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Huisman EJ, Holle N, Schipperus M, Cnossen MH, de Haas M, Porcelijn L, Zwaginga JJ. Should HLA and HPA-matched platelet transfusions for patients with Glanzmann Thrombasthenia or Bernard-Soulier syndrome be standardized care? A Dutch survey and recommendations. Transfusion 2024; 64:824-838. [PMID: 38642032 DOI: 10.1111/trf.17824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/23/2023] [Accepted: 03/18/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Glanzmann thrombasthenia (GT) and Bernard-Soulier syndrome (BSS) patients require frequent platelet transfusions and hence have an increased risk for alloimmunization against donor Human Leukocyte Antigens (HLA) when no HLA-matching is performed. Knowing that Human Platelet Antigens (HPA) are located on the platelet glycoproteins that can be absent in these patients, preventive HPA-matching may also be considered. Uniform recommendations on this topic lack in transfusion guidelines making standard practice unclear, therefore, we aimed to provide a framework for matched platelet transfusions. STUDY DESIGN AND METHODS We conducted a targeted literature search and a national survey of Dutch (pediatric) hematologists from July to September 2021. RESULTS We found 20 articles describing platelet transfusion policies in 483 GT-patients and 29 BSS-patients, both adults and children. Twenty surveys were returned for full analysis. All responders treated patients with platelet disorders, including GT (n = 36 reported) and BSS (n = 29 reported). Of respondents, 75% estimated the risk of antibody formation as "likely" for HLA and 65% for HPA. Formation of HLA antibodies was reported in 5 GT and in 5 BSS-patients, including one child. Fifteen respondents gave preventive HLA-matched platelets in elective setting (75%). Three respondents additionally matched for HPA in GT-patients (15%). Main argument for matched platelet transfusions was preventing alloimmunization to safeguard the effectivity of 'random' donor-platelets in acute settings. CONCLUSION Elective HLA-matching for GT and BSS-patients is already conducted by most Dutch (pediatric) hematologists. HPA-matching is mainly applied when HPA-antibodies are formed. Based on the current literature and the survey, recommendations are proposed.
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Affiliation(s)
- Elise J Huisman
- Department of Pediatric Hematology and Oncology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Medical Affairs, Unit of Transfusion Medicine, Sanquin Blood bank, Amsterdam, The Netherlands
- Laboratory of Blood Transfusion, Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Nory Holle
- Department of Pediatric Hematology and Oncology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martin Schipperus
- Department of Pediatric Hematology and Oncology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marjon H Cnossen
- Department of Medical Affairs, Unit of Transfusion Medicine, Sanquin Blood bank, Amsterdam, The Netherlands
| | - Masja de Haas
- Department of Immunohematology Diagnostics, Sanquin Diagnostic Services and Sanquin Research, Amsterdam, The Netherlands
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin Diagnostic Services and Sanquin Research, Amsterdam, The Netherlands
- Laboratory of Platelet and Leucocyte Serology, Sanquin Diagnostic Services and Sanquin Research, Amsterdam, The Netherlands
| | - Jaap-Jan Zwaginga
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
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2
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Han R, He HC, Zhang WN, Pan ZT, Feng CY, Liang MJ, Wu MY, Zhong W, Lin WQ. Investigation of the correlation between platelet antibodies and peripheral blood cytopenia in patients with hepatocellular carcinoma. Sci Rep 2024; 14:9705. [PMID: 38678158 PMCID: PMC11055914 DOI: 10.1038/s41598-024-60603-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 04/25/2024] [Indexed: 04/29/2024] Open
Abstract
The primary triggers that stimulate the body to generate platelet antibodies via immune mechanisms encompass events such as pregnancy, transplantation, and blood transfusion. Interestingly, our findings revealed that a subset of male patients with hepatocellular carcinoma (HCC), despite having no history of transplantation or blood transfusion, has shown positive results in platelet antibody screenings. This hints at the possibility that certain factors, potentially related to the tumor itself or its treatment, may affect antibody production. To delve the causes we initiated this study. We employed a case-control study approach to analyze potential influential factors leading to the positive results via univariate and multivariate regression analysis. We utilized Kendall's tau-b correlation to examine the relationship between the strength of platelet antibodies and peripheral blood cytopenia. Antitumor medication emerged as an independent risk factor for positive results in HCC patients, and the strength of platelet antibodies positively correlated with the severity of anemia and thrombocytopenia. Without history of blood transfusion, transplantation, pregnancy, those HCC patients underwent recent tumor medication therapy are experiencing peripheral erythrocytopenia or thrombocytopenia, for them platelet antibody screenings holds potential clinical value for prevention and treatment of complications like drug-immune-related anemia and/or bleeding.
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Affiliation(s)
- Rui Han
- Laboratory of Oncology in South China, Department of Blood Transfusion, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Hui-Chan He
- Laboratory of Oncology in South China, Department of Blood Transfusion, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Wan-Ning Zhang
- Laboratory of Oncology in South China, Department of Blood Transfusion, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Ze-Tao Pan
- Laboratory of Oncology in South China, Department of Blood Transfusion, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Chen-Yang Feng
- Laboratory of Oncology in South China, Department of Blood Transfusion, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Ming-Jian Liang
- Laboratory of Oncology in South China, Department of Blood Transfusion, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Mei-Yi Wu
- Laboratory of Oncology in South China, Department of Blood Transfusion, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Wei Zhong
- Department of Internal Medicine, Huangpu Hospital of Traditional Chinese Medicine, 3 Xieshan Road, Huangpu District, Guangzhou, 510700, People's Republic of China.
| | - Wen-Qian Lin
- Laboratory of Oncology in South China, Department of Blood Transfusion, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China.
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Cavalera S, Di Nardo F, Serra T, Testa V, Baggiani C, Rosati S, Colitti B, Brienza L, Colasanto I, Nogarol C, Cosseddu D, Guiotto C, Anfossi L. A semi-quantitative visual lateral flow immunoassay for SARS-CoV-2 antibody detection for the follow-up of immune response to vaccination or recovery. J Mater Chem B 2024; 12:2139-2149. [PMID: 38315042 DOI: 10.1039/d3tb02895j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
The lateral flow immunoassay (LFIA) technique is largely employed for the point-of-care detection of antibodies especially for revealing the immune response in serum. Visual LFIAs usually provide the qualitative yes/no detection of antibodies, while quantification requires some equipment, making the assay more expensive and complicated. To achieve visual semi-quantification, the alignment of several lines (made of the same antigen) along a LFIA strip has been proposed. The numbering of the reacting lines has been used to correlate with the quantity of some biomarkers in serum. Here, we designed the first semiquantitative LFIA for detecting antibodies and applied it to classify the immune response to SARS-CoV-2 raised by vaccination or natural infection. We used a recombinant spike receptor-binding domain (RBD) as the specific capture reagent to draw two test lines. The detection reagent was selected among three possible ligands that are able to bind to anti-spike human antibodies: the same RBD, staphylococcal protein A, and anti-human immunoglobulin G antibodies. The most convenient detector, adsorbed on gold nanoparticles, was chosen based on the highest correlation with an antibody titre of 171 human sera, measured by a reference serological method, and was the RBD (Spearman's rho = 0.84). Incorporated into the semiquantitative LFIA, it confirmed the ability to discriminate high- and low-titre samples and to classify them into two classes (Dunn's test, P < 0.05). The proposed approach enabled the semiquantification of the immune response to SARS-CoV-2 by the unaided eye observation, thus overcoming the requirement of costly and complicated equipment, and represents a general strategy for the development of semiquantitative serological LFIAs.
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Affiliation(s)
- Simone Cavalera
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, Turin, Italy.
| | - Fabio Di Nardo
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, Turin, Italy.
| | - Thea Serra
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, Turin, Italy.
| | - Valentina Testa
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, Turin, Italy.
| | - Claudio Baggiani
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, Turin, Italy.
| | - Sergio Rosati
- Department of Veterinary Science, University of Turin, Largo Braccini 2, Grugliasco (TO), Italy
| | - Barbara Colitti
- Department of Veterinary Science, University of Turin, Largo Braccini 2, Grugliasco (TO), Italy
| | - Ludovica Brienza
- Department of Veterinary Science, University of Turin, Largo Braccini 2, Grugliasco (TO), Italy
| | - Irene Colasanto
- Department of Veterinary Science, University of Turin, Largo Braccini 2, Grugliasco (TO), Italy
| | - Chiara Nogarol
- In3diagnostic srl, Largo Braccini 2, Grugliasco (TO), Italy
| | - Domenico Cosseddu
- A.O. Ordine Mauriziano, Ospedale Umberto I di Torino, Via Magellano 1, Turin, Italy
| | - Cristina Guiotto
- A.O. Ordine Mauriziano, Ospedale Umberto I di Torino, Via Magellano 1, Turin, Italy
| | - Laura Anfossi
- Department of Chemistry, University of Turin, Via Pietro Giuria 7, Turin, Italy.
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de Vos TW, van Zagten M, de Haas M, Oepkes D, Tan RNGB, van der Schoot CE, Steggerda SJ, de Vries LS, Lopriore E, van Klink JMM. Children Newly Diagnosed with Fetal and Neonatal Alloimmune Thrombocytopenia: Neurodevelopmental Outcome at School Age. J Pediatr 2023; 258:113385. [PMID: 36933767 DOI: 10.1016/j.jpeds.2023.02.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 01/31/2023] [Accepted: 02/20/2023] [Indexed: 03/20/2023]
Abstract
OBJECTIVE To evaluate the neurodevelopmental outcome at school age in children newly diagnosed with fetal and neonatal alloimmune thrombocytopenia (FNAIT). STUDY DESIGN This observational cohort study included children diagnosed with FNAIT between 2002 and 2014. Children were invited for cognitive and neurological testing. Behavioral questionnaires and school performance results were obtained. A composite outcome of neurodevelopmental impairment (NDI) was used, defined, and subdivided into mild-to-moderate and severe NDI. Primary outcome was severe NDI, defined as IQ <70, cerebral palsy with Gross Motor Functioning Classification System level ≥ III, or severe visual/hearing impairment. Mild-to-moderate NDI was defined as IQ 70-85, minor neurological dysfunction or cerebral palsy with Gross Motor Functioning Classification System level ≤ II, or mild visual/hearing impairment. RESULTS In total, 44 children were included at a median age of 12 years (range: 6-17 years). Neuroimaging at diagnosis was available in 82% (36/44) of children. High-grade intracranial hemorrhage (ICH) was detected in 14% (5/36). Severe NDI was detected in 7% (3/44); two children had high-grade ICH, and one had low-grade ICH and perinatal asphyxia. Mild-to-moderate NDI was detected in 25% (11/44); one child had high-grade ICH, and eight children were without ICH, yet for two children, neuroimaging was not performed. Adverse outcome (perinatal death or NDI) was 39% (19/49). Four children (9%) attended special needs education, three of whom had severe NDI and one had mild-to-moderate NDI. Total behavioral problems within the clinical range were reported in 12%, which is comparable with 10% in the general Dutch population. CONCLUSION Children who are newly diagnosed with FNAIT are at increased risk for long-term neurodevelopmental problems, even those without ICH. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (Identifier: NCT04529382).
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Affiliation(s)
- Thijs W de Vos
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, The Netherlands; Center of Clinical Transfusion Research, Sanquin Research, Amsterdam; Department of Experimental Immunohematology, Sanquin Research, Amsterdam.
| | - Maud van Zagten
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, The Netherlands
| | - Masja de Haas
- Center of Clinical Transfusion Research, Sanquin Research, Amsterdam; Department Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam; Department of Hematology, Leiden University Medical Center, Leiden
| | - Dick Oepkes
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden
| | - Ratna N G B Tan
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, The Netherlands
| | | | - Sylke J Steggerda
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, The Netherlands
| | - Linda S de Vries
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, The Netherlands
| | - Enrico Lopriore
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, The Netherlands
| | - Jeanine M M van Klink
- Division of Child and Adolescent Psychology, Department of Pediatrics, Leiden University Medical Center, Willem-Alexander Children's Hospital, The Netherlands
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Garraud O, Hamzeh-Cognasse H, Chalayer E, Duchez AC, Tardy B, Oriol P, Haddad A, Guyotat D, Cognasse F. Platelet transfusion in adults: An update. Transfus Clin Biol 2023; 30:147-165. [PMID: 36031180 DOI: 10.1016/j.tracli.2022.08.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many patients worldwide receive platelet components (PCs) through the transfusion of diverse types of blood components. PC transfusions are essential for the treatment of central thrombocytopenia of diverse causes, and such treatment is beneficial in patients at risk of severe bleeding. PC transfusions account for almost 10% of all the blood components supplied by blood services, but they are associated with about 3.25 times as many severe reactions (attributable to transfusion) than red blood cell transfusions after stringent in-process leukoreduction to less than 106 residual cells per blood component. PCs are not homogeneous, due to the considerable differences between donors. Furthermore, the modes of PC collection and preparation, the safety precautions taken to limit either the most common (allergic-type reactions and febrile non-hemolytic reactions) or the most severe (bacterial contamination, pulmonary lesions) adverse reactions, and storage and conservation methods can all result in so-called PC "storage lesions". Some storage lesions affect PC quality, with implications for patient outcome. Good transfusion practices should result in higher levels of platelet recovery and efficacy, and lower complication rates. These practices include a matching of tissue ABH antigens whenever possible, and of platelet HLA (and, to a lesser extent, HPA) antigens in immunization situations. This review provides an overview of all the available information relating to platelet transfusion, from donor and donation to bedside transfusion, and considers the impact of the measures applied to increase transfusion efficacy while improving safety and preventing transfusion inefficacy and refractoriness. It also considers alternatives to platelet component (PC) transfusion.
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Affiliation(s)
- O Garraud
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France.
| | | | - E Chalayer
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Saint-Etienne University Hospital, Department of Hematology and Cellular Therapy, Saint-Étienne, France
| | - A C Duchez
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
| | - B Tardy
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; CHU de Saint-Etienne, INSERM and CIC EC 1408, Clinical Epidemiology, Saint-Étienne, France
| | - P Oriol
- CHU de Saint-Etienne, INSERM and CIC EC 1408, Clinical Epidemiology, Saint-Étienne, France
| | - A Haddad
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Sacré-Cœur Hospital, Beirut, Lebanon; Lebanese American University, Beirut, Lebanon
| | - D Guyotat
- Saint-Etienne University Hospital, Department of Hematology and Cellular Therapy, Saint-Étienne, France
| | - F Cognasse
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
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6
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de Vos TW, Winkelhorst D, Árnadóttir V, van der Bom JG, Canals Surís C, Caram-Deelder C, Deschmann E, Haysom HE, Hverven HBC, Lozar Krivec J, McQuilten ZK, Muñiz-Diaz E, Nogués N, Oepkes D, Porcelijn L, van der Schoot CE, Saxonhouse M, Sola-Visner M, Tiblad E, Tiller H, Wood EM, Young V, Železnik M, de Haas M, Lopriore E. Postnatal treatment for children with fetal and neonatal alloimmune thrombocytopenia: a multicentre, retrospective, cohort study. Lancet Haematol 2022; 9:e844-e853. [PMID: 36108655 DOI: 10.1016/s2352-3026(22)00243-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Children affected by fetal and neonatal alloimmune thrombocytopenia (FNAIT) are at risk of severe intracranial haemorrhage. Management in the postnatal period is based on sparse evidence. We aimed to describe the contemporary management and outcomes of patients with FNAIT in high-income countries. METHODS In this multicentre, retrospective, cohort study, we set up a web-based registry for the collection of deidentified data on the management and course of neonates with FNAIT. Eight centres from seven countries (Australia, Norway, Slovenia, Spain, Sweden, the Netherlands, and the USA) participated. Eligibility criteria comprised neonates with FNAIT being liveborn between Jan 1, 2010, and Jan 1, 2020; anti-human platelet antigen (HPA) alloantibodies in maternal serum; confirmed maternal and fetal HPA incompatibility; and bleeding detected at antenatal ultrasound, neonatal thrombocytopenia (<150 × 109 platelets per L), or both in the current or previous pregnancy. Clinical data were retrieved from local medical records of the first neonatal admission and entered in the registry. The key outcome was the type of postnatal treatment given to neonates with FNAIT. Other outcomes were daily median platelet counts in the first week of life, median platelet count increment after first unmatched versus first matched transfusions, and the proportion of neonates with mild or severe bleeding. FINDINGS 408 liveborn neonates with FNAIT were entered into the FNAIT registry, of whom 389 from Australia (n=74), Norway (n=56), Slovenia (n=19), Spain (n=55), Sweden (n=31), the Netherlands (n=138), and the USA (n=16) were included in our analyses. The median follow-up was 5 days (IQR 2-9). More neonates were male (241 [64%] of 379) than female (138 [36%]). Severe thrombocytopenia (platelet count <50 × 109 platelets per L) was reported in 283 (74%) of 380 neonates, and extreme thrombocytopenia (<10 × 109 platelets per L) was reported in 92 (24%) neonates. Postnatal platelet count nadir was higher in the no-treatment group than in all other groups. 163 (42%) of 389 neonates with FNAIT received no postnatal treatment. 207 (53%) neonates received platelet transfusions, which were either HPA-unmatched (88 [43%] of 207), HPA-matched (84 [41%]), or a combination of both (35 [17%]). The proportion of neonates who received HPA-matched platelet transfusions varied between countries, ranging from 0% (Slovenia) to 63% (35 of 56 neonates; Norway). Postnatal intravenous immunoglobulin treatment was given to 110 (28%) of 389 neonates (alone [n=19] or in combination with platelet transfusions [n=91]), with the proportion receiving it ranging from 12% (17 of 138 neonates; the Netherlands) to 63% (ten of 16 neonates; the USA) across countries. The median platelet increment was 59 × 109 platelets per L (IQR 35-94) after HPA-unmatched platelet transfusions and 98 × 109 platelets per L (67-134) after HPA-matched platelet transfusions (p<0·0001). Severe bleeding was diagnosed in 23 (6%) of 389 liveborn neonates, with one having a severe pulmonary haemorrhage and 22 having severe intracranial haemorrhages. Mild bleeding was diagnosed in 186 (48%) neonates. INTERPRETATION Postnatal management of FNAIT varies greatly between international centres, highlighting the absence of consensus on optimal treatments. Our data suggest that HPA-matched transfusions lead to a larger median platelet count increment than HPA-unmatched transfusions, but whether HPA matching is also associated with a reduced risk of bleeding remains unknown. FUNDING Sanquin.
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Affiliation(s)
- Thijs W de Vos
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, Netherlands; Center of Clinical Transfusion Research, Sanquin Research, Leiden, Netherlands; Department of Experimental Immunohematology, Sanquin Research, Amsterdam, Netherlands.
| | - Dian Winkelhorst
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, Netherlands; Department of Experimental Immunohematology, Sanquin Research, Amsterdam, Netherlands
| | - Valgerdur Árnadóttir
- Department of Pediatrics, Division of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| | - Johanna G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Camila Caram-Deelder
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands; Center of Clinical Transfusion Research, Sanquin Research, Leiden, Netherlands
| | - Emöke Deschmann
- Department of Pediatrics, Division of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| | - Helen E Haysom
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Hem Birgit C Hverven
- Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway
| | - Jana Lozar Krivec
- Department of Neonatology, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Zoe K McQuilten
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Clinical Haematology, Monash Health, Melbourne, VIC, Australia
| | | | - Núria Nogués
- Immunohematology Laboratory, Blood and Tissue Bank, Barcelona, Spain
| | - Dick Oepkes
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, Netherlands
| | - Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, Netherlands
| | | | - Matthew Saxonhouse
- Division of Neonatology, Levine Children's Hospital, Atrium Healthcare, Wake Forest School of Medicine, Charlotte, NC, USA
| | - Martha Sola-Visner
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Eleonor Tiblad
- Center for Fetal Medicine, Pregnancy Care and Delivery, Women's Health, Karolinska University Hospital, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Heidi Tiller
- Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway; Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway
| | - Erica M Wood
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Clinical Haematology, Monash Health, Melbourne, VIC, Australia
| | - Vanessa Young
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mojca Železnik
- Department of Neonatology, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Masja de Haas
- Department of Hematology, Leiden University Medical Center, Leiden, Netherlands; Department of Experimental Immunohematology, Sanquin Research, Amsterdam, Netherlands; Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, Netherlands
| | - Enrico Lopriore
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, Netherlands
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Xue Y, Xin W, Li C, Zeng X, Song Z, Cao C, Zhao T. Maternal alloimmune antibodies against HPA and HLA class I antigens are associated with reduced birthweight among healthy neonates delivered by Chinese women. Acta Obstet Gynecol Scand 2022; 101:1215-1219. [PMID: 35871773 PMCID: PMC9812071 DOI: 10.1111/aogs.14421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/25/2022] [Accepted: 06/17/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION It is well known that HPA-1a antibodies lead to fetal and neonatal alloimmune thrombocytopenia (FNAIT), and an association with reduced birthweight in boys has been reported. Although it remains unclear whether HLA antibodies cause FNAIT, an association between HLA class I antibodies and reduced birthweight in FNAIT neonates has been observed. The aim of this study was to investigate the incidence of platelet antibodies among Chinese women and the impact of maternal alloimmune antibodies on birthweight among healthy neonates. MATERIAL AND METHODS In this retrospective observational cohort study, platelet antibody screening was performed among women hospitalized for delivery from March 2019 to November 2020. A portion of each serum sample was used to distinguish HLA class I antibodies from HPA antibodies. Based on neonatal sex, gestational age and maternal age, platelet antibody-negative women who were hospitalized for delivery during the same period were randomly selected as reference groups at a 1:1 ratio for comparisons of the birthweights of healthy neonates delivered by women who were positive or negative for platelet antibodies. RESULTS Among 15 156 women, 1008 (6.7%) were positive for platelet antibodies; the incidences of positive platelet antibody were 1.2%, 1.9%, 1.6% and 2.0% among women with 1, 2, 3 and >3 pregnancies, respectively. Among 787 platelet antibody-positive serum samples available for further analysis, 548 (69.6%) were positive for HLA class I antibodies bound to platelets, and 239 (30.4%) were positive for HPA antibodies. The average birthweight of healthy neonates delivered by women who were positive for platelet antibodies, HLA class I antibodies or HPA antibodies was 161-483 g lower than that of neonates delivered by women who were negative for these antibodies (P < 0.001). Regarding birthweight reduction, there was no significant difference among women who were positive for these antibodies or between boys and girls (P > 0.05). CONCLUSIONS This study is the first to report that maternal HPA and HLA class I antibodies are associated with reduced birthweight among healthy neonates delivered by Chinese women. This finding provides information for the study of the effect of maternal alloimmune antibodies on fetal development.
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Affiliation(s)
- Yang Xue
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Wenlong Xin
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Chao Li
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Xing Zeng
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Zhanyun Song
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Chen Cao
- The United Reference Laboratory (jiangyin) for Blood Group Gene Detection of National Health CommissionJiangyinJiangsuChina
| | - Tongmao Zhao
- The United Reference Laboratory (jiangyin) for Blood Group Gene Detection of National Health CommissionJiangyinJiangsuChina
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8
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De Vos TW, De Haas M, Oepkes D, Tan RRNGB, Van der Schoot CE, Steggerda SJ, de Vries LS, Lopriore E, Van Klink JMM. Long-term neurodevelopmental outcome in children after antenatal intravenous immune globulin treatment in fetal and neonatal alloimmune thrombocytopenia. Am J Obstet Gynecol 2022; 227:637.e1-637.e9. [PMID: 35671780 DOI: 10.1016/j.ajog.2022.05.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/17/2022] [Accepted: 05/29/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children with fetal and neonatal alloimmune thrombocytopenia (FNAIT) face increased risk of intracranial hemorrhage (ICH) potentially leading to developmental impairment. To prevent ICH, pregnant women with alloantibodies against fetal platelets are often treated with intravenous immunoglobulin (IVIg). IVIg appears effective in vastly reducing the risk of fetal or neonatal bleeding complications. However, information on long-term neurodevelopment of these children is lacking. OBJECTIVE To evaluate long-term neurodevelopmental outcome in children with FNAIT who were treated with IVIg antenatally. STUDY DESIGN An observational cohort study was performed including children of mothers who were treated with IVIg during pregnancy because a previous child was diagnosed with FNAIT. Children, were invited for a follow-up assessment including standardized cognitive and neurologic tests. The parents were asked to complete a behavioral questionnaire and school performance reports. The primary outcome was severe neurodevelopmental impairment (NDI), defined as severe cognitive impairment (IQ < 70), cerebral palsy with Gross Motor Function Classification System (GMFCS) Level ≥ 3, bilateral blindness, and/or bilateral deafness (requiring amplification). The secondary outcome was mild to moderate NDI, defined as either mild to moderate cognitive impairment (IQ < 85), cerebral palsy with GMFCS Level ≤ 2, minor neurologic dysfunction, vision loss, and/or hearing loss. RESULTS Between 2003 and 2017, 51 children were liveborn after antenatal IVIg treatment. One family moved abroad and was therefore not eligible for inclusion. In total, 82% (41/50) of the eligible cases were included for neurodevelopmental assessment at a median age of 9 years and 8 months. Severe NDI was not detected. The incidence of mild to moderate NDI was 14% (6/41, 95% confidence interval: 6%-29%). The children's mean cognitive score, behavioral scores, and academic achievement were not different from the Dutch norm groups. Neuroimaging was performed in 90% (37/41) of cases. Severe ICH had been diagnosed in two cases (5%), one antenatally before the start of IVIg and the other case 1 day after birth. Both cases had a normal neurodevelopmental outcome. CONCLUSION The risk of NDI in children whose mothers were treated for FNAIT with antenatal IVIg is comparable to that in the general population.
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Affiliation(s)
- Thijs W De Vos
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, the Netherlands; Center of Clinical Transfusion Research, Sanquin Research, Amsterdam; Department of Experimental Immunohematology, Sanquin Research, Amsterdam.
| | - Masja De Haas
- Center of Clinical Transfusion Research, Sanquin Research, Amsterdam; Department Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam; Department of Hematology, Leiden University Medical Center, Leiden
| | - Dick Oepkes
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden
| | - Ratna R N G B Tan
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, the Netherlands
| | | | - Sylke J Steggerda
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, the Netherlands
| | - Linda S de Vries
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, the Netherlands
| | - Enrico Lopriore
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, the Netherlands
| | - Jeanine M M Van Klink
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Child and Adolescent Psychology, Leiden University Medical Center, the Netherlands
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9
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Surface imprinted core–shell nanorod for selective extraction of glycoprotein. J Colloid Interface Sci 2022; 615:597-605. [DOI: 10.1016/j.jcis.2022.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/24/2022] [Accepted: 02/04/2022] [Indexed: 12/23/2022]
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10
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Petito E, Colonna E, Falcinelli E, Mezzasoma AM, Cesari E, Giglio E, Fiordi T, Almerigogna F, Villa A, Gresele P. Anti-severe acute respiratory syndrome coronavirus-2 adenoviral-vector vaccines trigger subclinical antiplatelet autoimmunity and increase of soluble platelet activation markers. Br J Haematol 2022; 198:257-266. [PMID: 35577507 DOI: 10.1111/bjh.18245] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/21/2022] [Accepted: 05/01/2022] [Indexed: 12/16/2022]
Abstract
To slow down the coronavirus disease 2019 (COVID-19) pandemic an unequalled vaccination campaign was initiated. Despite proven efficacy and safety, a rare but potentially fatal complication of adenoviral-vector vaccines, called vaccine-induced immune thrombotic thrombocytopenia (VITT), has emerged the pathogenesis of which seems to be related to the development of platelet-activating anti-platelet factor 4 (PF4) antibodies. While a few studies have evaluated the incidence of anti-PF4 positivity in anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine recipients, to date no studies have assessed whether an antiplatelet immunological response develops and if this associates with platelet and blood clotting activation. We carried out a prospective study in healthy subjects who received the first dose of ChAdOx1 or Ad26.COV2.S or BNT162b2 vaccines to evaluate platelet-specific and non-specific immune response and in vivo platelet activation and blood clotting activation. Individuals receiving ChAdOx1 and, less so, Ad26.COV2.S developed with high frequency auto- or alloantiplatelet antibodies, increased circulating platelet-derived microvesicles and soluble P-selectin associated with mild blood clotting activation. Our study shows that an immunological reaction involving platelets is not uncommon in individuals receiving anti-SARS-CoV-2 vaccination, especially after ChAdOx1 and Ad26.COV2.S, and that it associates with in vivo platelet and blood clotting activation.
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Affiliation(s)
- Eleonora Petito
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Elisabetta Colonna
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Emanuela Falcinelli
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Anna Maria Mezzasoma
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Enrica Cesari
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Elisa Giglio
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Tiziana Fiordi
- Section of Occupational Medicine and Toxicology, University of Perugia, Perugia, Italy
| | - Fabio Almerigogna
- Unit of Allergology and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Alfredo Villa
- Central Clinical Chemistry Laboratory, S.M. della Misericordia Hospital, Perugia, Italy
| | - Paolo Gresele
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
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11
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Kuroishi A, Takihara Y, Hirayama F. Current understanding and future perspectives for anti-human platelet antigen-15 antibodies in patients with alloimmune thrombocytopenia: History, laboratory testing, and clinical impact. Transfusion 2022; 62:1128-1141. [PMID: 35266549 DOI: 10.1111/trf.16845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 02/02/2022] [Accepted: 02/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ayumu Kuroishi
- Laboratory, Japanese Red Cross Kinki Block Blood Center, Ibaraki-shi, Osaka, Japan
| | | | - Fumiya Hirayama
- Japanese Red Cross Kinki Block Blood Center, Ibaraki-shi, Osaka, Japan
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12
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Next generation sequencing of human platelet antigens for routine clinical investigations and donor screening. Transfus Med Rev 2022; 36:87-96. [DOI: 10.1016/j.tmrv.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/21/2022]
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13
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de Vos TW, Porcelijn L, Hofstede-van Egmond S, Pajkrt E, Oepkes D, Lopriore E, van der Schoot CE, Winkelhorst D, de Haas M. Clinical characteristics of human platelet antigen (HPA)-1a and HPA-5b alloimmunised pregnancies and the association between platelet HPA-5b antibodies and symptomatic fetal neonatal alloimmune thrombocytopenia. Br J Haematol 2021; 195:595-603. [PMID: 34402048 PMCID: PMC9291578 DOI: 10.1111/bjh.17731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Fetal neonatal alloimmune thrombocytopenia (FNAIT) is caused by maternal alloantibodies directed against the human platelet antigens (mostly HPA-1a or HPA-5b) of the (unborn) child and can lead to severe bleeding. Anti-HPA-1a-mediated FNAIT shows a severe clinical outcome more often than anti-HPA-5b-mediated FNAIT. Given the relatively high prevalence of anti-HPA-5b in pregnant women, the detection of anti-HPA-5b in FNAIT-suspected cases may in some cases be an incidental finding. Therefore we investigated the frequency of anti-HPA-5b-associated severe bleeding in FNAIT. We performed a retrospective nationwide cohort study in cases with clinical suspicion of FNAIT. HPA antibody screening was performed using monoclonal antibody-specific immobilisation of platelet antigens. Parents and neonates were typed for the cognate antigen. Clinical data were collected by a structured questionnaire. In 1 864 suspected FNAIT cases, 161 cases (8·6%) had anti-HPA-1a and 60 (3·2%) had anti-HPA-5b. The proportion of cases with severe bleeding did not differ between the cases with anti-HPA-1a (14/129; 11%) and anti-HPA-5b (4/40; 10%). In multigravida pregnant women with a FNAIT-suspected child, 100% (81/81) of anti-HPA-1a cases and 79% (38/48) of anti-HPA-5b cases were HPA-incompatible, whereas 86% and 52% respectively were expected, based on the HPA allele distribution. We conclude that anti-HPA-5b can be associated with severe neonatal bleeding symptoms. A prospective study is needed for true assessment of the natural history of anti-HPA-5b mediated FNAIT.
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Affiliation(s)
- Thijs W de Vos
- Department of Pediatrics, Division of Neonatology, Leiden University Medical Centre, Leiden, the Netherlands.,Centre for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands.,Department of Obstetrics and Gynecology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin, Amsterdam, the Netherlands
| | | | - Eva Pajkrt
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Dick Oepkes
- Department of Obstetrics and Gynecology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Enrico Lopriore
- Department of Pediatrics, Division of Neonatology, Leiden University Medical Centre, Leiden, the Netherlands
| | | | - Dian Winkelhorst
- Department of Obstetrics and Gynecology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Experimental Immunohematology, Sanquin, Amsterdam, the Netherlands
| | - Masja de Haas
- Centre for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands.,Department of Obstetrics and Gynecology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Hematology, Leiden University Medical Centre, Leiden, the Netherlands
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14
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Placental Complement Activation in Fetal and Neonatal Alloimmune Thrombocytopenia: An Observational Study. Int J Mol Sci 2021; 22:ijms22136763. [PMID: 34201864 PMCID: PMC8267834 DOI: 10.3390/ijms22136763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022] Open
Abstract
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a disease that causes thrombocytopenia and a risk of bleeding in the (unborn) child that result from maternal alloantibodies directed against fetal, paternally inherited, human platelet antigens (HPA). It is hypothesized that these alloantibodies can also bind to the placenta, causing placental damage. This study aims to explore signs of antibody-mediated placental damage in FNAIT. We performed a retrospective study that included pregnant women, their newborns, and placentas. It comprised 23 FNAIT cases, of which nine were newly diagnosed (14 samples) and 14 were antenatally treated with intravenous immune globulins (IVIg) (21 samples), and 20 controls, of which 10 had anti-HLA-class I antibodies. Clinical information was collected from medical records. Placental samples were stained for complement activation markers (C1q, C4d, SC5b-9, and mannose-binding lectin) using immunohistochemistry. Histopathology was examined according to the Amsterdam criteria. A higher degree of C4d deposition was present in the newly diagnosed FNAIT cases (10/14 samples), as compared to the IVIg-treated FNAIT cases (2/21 samples, p = 0.002) and anti-HLA-negative controls (3/20 samples, p = 0.006). A histopathological examination showed delayed maturation in four (44%) placentas in the newly diagnosed FNAIT cases, five (36%) in the IVIg-treated FNAIT cases, and one in the controls (NS). C4d deposition at the syncytiotrophoblast was present in combination with low-grade villitis of unknown etiology in three newly diagnosed FNAIT cases that were born SGA. We conclude that a higher degree of classical pathway-induced complement activation is present in placentas from pregnancies with untreated FNAIT. This may affect placental function and fetal growth.
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15
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Ding Q, Guo Z, Chen W, Yu H, Zhu X, Liu Q, Fu M. Biomass activated carbon-derived imprinted polymer with multi-boronic acid sites for selective capture of glycoprotein. J Colloid Interface Sci 2021; 596:225-232. [PMID: 33848742 DOI: 10.1016/j.jcis.2021.03.151] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 12/19/2022]
Abstract
Glycoproteins play crucial roles in many biological events such as protein folding, information transmission, nerve conduction, and molecular recognition. Some glycoproteins serve as disease biomarkers in clinical settings. However, selective detection of glycoprotein often faces great challenges, owing to its low abundance in complex biological samples. In this case, develop a highly sensitive and selective approach for glycoprotein detection is urgently needed. Molecularly imprinted polymers (MIPs) have proved to be an ideal absorbent material in detection and separation science. Herein, a novel biomass activated carbon-derived imprinted polymer (BAC@PEI/PBA/MIPs) was fabricated for selective recognition of glycoprotein. The as-prepared BAC@PEI/PBA/MIPs was synthesized using waste tea derived carbon as matrix, albumin chicken egg (OVA) as template, and dopamine as functional monomer. Branched polyethyleneimine (PEI) was covalently bonded on the BAC surface to increase the number of boronic acid moieties. Benefiting from the self-polymerization of dopamine and multi-boronic acid sites, a great number of recognition sites were presented under mild conditions. The static adsorption experiment showed that the BAC@PEI/PBA/MIPs exhibited a high binding capacity of 196.2 mg/g, rapid adsorption dynamics of 40 min, excellent selectivity and satisfactory reusability for OVA. Furthermore, the practicability of BAC@PEI/PBA/MIPs was verified by isolation of OVA from egg white. The good binding performance and facile preparation process make BAC@PEI/PBA/MIPs attractive for glycoprotein recognition, indicating its potential applications in biomedical research and clinical diagnostics.
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Affiliation(s)
- Qian Ding
- College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao, Shandong 266590, China
| | - Zhiyang Guo
- College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao, Shandong 266590, China
| | - Wei Chen
- College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao, Shandong 266590, China.
| | - Hao Yu
- College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao, Shandong 266590, China
| | - Xixi Zhu
- College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao, Shandong 266590, China
| | - Qingyun Liu
- College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao, Shandong 266590, China.
| | - Min Fu
- College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao, Shandong 266590, China.
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16
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The molecular basis of immune-based platelet disorders. Clin Sci (Lond) 2021; 134:2807-2822. [PMID: 33140828 DOI: 10.1042/cs20191101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/12/2020] [Accepted: 10/23/2020] [Indexed: 12/17/2022]
Abstract
Platelets have a predominant role in haemostasis, the maintenance of blood volume and emerging roles as innate immune cells, in wound healing and in inflammatory responses. Platelets express receptors that are important for platelet adhesion, aggregation, participation in inflammatory responses, and for triggering degranulation and enhancing thrombin generation. They carry a cargo of granules bearing enzymes, adhesion molecules, growth factors and cytokines, and have the ability to generate reactive oxygen species. The platelet is at the frontline of a host of cellular responses to invading pathogens, injury, and infection. Perhaps because of this intrinsic responsibility of a platelet to rapidly respond to thrombotic, pathological and immunological factors as part of their infantry role; platelets are susceptible to targeted attack by the adaptive immune system. Such attacks are often transitory but result in aberrant platelet activation as well as significant loss of platelet numbers and platelet function, paradoxically leading to elevated risks of both thrombosis and bleeding. Here, we discuss the main molecular events underlying immune-based platelet disorders with specific focus on events occurring at the platelet surface leading to activation and clearance.
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17
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Norrenbrock S, Müller TH, Mayer C, Doescher A. A nait-associated and previously unreported mutation in the ITGB3 gene with a low frequency in the local population. Transfus Med 2021; 31:286-291. [PMID: 33724573 DOI: 10.1111/tme.12769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/05/2021] [Accepted: 02/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neonatal alloimmune thrombocytopenia is a rare but potentially severe postnatal complication caused by maternal allo-antibodies against platelet antigens of the newborn. In relatively few cases, immunisation against low-frequency antigens has been reported. METHODS Platelet antigens of a newborn with severe thrombocytopenia and his family members were investigated by serological and molecular biological methods. A real-time PCR assay was developed to reliably detect this mutation in pools of DNA from up to seven individuals. RESULTS Serological testing showed positive reactions of maternal plasma with paternal platelets but not with conventional platelet donor panels. Sequencing of the ITGB3 gene revealed a G > A polymorphism in position c.1915 of exon 12 for the father, the newborn and three of four paternal relatives. Screening of samples from a local population of 1575 Caucasian blood donors identified only a single individual with this mutation. CONCLUSION This finding of a previously unreported private platelet antigen demonstrates that the identification of the target glycoprotein by MAIPA assay followed by sequencing of the affected gene can be combined with an efficient population screening by real-time PCR with pooling of DNA samples.
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Affiliation(s)
- Stefan Norrenbrock
- DRK-Blutspendedienst NSTOB, Institut Bremen-Oldenburg, Oldenburg, Germany
| | - Thomas H Müller
- DRK-Blutspendedienst NSTOB, Institut Springe, Springe, Germany
| | | | - Andrea Doescher
- DRK-Blutspendedienst NSTOB, Institut Bremen-Oldenburg, Oldenburg, Germany
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18
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Platelet antibodies identification: comparison between two laboratory tests. Hematol Transfus Cell Ther 2021; 44:365-368. [PMID: 33814346 PMCID: PMC9477764 DOI: 10.1016/j.htct.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/30/2020] [Accepted: 12/15/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Platelet antibody identification is indispensable for diagnosing the human platelet antigen (HPA) or human leukocyte antigen (HLA) immunization, mostly because it can restrict the compatibility and results of transfusions. Correct detection of these antibodies is of utmost importance for the diagnosis and treatment. Method We present 16 platelet alloimmunization results, comparing two tests with different technologies: the MAIPA (monoclonal antibody immobilization of platelet antigens), as a reference technique, and a bead-based assay, the Pak-Lx. Results Eleven samples (68.75%) showed agreement in both techniques. Two tests were false negatives in the Pak-Lx: a pan-reactivity in GPIIbIIIa and an anti-HPA-9b. On the other hand, the Pak-Lx was more sensitive to detect a decreasing anti-HPA-5b. The Pak-Lx found an anti-HPA-2b positive, but with a low median fluorescent intensity (MFI), suggesting a false-positive result. Moreover, in one case, the MAIPA was negative for a positive Pak-Lx HLA. Conclusion Antibody platelet diagnosis can sometimes be challenging. The methods seemed similar, the Pak-Lx being faster and simpler than the MAIPA, and they can be complementary to solve clinical issues.
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Porcelijn L, Schmidt DE, Oldert G, Hofstede-van Egmond S, Kapur R, Zwaginga JJ, de Haas M. Evolution and Utility of Antiplatelet Autoantibody Testing in Patients with Immune Thrombocytopenia. Transfus Med Rev 2020; 34:258-269. [PMID: 33046350 DOI: 10.1016/j.tmrv.2020.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 01/01/2023]
Abstract
To this day, immune thrombocytopenia (ITP) remains a clinical diagnosis made by exclusion of other causes for thrombocytopenia. Reliable detection of platelet autoantibodies would support the clinical diagnosis, but the lack of specificity and sensitivity of the available methods for platelet autoantibody testing limits their value in the diagnostic workup of thrombocytopenia. The introduction of methods for glycoprotein-specific autoantibody detection has improved the specificity of testing and is acceptable for ruling in ITP but not ruling it out as a diagnosis. The sensitivity of these assays varies widely, even between studies using comparable assays. A review of the relevant literature combined with our own laboratory's experience of testing large number of serum and platelet samples makes it clear that this variation can be explained by variations in the characteristics of the tests, including in the glycoprotein-specific monoclonal antibodies, the glycoproteins that are tested, the platelet numbers used in the assay and the cutoff levels for positive and negative results, as well as differences in the tested patient populations. In our opinion, further standardization and optimization of the direct autoantibody detection methods to increase sensitivity without compromising specificity seem possible but will still likely be insufficient to distinguish the often very weak specific autoantibody signals from background signals. Further developments of autoantibody detection methods will therefore be necessary to increase sensitivity to a level acceptable to provide laboratory confirmation of a diagnosis of ITP.
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Affiliation(s)
- Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, the Netherlands.
| | - David E Schmidt
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gonda Oldert
- Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, the Netherlands
| | | | - Rick Kapur
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jaap Jan Zwaginga
- Department of Immuno-hematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands; Sanquin Research, Center for Clinical Transfusion Research, Leiden, the Netherlands; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands
| | - Masja de Haas
- Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, the Netherlands; Sanquin Research, Center for Clinical Transfusion Research, Leiden, the Netherlands; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands
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