Platelet & Neutrophil Immunology Laboratory, BloodCenter of Wisconsin, Milwaukee, WI, USA.
Vox Sang. 2014 Feb;106(2):93-102. doi: 10.1111/vox.12085. Epub 2013 Sep 16.
To date, 33 human platelet alloantigens (HPAs) have been identified on six functionally important platelet glycoprotein (GP) complexes and have been implicated in alloimmune platelet disorders including foetal and neonatal alloimmune thrombocytopenia (FNAIT), posttransfusion purpura (PTP) and multitransfusion platelet refractoriness (MPR). The greatest number of recognized HPA (20 of 33) resides on the GPIIb/IIIa complex, which serves as the receptor for ligands important in mediating haemostasis and inflammation. These include HPA-1a, the most commonly implicated HPA in FNAIT and PTP in Caucasian populations. Other platelet GP complexes, GPIb/V/IX, GPIa/IIa and CD109, express the remaining 13 HPAs. Of the recognized HPAs, 12 occur as six serologically and genetically defined biallelic 'systems' where the -a form designates the higher frequency allele and the -b form, the lower. Twenty-one other HPAs are low-frequency or rare antigens for which postulated higher frequency -a alleles have not yet been identified as antibody specificities. In addition to the HPA markers, platelets also express ABO and human leucocyte antigen (HLA) antigens; antibodies directed at the former are occasionally important in FNAIT, and to the latter, in MPR.
迄今为止,已在六个功能重要的血小板糖蛋白 (GP) 复合物上鉴定出 33 个人类血小板同种抗原 (HPA),并已证实其与同种免疫性血小板疾病有关,包括胎儿和新生儿同种免疫性血小板减少症 (FNAIT)、输血后紫癜 (PTP) 和多次输血血小板反应性降低 (MPR)。已识别的 HPA 中数量最多的 (33 个中的 20 个) 位于 GPIb/IIIa 复合物上,该复合物是介导止血和炎症的重要配体的受体。其中包括 HPA-1a,这是在白种人群中最常与 FNAIT 和 PTP 相关的 HPA。其他血小板 GP 复合物,GPIb/V/IX、GPIa/IIa 和 CD109,表达其余的 13 个 HPA。在已识别的 HPA 中,有 12 个为六种血清学和遗传定义的双等位基因“系统”,其中 -a 形式表示高频等位基因,-b 形式表示低频等位基因。其他 21 个 HPA 是低频或稀有抗原,尚未确定推测的高频 -a 等位基因是否为抗体特异性。除了 HPA 标记物外,血小板还表达 ABO 和人类白细胞抗原 (HLA) 抗原;针对前者的抗体在 FNAIT 中偶尔很重要,而针对后者的抗体在 MPR 中很重要。