L'Abbé D, Tremblay L, Filion M, Busque L, Goldman M, Décary F, Chartrand P
Blood Services, Canadian Red Cross Society, Montreal Center, Quebec.
Hum Immunol. 1992 Jun;34(2):107-14. doi: 10.1016/0198-8859(92)90036-m.
Antibodies to the platelet HPA-1a antigen can elicit in the newborn a condition known as neonatal alloimmune thrombocytopenic purpura (NAITP). Previous studies based on RFLP analysis showed that 100% of HPA-1a-negative women who produced anti-HPA-1a antibodies (responders) were HLA-DRw52a (DRB30101). However, this specificity could also be found in some HPA-1a-negative women not producing anti-HPA-1a antibodies (nonresponders). We have analyzed in detail by PCR-SSOP the HLA-DR, -DQ, and -DP loci of 36 responders and 10 nonresponders. We found that while the allele DRB30101 was present in the vast majority of responders (91%), there were exceptions. Furthermore, the DQB10201 allele was found to be present in almost all responders (94%), but again was also found in nonresponders. The risk of alloimmunization to HPA-1a in an HPA-1b homozygous mother significantly increases with the presence of either allele, the odds ratio being 39.7 for DQB10201 and 24.9 for DRB3*0101. Sequencing of exon 2 of these two alleles from responders indicated no sequence difference when compared with the consensus sequences. This indicates that they do not represent variants when compared with the same alleles found in some nonresponders.
针对血小板HPA-1a抗原的抗体可在新生儿中引发一种称为新生儿同种免疫性血小板减少性紫癜（NAITP）的病症。先前基于限制性片段长度多态性（RFLP）分析的研究表明，产生抗HPA-1a抗体的HPA-1a阴性女性（反应者）中100%为HLA-DRw52a（DRB30101）。然而，在一些不产生抗HPA-1a抗体的HPA-1a阴性女性（无反应者）中也能发现这种特异性。我们通过聚合酶链反应-序列特异性寡核苷酸探针（PCR-SSOP）详细分析了36名反应者和10名无反应者的HLA-DR、-DQ和-DP基因座。我们发现，虽然绝大多数反应者（91%）存在DRB30101等位基因，但也有例外情况。此外，几乎所有反应者（94%）都存在DQB10201等位基因，但在无反应者中也同样被发现。在HPA-1b纯合母亲中，无论存在哪种等位基因，对HPA-1a发生同种免疫的风险都会显著增加，DQB10201的优势比为39.7，DRB3*0101的优势比为24.9。对反应者这两个等位基因的第2外显子进行测序表明，与共有序列相比没有序列差异。这表明与在一些无反应者中发现的相同等位基因相比，它们并不代表变体。
