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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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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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Hayashi T, Aminaka R, Ishii H, Tani Y, Fujimura Y, Takihara Y, Hirayama F. Frequency of allotype "b" in human platelet antigen 1 to 29 systems among blood donors in Japan estimated using high-resolution melt analysis. Transfusion 2020; 60:2702-2713. [PMID: 32710598 DOI: 10.1111/trf.15967] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/27/2020] [Accepted: 06/11/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Antibodies against human platelet antigens (HPAs) cause thrombocytopenias. It is thus important to know the frequency of "b" allotypes in each HPA system for the diagnosis and treatment of anti-HPA antibody-mediated thrombocytopenia. STUDY DESIGN AND METHODS Genomic DNA was extracted from peripheral blood cells obtained from 2170 blood donors in Japan and was subjected to high-resolution melt (HRM) analysis using polymerase chain reaction for each of the HPA genes, using 23 primer pairs. For genotyping, the resulting amplicons were classified based on their HRM curves. In some cases, direct sequence analysis was performed after HRM analysis to determine nucleotide substitutions. In cases where amino acid substitutions were predicted, protein expression levels were examined in a cell line using 293T cells. RESULTS The frequencies of each of the HPA-b genotypes were as follows: HPA-1b, 0.4%; HPA-2b, 11.8%; HPA-3b, 41.3%; HPA-4b, 0.8%; HPA-5b, 4.3%; HPA-6b, 1.9%; HPA-15b, 48.8%; HPA-21b, 0.6%; and "b" allotype in the other HPA systems, 0.0%. Twenty-eight variants were found; nine of them were predicted to cause amino acid substitution. However, expression analysis revealed that they did not affect protein expression levels on the cell surface. CONCLUSION Nine HPA systems are of primary importance in Japan in potentially triggering thrombocytopenia via the HPA antibodies. Similar studies in other countries or races, together with ours, could provide basic information for clinicians in multiethnic societies.
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Affiliation(s)
- Tomoya Hayashi
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
| | - Ryota Aminaka
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
| | - Hiroyuki Ishii
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
| | | | | | | | - Fumiya Hirayama
- Japanese Red Cross Kinki Block Blood Centre, Ibaraki, Osaka, Japan
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Koh Y, Nishimiya H, Inoue H, Kishigami A, Tsuji Y, Sakamoto R, Hirayama F, Kuroishi A. A novel simple assay system for the detection of human platelet antigen 15 (HPA‐15) alloantibodies based on three techniques: an HPA‐15 expressing cell line, a monoclonal antibody‐specific antigen‐capture method and mixed‐passive haemagglutination. Vox Sang 2019; 115:202-206. [DOI: 10.1111/vox.12843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/03/2019] [Accepted: 08/12/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Yangsook Koh
- Japanese Red Cross Kinki Block Blood Centre Osaka Japan
| | | | - Hiroko Inoue
- Japanese Red Cross Kinki Block Blood Centre Osaka Japan
| | | | - Yukari Tsuji
- Japanese Red Cross Kinki Block Blood Centre Osaka Japan
| | - Rumi Sakamoto
- Japanese Red Cross Kinki Block Blood Centre Osaka Japan
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Okubo M, Nishida E, Watanabe A, Nishizaki N, Obinata K, Azuma F, Matsuhashi M, Watanabe-Okochi N, Tsuno NH, Miyake K, Yamaguchi M, Yoshida K, Ohsaka A. Marked thrombocytopenia in a neonate is associated with anti-HPA-5b, anti-HLA-A31, and anti-HLA-B55 antibodies. Pediatr Blood Cancer 2019; 66:e27555. [PMID: 30488611 DOI: 10.1002/pbc.27555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/03/2018] [Accepted: 10/25/2018] [Indexed: 11/09/2022]
Abstract
Maternal antibodies against human platelet antigen (HPA) and/or human leukocyte antigen (HLA) cause fetal and neonatal alloimmune thrombocytopenia (FNAIT) in 0.09-0.15% of live births. Severe cases account for 5-31% and the frequency of multiple kinds of alloantibodies is 6.9-9% of FNAIT. We present a case of severe FNAIT associated with anti-HPA-5b, anti-HLA-A31, and anti-HLA-B55 antibodies, successfully treated with immunoglobulin and platelet transfusion. The anti-HLA-B55 antibody was detected in the newborn's serum, but disappeared on the 20th day, which was followed by an increase of the platelet count. These findings suggested the potential involvement of an anti-HLA antibody in the pathogenesis of FNAIT.
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Affiliation(s)
- Mitsuo Okubo
- Department of Transfusion Service, Juntendo University Urayasu Hospital, Urayasu City, Japan.,Department of Transfusion Medicine and Stem Cell Regulation, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Eriko Nishida
- Department of Pediatrics, Juntendo University Urayasu Hospital, Urayasu City, Japan
| | - Akiko Watanabe
- Department of Pediatrics, Juntendo University Urayasu Hospital, Urayasu City, Japan
| | - Naoto Nishizaki
- Department of Pediatrics, Juntendo University Urayasu Hospital, Urayasu City, Japan
| | - Kaoru Obinata
- Department of Pediatrics, Juntendo University Urayasu Hospital, Urayasu City, Japan
| | - Fumihiro Azuma
- Laboratory Department, Kanto-Koshinetsu Block Blood Center, Japanese Red Cross, Tokyo, Japan
| | - Mika Matsuhashi
- Laboratory Department, Kanto-Koshinetsu Block Blood Center, Japanese Red Cross, Tokyo, Japan
| | - Naoko Watanabe-Okochi
- Laboratory Department, Kanto-Koshinetsu Block Blood Center, Japanese Red Cross, Tokyo, Japan
| | - Nelson Hirokazu Tsuno
- Laboratory Department, Kanto-Koshinetsu Block Blood Center, Japanese Red Cross, Tokyo, Japan
| | - Kazunori Miyake
- Department of Laboratory Medicine, Juntendo University Urayasu Hospital, Urayasu City, Japan
| | | | - Koyo Yoshida
- Department of Obstetrics and Gynecology, Juntendo University Urayasu Hospital, Urayasu City, Japan
| | - Akimichi Ohsaka
- Department of Transfusion Medicine and Stem Cell Regulation, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Advances in alloimmune thrombocytopenia: perspectives on current concepts of human platelet antigens, antibody detection strategies, and genotyping. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 13:380-90. [PMID: 26057488 DOI: 10.2450/2015.0275-14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/15/2015] [Indexed: 12/22/2022]
Abstract
Alloimmunisation to platelets leads to the production of antibodies against platelet antigens and consequently to thrombocytopenia. Numerous molecules located on the platelet surface are antigenic and induce immune-mediated platelet destruction with symptoms that can be serious. Human platelet antigens (HPA) cause thrombocytopenias, such as neonatal alloimmune thrombocytopenia, post-transfusion purpura, and platelet transfusion refractoriness. Thirty-four HPA are classified into 28 systems. Assays to identify HPA and anti-HPA antibodies are critically important for preventing and treating thrombocytopenia caused by anti-HPA antibodies. Significant progress in furthering our understanding of HPA has been made in the last decade: new HPA have been discovered, antibody-detection methods have improved, and new genotyping methods have been developed. We review these advances and discuss issues that remain to be resolved as well as future prospects for preventing and treating immune thrombocytopenia.
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Ueda H, Sugiura T, Katano K, Matsuhashi M, Kato S, Ito K, Nagasaki R, Kato T, Tsuno NH, Saitoh S. Perinatal management of neonatal alloimmune thrombocytopenia associated with anti-group A antibody. Transfus Med 2015; 25:42-6. [DOI: 10.1111/tme.12178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 02/09/2015] [Indexed: 11/30/2022]
Affiliation(s)
- H. Ueda
- Department of Pediatrics and Neonatology; Nagoya Japan
| | - T. Sugiura
- Department of Pediatrics and Neonatology; Nagoya Japan
| | - K. Katano
- Department of Obstetrics and Gynecology; Graduate School of Medical Sciences Nagoya City University; Nagoya Japan
| | - M. Matsuhashi
- Department of Transfusion Medicine; The University of Tokyo; Tokyo Japan
| | - S. Kato
- Department of Pediatrics and Neonatology; Nagoya Japan
| | - K. Ito
- Department of Pediatrics and Neonatology; Nagoya Japan
| | - R. Nagasaki
- Department of Pediatrics and Neonatology; Nagoya Japan
| | - T. Kato
- Department of Pediatrics and Neonatology; Nagoya Japan
| | - N. H. Tsuno
- Department of Transfusion Medicine; The University of Tokyo; Tokyo Japan
| | - S. Saitoh
- Department of Pediatrics and Neonatology; Nagoya Japan
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Wu GG. Detection of clinically relevant platelet antibodies in the Asian population. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/voxs.12098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- G.-G. Wu
- Nanning Institute of Transfusion Medicine; Nanning China
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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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10
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Asmarinah, Dharma R, Ritchie NK, Rahayu S, Putricahya E, Santoso S. Human platelet-specific antigen frequencies in Indonesian population. Transfus Med 2013; 23:250-3. [PMID: 23617356 DOI: 10.1111/tme.12039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 02/14/2013] [Accepted: 03/18/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Alloantibodies against human platelet antigens (HPAs) are responsible for the development of alloimmune thrombocytopenia including platelet transfusion refractoriness (PTR) and neonatal alloimmune thrombocytopenia (NAIT). Therefore, transfusion of HPA-compatible platelets is of importance for the management of these diseases. AIM Determination of the allele frequency of the major HPA systems for Indonesian blood donors and the development of the first HPA-typed donor registry in Indonesia. METHODS DNA derived from 500 Indonesian healthy blood donors was genotyped for HPA-1 to HPA-6 and HPA-15 alleles by the use of polymerase chain reaction sequence-specific primer method. RESULTS The gene frequencies of the rare allelic variants HPA-1b, -2b, -3b, -4b, -5b, -6b and -15b were 0·023, 0·060, 0·493, 0·052, 0·032, 0·044 and 0·049, respectively. However, donors homozygous for the HPA-1b, -2b and -6b were not found in this cohort, indicating that the risks of alloimmunisation caused by incompatibility of these three HPA systems are extremely low. In contrast, alloimmunisation against HPA-3, -4, -5 and -15 systems is anticipated. CONCLUSION The development of an HPA-genotyped registry for donors homozygous for HPA-1b, -2b and -6b is desired for the optimum management of PTR patients and children with NAIT.
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Affiliation(s)
- Asmarinah
- Department of Medical Biology, Faculty of Medicine, Universitas Indonesia.
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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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Lee AI, Kaufman RM. Transfusion Medicine and the Pregnant Patient. Hematol Oncol Clin North Am 2011; 25:393-413, ix. [DOI: 10.1016/j.hoc.2011.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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