Bhatti F A, Uddin M, Ahmed A, Bugert P
PNS Shifa Hospital, Karachi, Pakistan.
Transfus Med. 2010 Apr;20(2):78-87. doi: 10.1111/j.1365-3148.2009.00982.x. Epub 2009 Nov 26.
Gene frequencies of human platelet antigens (HPA) determine the magnitude of platelet immunological disorders like neonatal alloimmune thrombocytopenia, platelet refractoriness and ease of availability of particular HPA-typed platelet donors in a given community.
However, the pattern of HPA in Pakistani population is not known.
The aim of present study was to determine the gene frequencies of HPA (HPA-1 to -5 and -15) in individuals belonging to major ethnic groups and castes of Pakistani population.
HPA genotyping was done in 593 individuals belonging to all ethnic groups of Pakistan, by polymerase chain reaction-sequence specific primers with detection on polyacrylamide electrophoresis.
The gene frequencies of the 'a' and 'b' alleles of HPA-1 to -5 and -15 in Pakistanis were as follows: HPA-1a/b, 0.885/0.115; HPA-2a/b, 0.92/0.08; HPA-3a/b, 0.69/0.31; HPA-4a/b, 1/0; HPA-5a/b, 0.9/0.1; HPA-15a/b, 0.59/0.41. Except for significant difference regarding gene frequency of HPA-3 between Pathans and Sindhis, there was no significant difference of HPA-1 to -5 and -15 between major ethnic groups of Pakistan. The estimated mismatch probability regarding platelet antigens 1-5 and 15 in Pakistanis, after transfusion of random donor platelets, is from 14 to 37%. The expected incidence of neonatal alloimmune thrombocytopenia due to anti-HPA-1a in Pakistani pregnant females is < 1 of 1000 pregnancies and 8-12 of 1000 in case of anti-HPA-5b. Homozygosity of HPA-1b, -2b and -5b genotypes ranged from 1 to 2% in the Pakistani population, whereas homozygosity of HPA-3b and -15b was 11 and 18%.
There is a need to establish donor registries typed for HPA in the transfusion centres of the country.
人类血小板抗原(HPA)的基因频率决定了血小板免疫性疾病的严重程度,如新生儿同种免疫性血小板减少症、血小板输注无效以及在特定社区中特定HPA类型血小板供体的可获得性。
然而,巴基斯坦人群中HPA的模式尚不清楚。
本研究的目的是确定巴基斯坦主要种族和种姓人群中HPA(HPA-1至-5和-15)的基因频率。
采用聚合酶链反应-序列特异性引物结合聚丙烯酰胺凝胶电泳检测,对593名来自巴基斯坦所有种族的个体进行HPA基因分型。
巴基斯坦人HPA-1至-5和-15的“a”和“b”等位基因的基因频率如下:HPA-1a/b,0.885/0.115;HPA-2a/b,0.92/0.08;HPA-3a/b,0.69/0.31;HPA-4a/b,1/0;HPA-5a/b,0.9/0.1;HPA-15a/b,0.59/0.41。除普什图人和信德人之间HPA-3的基因频率存在显著差异外,巴基斯坦主要种族之间HPA-1至-5和-15没有显著差异。在输注随机供体血小板后,巴基斯坦人血小板抗原1-5和15的估计错配概率为14%至37%。巴基斯坦孕妇因抗HPA-1a导致新生儿同种免疫性血小板减少症的预期发病率<1/1000次妊娠,而抗HPA-5b的情况下为8-12/1000次妊娠。HPA-1b、-2b和-5b基因型的纯合子在巴基斯坦人群中的比例为1%至2%,而HPA-3b和-15b的纯合子比例分别为11%和18%。
该国输血中心需要建立HPA分型的供体登记册。