN AND METHODS Primers and four differently fluorophor-labeled displacing probes were designed and synthesized to detect single-nucleotide polymorphisms responsible for each of the HPA-1, -2, -3, -4, -5, and -15 genotypes. Two HPA systems were analyzed in a single PCR procedure. After validation with samples of known genotypes, a total of 150 blood samples from healthy donors were genotyped. The results were compared with PCR with sequence-specific primers (SSP), PCR-restriction fragment length polymorphism (RFLP), and/or direct DNA sequencing. The frequencies of each HPA allele were calculated. RESULTS Unequivocal real-time PCR genotyping results were obtained with minimal manual manipulation and carryover contamination. All 150 blood samples were correctly genotyped as confirmed by PCR-SSP, PCR-RFLP, and/or direct DNA sequencing. The allelic frequencies of HPA-1 through -5 and -15 among the Chinese population in Xiamen were comparable with those previously reported with Chinese living in other territories. For each specimen, genotyping of all six HPA biallelic systems was achieved in three tubes of PCR within 90 minutes and with material cost of no more than $1. CONCLUSION Genotyping of HPA with real-time PCR using displacing probes is more rapid and reliable compared with PCR-SSP and PCR-RFLP methods and is more affordable than existing real-time PCR-based HPA genotyping assays. Thus, our approach is more suitable for routine HPA analysis and ideal for both urgent clinical testing and high-throughput screening.
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Affiliation(s)
- Li Ruan
- Molecular Diagnostics Laboratory, Department of Biomedicine, School of Life Sciences, Xiamen University, Xiamen, Fujian, China
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23
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Kjeldsen-Kragh J, Killie MK, Tomter G, Golebiowska E, Randen I, Hauge R, Aune B, Øian P, Dahl LB, Pirhonen J, Lindeman R, Husby H, Haugen G, Grønn M, Skogen B, Husebekk A. A screening and intervention program aimed to reduce mortality and serious morbidity associated with severe neonatal alloimmune thrombocytopenia. Blood 2007; 110:833-9. [PMID: 17429009 DOI: 10.1182/blood-2006-08-040121] [Citation(s) in RCA: 203] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The study's objective was to identify HPA 1a-negative women and to offer them an intervention program aimed to reduce morbidity and mortality of neonatal alloimmune thrombocytopenia (NAIT). HPA 1 typing was performed in 100 448 pregnant women. The HPA 1a-negative women were screened for anti-HPA 1a. In immunized women, delivery was performed by Cesarean section 2 to 4 weeks prior to term, with platelets from HPA 1a-negative donors reserved for immediate transfusion if petechiae were present and/or if platelet count was less than 35 x 10(9)/L. Of the women screened, 2.1% were HPA 1a negative, and anti-HPA 1a was detected in 10.6% of these. One hundred seventy pregnancies were managed according to the intervention program, resulting in 161 HPA 1a-positive children. Of these, 55 had severe thrombocytopenia (< 50 x 10(9)/L), including 2 with intracranial hemorrhage (ICH). One woman with a twin pregnancy missed the follow-up and had one stillborn and one severely thrombocytopenic live child. In 15 previous prospective studies (136 814 women) there were 51 cases of severe NAIT (3 intrauterine deaths and 7 with ICH). Acknowledging the limitation of comparing with historic controls, implementation of our screening and intervention program seemed to reduce the number of cases of severe NAIT-related complications from 10 of 51 to 3 of 57.
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MESH Headings
- Adult
- Antigens, Human Platelet/blood
- Antigens, Human Platelet/immunology
- Blood Grouping and Crossmatching
- Blood Transfusion
- Cesarean Section
- Female
- Fetal Death/blood
- Fetal Death/immunology
- Fetal Death/prevention & control
- Follow-Up Studies
- Humans
- Immunization
- Infant, Newborn
- Infant, Newborn, Diseases/blood
- Infant, Newborn, Diseases/immunology
- Infant, Newborn, Diseases/mortality
- Infant, Newborn, Diseases/prevention & control
- Integrin beta3
- Intracranial Hemorrhages/blood
- Intracranial Hemorrhages/immunology
- Intracranial Hemorrhages/mortality
- Intracranial Hemorrhages/prevention & control
- Male
- Neonatal Screening
- Platelet Count
- Pregnancy
- Stillbirth
- Thrombocytopenia/blood
- Thrombocytopenia/immunology
- Thrombocytopenia/mortality
- Thrombocytopenia/prevention & control
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24
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Killie MK, Kjeldsen-Kragh J, Husebekk A, Skogen B, Olsen JA, Kristiansen IS. Cost-effectiveness of antenatal screening for neonatal alloimmune thrombocytopenia. BJOG 2007; 114:588-95. [PMID: 17355359 DOI: 10.1111/j.1471-0528.2007.01289.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To estimate the costs and health consequences of three different screening strategies for neonatal alloimmune thrombocytopenia (NAIT). DESIGN Cost-utility analysis on the basis of a decision tree that incorporates the relevant strategies and outcomes. SETTING Three health regions in Norway encompassing a 2.78 million population. POPULATION Pregnant women (n = 100,448) screened for human platelet antigen (HPA) 1a and anti-HPA 1a antibodies, and their babies. METHOD Decision tree analysis. In three branches of the decision tree, pregnant women entered a programme while in one no screening was performed. The three different screening strategies included all HPA 1a negative women, only HPA 1a negative, HLA DRB3*0101 positive women or only HPA 1a negative women with high level of anti-HPA 1a antibodies. Included women underwent ultrasound examination and elective caesarean section 2-4 weeks before term. Severely thrombocytopenic newborn were transfused immediately with compatible platelets. MAIN OUTCOME MEASUREMENTS Quality-adjusted life years (QALYs) and costs. RESULTS Compared with no screening, a programme of screening and subsequent treatment would generate between 210 and 230 additional QALYs among 100,000 pregnant women, and at the same time, reduce health care costs by approximately 1.7 million euros. The sensitivity analyses indicate that screening is cost effective or even cost saving within a wide range of probabilities and costs. CONCLUSION Our calculations indicate that it is possible to establish an antenatal screening programme for NAIT that is cost effective.
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Affiliation(s)
- M K Killie
- Department of Immunology and Transfusion Medicine, University Hospital of North Norway, Tromsø, Norway.
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25
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Liew M, Nelson L, Margraf R, Mitchell S, Erali M, Mao R, Lyon E, Wittwer C. Genotyping of human platelet antigens 1 to 6 and 15 by high-resolution amplicon melting and conventional hybridization probes. J Mol Diagn 2006; 8:97-104. [PMID: 16436640 PMCID: PMC1867566 DOI: 10.2353/jmoldx.2006.050053] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
High-resolution melting techniques are a simple and cost-effective alternative to other closed-tube genotyping methods. Here, we genotyped human platelet antigens (HPAs) 1 to 6 and 15 by high-resolution melting methods that did not require labeled probes. Conventional melting analysis with hybridization probes (HybProbes) was also performed at each locus. HybProbe assays were performed individually, whereas amplicon melting (HPAs 1 to 5 and 16) and unlabeled probe (HPA 6) assays were duplexed when possible. At all loci for each method, both homozygous and heterozygous genotypes were easily identified. We analyzed 100 blinded clinical samples (33 amniotic fluid, 12 cultured amniocytes, and 55 blood samples) for all 7 single-nucleotide polymorphisms (SNPs) by each method. Genotype assignments could be made in 99.0% of the SNPs by high-resolution melting and in 98.7% of the SNPs with HybProbes with an overall genotype concordance of 98.8%. Errors included two sample misidentifications and six incorrect assignments that were all resolved by repeating the analysis. Advantages of high-resolution melting include rapid assay development and execution, no need for modified oligonucleotides, and similar accuracy in genotyping compared with other closed-tube melting methods.
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Affiliation(s)
- Michael Liew
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108-1221, USA.
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Wu YY, Csako G. Rapid and/or high-throughput genotyping for human red blood cell, platelet and leukocyte antigens, and forensic applications. Clin Chim Acta 2006; 363:165-76. [PMID: 16154123 DOI: 10.1016/j.cccn.2005.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Revised: 07/08/2005] [Accepted: 07/11/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Traditionally, transfusion medicine, platelet and human leukocyte antigen (HLA) typing, and forensic medicine relied on serologic studies. METHODS In recent years, molecular testing on nucleic acids has been increasingly applied to these areas. Although conventional molecular diagnostic methods such as PCR-sequence-specific priming, PCR-restriction fragment-length polymorphism, PCR-single-strand conformation polymorphism, sequence-based typing, and DNA fingerprinting have been shown to perform well, their use is limited by long turnaround times, high cost, labor-intensiveness, the need for special technical skills, and/or the high risk of amplicon contamination. With advance of fast and/or high-throughput methods and platforms that often combine amplification and detection, a new era of molecular genotyping is emerging in these fields dominated by serology for a century. As new targets, short tandem repeats, mitochondrial DNA and Y-chromosome sequences were introduced for forensic applications. This article reviews the current status of the application of rapid and/or high-throughput genotyping methods to these areas. RESULTS The results are already promising with real-time PCR, pyrosequencing, microarrays, and mass spectrometry and show high concordance rates with classic serologic and earlier manual molecular diagnostic methods. Exploration of other emerging methodologies will likely further enhance the diagnostic utility of molecular testing in these areas.
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Affiliation(s)
- Yan Yun Wu
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT 06510-3202, USA.
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Tomicic M, Bingulac-Popovic J, Drazic V, Hundric-Haspl Z. Frequency of HPA-15a and HPA-15b (Gov a/b) Human Platelet Alloantigens in the Croatian Population. Arch Med Res 2006; 37:172-4. [PMID: 16314205 DOI: 10.1016/j.arcmed.2005.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2005] [Accepted: 06/09/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Human platelet antigen (HPA) genotyping is important for epidemiological studies because the prevalence of particular HPA allotypes differs among various populations and plays a major role in the occurrence of HPA alloimmunization. In Caucasians, antibodies to HPA-1a are the most important causes of neonatal alloimmune thrombocytopenia (NATP). Recent studies suggest that anti-HPA 15a/15b (Gov b, Gov a) might be the most likely candidate antibodies following anti-HPA-1a in inducing NATP. METHODS In the present study, HPA-15 system genotype was determined by PCR-SSP method in 279 unrelated subjects from the Croatian population, yielding an HPA-15a and HPA-15b frequency of 0.53 and 0.47, respectively. RESULTS Retrograde testing for the presence of anti-HPA-15 antibodies by use of MAIPA in 39 frozen serum samples from serologically negative cases of clinically suspect NATP produced negative results. CONCLUSION The clinical role of anti-HPA-15 alloantibodies was unable to be confirmed.
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Affiliation(s)
- Maja Tomicic
- Department of Immunohematology, Croatian Institute of Transfusion Medicine, Zagreb, Croatia.
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Mandelbaum M, Koren D, Eichelberger B, Auerbach L, Panzer S. Frequencies of maternal platelet alloantibodies and autoantibodies in suspected fetal/neonatal alloimmune thrombocytopenia, with emphasis on human platelet antigen-15 alloimmunization. Vox Sang 2005; 89:39-43. [PMID: 15938738 DOI: 10.1111/j.1423-0410.2005.00662.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Serological evaluation of maternal sera for platelet antibodies in suspected fetal/neonatal alloimmune thrombocytopenia (FNAITP) discloses in only approximately 30% of individuals a platelet-specific antibody. Transfusion-induced alloimmunization against human platelet antigen-15 (HPA-15) has been reported to be about as common as against HPA-5, the second most common platelet antibody. Thus, anti-HPA-15 may also contribute significantly to yet-unclear cases of FNAITP. MATERIALS AND METHODS In this retrospective analysis, we provide data on maternal platelet antibodies from 309 mothers who delivered an offspring with suspected FNAITP. RESULTS Genotyping maternal and paternal samples (together n = 573) revealed a gene frequency of 0.496 for HPA-15a and a gene frequency of 0.504 for HPA-15b. HPA-15 antibodies were detected in 2% of all samples. Anti-HPA-15a and -15b were detected in two and three samples, respectively. One serum reacted equally with HPA-15a and -15b platelets. The most frequent platelet-specific antibodies were anti-HPA-1a (22%), but anti-HPA-5b (8.4%) were more frequent than anti-HPA-15. In addition, panreactive (5.5%) or autoreactive (5.2%) anti-GPIIb/IIIa or anti-GPIb/IX were detectable in maternal samples. CONCLUSIONS These data indicate that HPA-15 alloimmunization needs only to be considered in subjects with suspected FNAITP if no other platelet-specific antibody is detectable. The presence of panreactive or autoreactive antibodies should also be considered in neonatal thrombocytopenia.
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Affiliation(s)
- M Mandelbaum
- Clinic for Blood Group Serology, Medical University Vienna, Vienna, Austria
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Ertel K, Al-Tawil M, Santoso S, Kroll H. Relevance of the HPA-15 (Gov) polymorphism on CD109 in alloimmune thrombocytopenic syndromes. Transfusion 2005; 45:366-73. [PMID: 15752154 DOI: 10.1111/j.1537-2995.2005.04281.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alloantibodies against the human platelet (PLT) alloantigen (HPA)-15 system residing on CD109 can cause fetal and neonatal alloimmune thrombocytopenia (FNAIT), posttransfusion purpura, and PLT transfusion refractoriness. The detection of antibodies against HPA-15, however, is hampered by the variable low expression and instability of the CD109 molecule during preparation and storage. STUDY DESIGN AND METHODS This study analyzed the occurrence of HPA-15 alloantibodies in 1403 patients: 930 FNAIT and 473 polytransfused (PT) patients by modified monoclonal antibody specific immobilization of PLT antigens (MAIPA) assay with well-defined phenotyped PLTs. A DNA typing technique was developed to confirm the phenotypes of PLT donors. B-cell lines were established as sources of reference DNA. RESULTS Genotyping of 407 unrelated blood donors revealed the gene frequencies 0.512 and 0.488 for HPA-15a and -15b, respectively. Based on the selection of PLTs expressing high amounts of CD109 on the surface (mean fluorescence intensity ratio 4-5 on expression peak on Days 2-4 after apheresis) antibody screening by the MAIPA assay was performed. In total, 16 (1.1%) HPA-15 alloantibodies were found comprising four anti-HPA-15a and 12 anti-HPA-15b. Anti-HPA-15b without other PLT-reactive antibodies were detectable in three serum samples of PT patients. The incidence of HPA-15 alloimmunization in PT patients was significantly higher than in mothers with FNAIT (3.0% vs. 0.22%). In relation to all detected HPA-specific antibodies, HPA-15 is responsible for 6.2 percent of alloimmunizations. CONCLUSION These observations indicate that alloimmunization against HPA-15 should be considered as a cause for immune thrombocytopenia, particularly in patients receiving multiple PLT transfusions.
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MESH Headings
- Antibodies, Monoclonal/immunology
- Antigens, CD/immunology
- Antigens, Human Platelet/genetics
- Antigens, Human Platelet/immunology
- Female
- GPI-Linked Proteins
- Genotype
- Humans
- Infant, Newborn
- Isoantibodies/immunology
- Male
- Neoplasm Proteins
- Pedigree
- Phenotype
- Polymerase Chain Reaction
- Polymorphism, Restriction Fragment Length
- Pregnancy
- Purpura, Thrombocytopenic, Idiopathic/genetics
- Purpura, Thrombocytopenic, Idiopathic/immunology
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Affiliation(s)
- Katharina Ertel
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
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Cardone JDB, Chiba AK, Boturão-Neto E, Vieira-Filho JPB, Bordin JO. Gene frequencies of the HPA-15 (Gov) platelet alloantigen system in Brazilians. Transfus Med 2004; 14:433-7. [PMID: 15569238 DOI: 10.1111/j.1365-3148.2004.00539.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The HPA-15 (Gov) alloantigen is a biallelic co-dominant system on human platelets, and its allele HPA-15a and HPA-15b differ by an A-->C single nucleotide polymorphism at nucleotide 2108 of the coding sequence resulting in a Tyr682Ser substitution in the mature CD109 glycoprotein. Employing the polymerase chain reaction-restriction fragment length polymorphism technique, we determined the HPA-15 gene frequencies among 276 subjects of distinct Brazilian ethnic groups including, 15 Caucasians, 15 African Brazilians, 15 Orientals, 106 Amazon Xikrin Indians, 31 Amazon Gavioes Indians and 94 blood donors. The calculated HPA-15a and HPA-15b allele frequencies found in Caucasians (0.53/0.47), African Brazilians (0.57/0.43), Orientals (0.57/0.43) and Brazilian blood donors (0.52/0.48) did not differ significantly. However, the HPA-15a and HPA-15b gene frequencies of Xikrin Indians (0.78/0.22) were significantly different from that of all other groups (P < 0.01). The HPA-15a/a, HPA-15a/b and HPA-15b/b genotype frequencies observed in Gavioes Indians were significantly different from those seen in African Brazilians (P = 0.04) and blood donors (P = 0.017). The present data showed that the distribution of the HPA-15 (Gov) system alleles observed among the Brazilian population is quite similar to the distributions already reported among Asian, Canadian and European populations. Moreover, the data indicated differences in the frequency of the HPA-15 system between Amazon Indians and other distinct Brazilian ethnic groups suggesting that Amerindians would be at higher risk of HPA-15 alloimmunization in the need of receiving blood components collected from blood donors of other ethnic groups.
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Affiliation(s)
- J D B Cardone
- Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, Rua Botucatu, 740 São Paulo, SP-04023-902, Brazil
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Davoren A, Curtis BR, Aster RH, McFarland JG. Human platelet antigen-specific alloantibodies implicated in 1162 cases of neonatal alloimmune thrombocytopenia. Transfusion 2004; 44:1220-5. [PMID: 15265127 DOI: 10.1111/j.1537-2995.2004.04026.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Neonatal alloimmune thrombocytopenia (NATP) caused by fetomaternal mismatch for human platelet (PLT) alloantigens (HPAs) complicates approximately 1 in 1000 to 1 in 2000 pregnancies and can lead to a serious bleeding diathesis, intracranial hemorrhage, and sometimes death of the fetus or neonate. As a national reference center for NATP investigations, our experience with this entity over a 12-year period was reviewed. STUDY DESIGN AND METHODS The laboratory records of all cases of suspected NATP referred for evaluation from January 1, 1990, to December 31, 2002, were analyzed. The spectrum of PLT alloantibody specificities identified was compared with an earlier reported series of serologically verified NATP cases. RESULTS HPA-specific alloantibodies were identified in 1162 (31%) of 3743 sera of mothers of infants with clinically suspected NATP. Maternal HPA-1a (PlA1) alloimmunization accounted for the majority (79%) of confirmed NATP cases, with HPA-5b (Bra), HPA-3a (Baka), and HPA-1b (PLA2) alloantibodies accounting for 9, 2, and 4 percent of cases, respectively. In addition, an increase in the number of cases in which multiple HPA-specific alloantibodies were present in maternal sera was observed during the study period. CONCLUSION Although, as with the earlier series, maternal HPA-1a alloimmunization was the dominant cause of NATP, the identification of an increasing number of cases due to alternative HPA polymorphisms suggests that investigation for HPA-1 incompatibility alone is no longer sufficient to fully evaluate clinically suspect NATP cases.
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Affiliation(s)
- Anne Davoren
- Blood Center of Southeastern Wisconsin, Milwaukee, Wisconsin 53201-2178, USA.
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Killie MK, Kjeldsen-Kragh J, Randen I, Skogen B, Husebekk A. Evaluation of a new flow cytometric HPA 1a screening method. Transfus Apher Sci 2004; 30:89-92. [PMID: 15062744 DOI: 10.1016/j.transci.2003.10.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2003] [Accepted: 10/31/2003] [Indexed: 11/24/2022]
Abstract
We have evaluated a flow cytometric screening method for identification of HPA la negative individuals, using a commercially available monoclonal anti-CD61 antibody specific for the HPA 1a allotype, and compared the method with an ELISA based method for HPA la phenotyping and two methods for PCR genotyping. HPA 1a phenotyping by fluorochrome conjugated monoclonal anti-HPA la and analysis by flow cytometry is a rapid, reliable and inexpensive technique, suitable for screening purposes.
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Affiliation(s)
- Mette Kjaer Killie
- Department of Immunology and Transfusion Medicine, University of Northern Norway, 9038 Tromsø, Norway.
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Abstract
Real-time PCR is the state-of-the-art technique to quantify nucleic acids for mutation detection, genotyping and chimerism analysis. Since its development in the 1990s, many different assay formats have been developed and the number of real-time PCR machines of different design is continuously increasing. This review provides a survey of the instruments and assay formats available and discusses the pros and cons of each. The principles of quantitative real-time PCR and melting curve analysis are explained. The quantification algorithms with internal and external standardization are derived mathematically, and potential pitfalls for the data analysis are discussed. Finally, examples of applications of this extremely versatile technique are given that demonstrate the enormous impact of real-time PCR on life sciences and molecular medicine.
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Affiliation(s)
- Jochen Wilhelm
- Institut für Pathologie, Klinikum der Justus-Liebig-Universität Giessen, Langhansstrasse 10, 35392 Giessen, Germany.
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