Kroll H, Kiefel V, Santoso S
Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany.
Vox Sang. 1998;74 Suppl 2:345-54. doi: 10.1111/j.1423-0410.1998.tb05441.x.
Platelet alloantigens can induce the formation of corresponding alloantibodies when exposed to phenotypically negative individuals. These antibodies are responsible for fetal and neonatal alloimmune thrombocytopenia, posttransfusion purpura, passive alloimmune thrombocytopenia and transplantation-associated thrombocytopenia and may contribute to platelet transfusion refractoriness together with HLA antibodies. Besides antibody detection laboratory diagnosis of the clinical syndromes requires alloantigen typing. Furthermore, typed platelet donors are a prerequisite for effective platelet transfusion therapy. Different techniques for phenotyping are well established and easy to perform but they rely on the availability of antisera. Since the molecular genetic background of the clinically most relevant alloantigens has been elucidated during the last years various genotyping methods have been applied to the platelet membrane polymorphisms and thus facilitated widespread platelet alloantigen typing. Generation of antibodies from phage display libraries and of lymphoblastoid cell lines from donors with all genetic variants will allow further developments.
血小板同种抗原暴露于表型阴性个体时可诱导相应同种抗体的形成。这些抗体导致胎儿和新生儿同种免疫性血小板减少症、输血后紫癜、被动同种免疫性血小板减少症以及移植相关血小板减少症，并且可能与HLA抗体一起导致血小板输注无效。除了抗体检测外，这些临床综合征的实验室诊断还需要进行同种抗原分型。此外，血型匹配的血小板供体是有效的血小板输血治疗的先决条件。不同的表型分析技术已经成熟且易于操作，但它们依赖于抗血清的可用性。由于近年来临床上最相关的同种抗原的分子遗传背景已被阐明，各种基因分型方法已应用于血小板膜多态性，从而促进了广泛的血小板同种抗原分型。从噬菌体展示文库产生抗体以及从具有所有遗传变异的供体产生淋巴母细胞系将推动进一步的发展。
