Décary F, L'Abbé D, Tremblay L, Chartrand P
Blood Services, Canadian Red Cross Society, Montréal, Québec, Canada.
Transfus Med. 1991 Mar;1(1):55-62. doi: 10.1111/j.1365-3148.1991.tb00010.x.
Antibodies to the HPA-1a antigen can elicit a condition in the new-born known as neonatal alloimmune thrombocytopenia (NAITP). Retrospective and prospective studies have shown that there is a strong correlation between the presence of HLA-DR3, HLA-DRw52 in the mother and the antibody response to HPA-1a. HLA Class II molecules play an important role in the initiation of the immune response and it has been postulated that HPA-1a antibody production could be determined by the presence of a specific HLA Class II molecule at the surface of the antigen-presenting cell. Thirty-one HPA-1a negative women with HPA-1a antibodies (responders) and nine HPA-1a negative women without HPA-1a antibodies (non-responders) were recruited. They were studied using serological HLA Class I and Class II typing and RFLP analysis with a DR beta probe. We found that all responders had the HLA-DRw52a sub-specificity confirming recently published data. Moreover, two of the nine non-responders were also found to be HLA-DRw52a. These results suggest that the HLA-DRw52a molecule is necessary for HPA-1a antibody responsiveness but not sufficient. The results also indicate that in HPA-1a negative women the absence of HLA-DRw52a is associated with a very low risk of being antibody producers and hence, is associated with a very low risk for NAITP in their new-borns.
针对HPA-1a抗原的抗体可引发新生儿的一种病症，即新生儿同种免疫性血小板减少症（NAITP）。回顾性和前瞻性研究表明，母亲体内HLA-DR3、HLA-DRw52的存在与对HPA-1a的抗体反应之间存在很强的相关性。HLA II类分子在免疫反应的启动中起重要作用，据推测，HPA-1a抗体的产生可能由抗原呈递细胞表面特定的HLA II类分子的存在所决定。招募了31名有HPA-1a抗体（反应者）的HPA-1a阴性女性和9名无HPA-1a抗体（无反应者）的HPA-1a阴性女性。使用血清学HLA I类和II类分型以及用DRβ探针进行的RFLP分析对她们进行研究。我们发现所有反应者都具有HLA-DRw52a亚特异性，这证实了最近发表的数据。此外，在9名无反应者中也发现有2名是HLA-DRw52a。这些结果表明，HLA-DRw52a分子对于HPA-1a抗体反应性是必要的，但并非充分条件。结果还表明，在HPA-1a阴性女性中，缺乏HLA-DRw52a与产生抗体的风险非常低相关，因此，与她们新生儿患NAITP的风险非常低相关。
