Panzer S, Auerbach L, Cechova E, Fischer G, Holensteiner A, Kitl E M, Mayr W R, Putz M, Wagenbichler P, Walchshofer S
Clinical Department for Blood Group Serology, University of Vienna, Austria.
Br J Haematol. 1995 Jul;90(3):655-60. doi: 10.1111/j.1365-2141.1995.tb05597.x.
Neonatal alloimmune thrombocytopenia (NAIT) is induced by maternal alloantibodies to fetal platelet antigens. This prospective study was carried out to evaluate the incidence of anti-platelet antibodies in 933 mother-child pairs where the mother and child were typed for the human platelet antigens (HPA)-1, -2, -3, -5. Sera from mismatched mother-child pairs were screened for anti-platelet antibodies, anti-HLA class I and blood group ABO IgG antibodies. Platelet-specific antibodies were anti-HPA-3a in one and anti-HPA-5b in 17 neonates, respectively. All these neonates had normal platelet counts. One woman had autoreactive antibodies. Anti-HLA class I and anti-blood group A IgG antibodies were detected in five and four neonates, respectively, born with a platelet count < 150 x 10(9)/l. None of the 11 homozygous HPA-1b mothers became immunized against their heterozygous offspring. The maternal HLA-allotypes HLA-DR52 and -DR6, typically found in individuals immunized against HPA-1a and -5b, respectively, were found in three of 11 HPA-b/b nonresponders and eight of the anti-HPA-5b responders. The results indicate that a risk for NAIT due to HPA-2 and -3 alloimmunization is low. The HLA allotypes do not predict the risk for NAIT due to HPA-1 or -5 alloimmunization. Maternal anti-HPA-5b antibodies do not correlate with the platelet count in the neonate.
新生儿同种免疫性血小板减少症（NAIT）是由母体针对胎儿血小板抗原的同种抗体所诱发。本前瞻性研究旨在评估933对母婴中抗血小板抗体的发生率，这些母婴均进行了人类血小板抗原（HPA）-1、-2、-3、-5分型。对血型不匹配的母婴对血清进行抗血小板抗体、抗I类人白细胞抗原（HLA）和血型ABO IgG抗体筛查。血小板特异性抗体在1例新生儿中为抗HPA-3a，在17例新生儿中为抗HPA-5b。所有这些新生儿血小板计数均正常。1名女性有自身反应性抗体。在血小板计数<150×10⁹/L的5例和4例新生儿中分别检测到抗I类HLA和抗血型A IgG抗体。11名纯合子HPA-1b母亲均未对其杂合子后代产生免疫。在11名HPA-b/b无反应者中的3例以及抗HPA-5b反应者中的8例中发现了通常分别在针对HPA-1a和-5b免疫的个体中发现的母体HLA同种异型HLA-DR52和-DR6。结果表明，因HPA-2和-3同种免疫导致NAIT的风险较低。HLA同种异型不能预测因HPA-1或-5同种免疫导致NAIT的风险。母体抗HPA-5b抗体与新生儿血小板计数无关。
