Neonatal alloimmune thrombocytopenia

Rayment, Rachel; Birchall, Janet; Yarranton, Helen; Hewertson, John; Allen, Dave; Murphy, Mike; Roberts, David J.

doi:10.1136/bmj.327.7410.331

Cited by 17 publications

(7 citation statements)

References 9 publications

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“…All neonates that received HPCs in utero maintained a platelet count >50 × 10 9 L −1 after birth. However, neonates with NAIT diagnosed postnatally had a more varied recovery time, as has been observed in previous studies (Mueller‐Eckhardt et al ., 1989a; Williamson et al ., 1998; Rayment et al ., 2003).…”

Section: Discussionmentioning

confidence: 99%

Survey of the use and clinical effectiveness of HPA‐1a/5b‐negative platelet concentrates in proven or suspected platelet alloimmunization

Allen

Samol

Benjamin

et al. 2004

Transfusion Medicine

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The optimal treatment of neonatal alloimmune thrombocytopenia (NAIT) is the transfusion of compatible donor platelets. The National Blood Service in England has established panels of "accredited" donors negative for human platelet antigens HPA-1a and HPA-5b, the most commonly implicated alloantigens. We have retrospectively surveyed the frequency of use and clinical effectiveness of donations collected over a 13-month period from the Oxford accredited panel. Ninety-five per cent of hyperconcentrated platelets (HPCs) collected were issued, all for intrauterine transfusion to fetuses at risk of NAIT due to the presence of maternal platelet alloantibodies and previously affected siblings. Thirty-one per cent of paediatric platelet concentrates (PPCs) collected were issued, of which 57% were used for cases of suspected NAIT. Fifty-four per cent of adult therapeutic doses collected were issued; 5% of these were used in cases of suspected NAIT or proven post-transfusion purpura (PTP). Good increments were seen in most NAIT cases transfused with HPCs or PPCs, and a moderate increment in the one PTP case. We conclude that the establishment of accredited panels is justified and enables delivery of a clinically effective treatment for NAIT. Increased use and cost-effectiveness could be achieved by the delivery of an educational programme to neonatal unit clinical staff to increase the awareness and appropriate treatment of NAIT.

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Section: Discussionmentioning

confidence: 99%

Survey of the use and clinical effectiveness of HPA‐1a/5b‐negative platelet concentrates in proven or suspected platelet alloimmunization

Allen

Samol

Benjamin

et al. 2004

Transfusion Medicine

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“…PLA variants have been demonstrated to be involved in neonatal alloimmune thrombocytopenia by the maternal PLA1 alloimmunisation [10,26,28]. Alloimmune thrombocytopenia in neonates represents a high risk for the development of IVH in neonates with the PLA1/PLA2 genotype [3,6,12].…”

Section: Discussionmentioning

confidence: 99%

“…Two major variants of the gene encoding the IIIa subunit [22], called PLA1 and PLA2 (HPA 1a and HPA 1b), have recently aroused significant interest, since the PLA2 allele has been suggested to contribute to the development of ischaemic heart disease of the elderly [34] and to the development of acute stroke [5,29]. The PLA variants are known to be involved in the neonatal alloimmune thrombocytopenia by the maternal PLA1 alloimmunisation [10,26,28]. The latter condition represents a high risk for the development of IVH in neonates [3,6,12].…”

Section: Introductionmentioning

confidence: 99%

Increased Prevalence of Glycoprotein IIb/IIIa Leu33Pro Polymorphism in Term Infants with Grade I Intracranial Haemorrhage

Havasi

Komlósi²,

Bene³

et al. 2006

Neuropediatrics

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The prevalence rates of the platelet glycoprotein IIb/IIIa Leu33Pro allele (PLA2), and factor V G1691A Leiden mutation were determined in 109 appropriate for gestational age neonates with grade I intraventricular haemorrhage (IVH) and in 118 IVH-free control infants. The PLA2 allele frequency was 16.4 % in the group of full-term infants with grade I IVH, while it was 9.5 % in the relevant controls (p < 0.005); there was no difference in the PLA allele frequencies on comparing the IVH affected (8.34 %) and unaffected (9.2 %) premature infants. By contrast, the factor V Leiden allele frequency was increased only in the subgroup of premature infants with grade I IVH as compared with the appropriate premature controls (9.25 % vs. 3.34 %, respectively, p < 0.005). These data suggest that besides the factor V Leiden mutation, the PLA2 allele, which has already been suggested to have a role in neonatal alloimmune thrombocytopenia and certain subtypes of adult stroke, can have significance in the development of the events of IVH.

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“…[2][3][4] Thus, screening and identification of maternal alloantibodies are critical in early detection of such alloimmunization. 5 Up to now, all methods for detecting auto-or alloantibodies directed at platelets, such as monoclonal antibody immobilization of platelet antigen assay (MAIPA) 6 or enzyme-linked immunosorbent assay (ELISA), 7 require human platelets.…”

Section: Introductionmentioning

confidence: 99%

A novel assay for the detection of anti-human platelet antigen antibodies (HPA-1a) based on peptide aptamer technology

Thibaut¹,

Mérieux²,

Rigal³

et al. 2011

Haematologica

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BackgroundNeonatal alloimmune thrombocytopenia is mostly due to the presence of maternal antibodies against the fetal platelet antigen HPA-1a on the platelet integrin GPIIb-IIIa. Accurate detection of anti-HPA-1a antibodies in the mother is, therefore, critical. Current diagnostic assays rely on the availability of pools of human platelets that vary according to donors and blood centers. There is still no satisfactory standardization of these assays. Design and MethodsPeptide aptamer was used to detect and identify HPA-1a-specific antibodies in human serum that do not require human platelets. A peptide aptamer library was screened using an anti-HPA1a human monoclonal antibody as a bait to isolate an aptamer that mimics the human platelet antigen HPA-1a. ResultsThis is the first report in platelet immunology of the use of a peptide aptamer for diagnostic purposes. This assay gives better results than the MAIPA currently in use, detecting around 90% of the expected alloantibodies. ConclusionsThis assay could help define a standard for the quantitation of anti-HPA antibodies. This report also demonstrates that peptide aptamers can potentially detect a variety of biomarkers in body fluids; this is of particular interest for diagnostic purposes.Key words: peptide aptamers, neonatal alloimmune thrombocytopenia, platelets, HPA-1a, diagnostic assay, MAIPA. Haematologica 2012; 97(5):696-704. doi:10.3324/haematol.2011 A novel assay for the detection of anti-human platelet antigen antibodies (HPA-1a) based on peptide aptamer technology Citation: Thibaut J, Mérieux Y, Rigal D, and Gillet G. A novel assay for the detection of anti-human platelet antigen antibodies (HPA-1a) based on peptide aptamer technology.

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Neonatal alloimmune thrombocytopenia

Abstract: Neonatal alloimmune thrombocytopenia-caused by movement of maternal alloantibodies directed against fetal platelet antigens across the placenta-is the most common cause of severe neonatal thrombocytopenia.

Cited by 17 publications

References 9 publications

Survey of the use and clinical effectiveness of HPA‐1a/5b‐negative platelet concentrates in proven or suspected platelet alloimmunization

Survey of the use and clinical effectiveness of HPA‐1a/5b‐negative platelet concentrates in proven or suspected platelet alloimmunization

Increased Prevalence of Glycoprotein IIb/IIIa Leu33Pro Polymorphism in Term Infants with Grade I Intracranial Haemorrhage

A novel assay for the detection of anti-human platelet antigen antibodies (HPA-1a) based on peptide aptamer technology

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