Dharma R, Ritchie N K, Rahayu S, Putricahya E, Santoso S
Department of Medical Biology, Faculty of Medicine, Universitas Indonesia.
Transfus Med. 2013 Aug;23(4):250-3. doi: 10.1111/tme.12039. Epub 2013 Apr 25.
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.
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.
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.
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.
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.
抗人血小板抗原（HPA）的同种抗体可导致同种免疫性血小板减少症，包括血小板输注无效（PTR）和新生儿同种免疫性血小板减少症（NAIT）。因此，输注HPA相容的血小板对于这些疾病的治疗至关重要。
确定印度尼西亚献血者主要HPA系统的等位基因频率，并建立印度尼西亚首个HPA分型献血者登记册。
采用聚合酶链反应序列特异性引物法，对500名印度尼西亚健康献血者的DNA进行HPA-1至HPA-6和HPA-15等位基因分型。
罕见等位基因变体HPA-1b、-2b、-3b、-4b、-5b、-6b和-15b的基因频率分别为0.023、0.060、0.493、0.052、0.032、0.044和0.049。然而，在该队列中未发现HPA-1b、-2b和-6b纯合的献血者，这表明这三种HPA系统不相容引起的同种免疫风险极低。相比之下，预计会出现针对HPA-3、-4、-5和-15系统的同种免疫。
为了对PTR患者和NAIT儿童进行最佳管理，需要为HPA-1b、-2b和-6b纯合的献血者建立HPA基因分型登记册。
