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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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Martins Lima A, Saint Auguste DS, Cuenot F, Martins Cavaco AC, Lachkar T, Khawand CME, Fraga-Silva RA, Stergiopulos N. Standardization and Validation of Fluorescence-Based Quantitative Assay to Study Human Platelet Adhesion to Extracellular-Matrix in a 384-Well Plate. Int J Mol Sci 2020; 21:ijms21186539. [PMID: 32906775 PMCID: PMC7554887 DOI: 10.3390/ijms21186539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 11/17/2022] Open
Abstract
Platelets play a crucial role in the immunological response and are involved in the pathological settings of vascular diseases, and their adhesion to the extracellular matrix is important to bring leukocytes close to the endothelial cells and to form and stabilize the thrombus. Currently there are several methods to study platelet adhesion; however, the optimal parameters to perform the assay vary among studies, which hinders their comparison and reproducibility. Here, a standardization and validation of a fluorescence-based quantitative adhesion assay to study platelet-ECM interaction in a high-throughput screening format is proposed. Our study confirms that fluorescence-based quantitative assays can be effectively used to detect platelet adhesion, in which BCECF-AM presents the highest sensitivity in comparison to other dyes.
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Affiliation(s)
- Augusto Martins Lima
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (D.S.S.A.); (F.C.); (T.L.); (C.M.E.K.); (R.A.F.-S.); (N.S.)
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne Station 09, MED 3.2924, CH-1015 Lausanne, Switzerland
- Correspondence:
| | - Damian S. Saint Auguste
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (D.S.S.A.); (F.C.); (T.L.); (C.M.E.K.); (R.A.F.-S.); (N.S.)
- Laboratory for Orthopaedic Technology, Institute for Biomechanics, Swiss Federal Institute of Technology Zurich, 8093 Zurich, Switzerland
| | - François Cuenot
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (D.S.S.A.); (F.C.); (T.L.); (C.M.E.K.); (R.A.F.-S.); (N.S.)
| | - Ana C. Martins Cavaco
- Luis Costa Lab, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal;
| | - Tom Lachkar
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (D.S.S.A.); (F.C.); (T.L.); (C.M.E.K.); (R.A.F.-S.); (N.S.)
| | - Cindy Marie Elodie Khawand
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (D.S.S.A.); (F.C.); (T.L.); (C.M.E.K.); (R.A.F.-S.); (N.S.)
| | - Rodrigo A. Fraga-Silva
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (D.S.S.A.); (F.C.); (T.L.); (C.M.E.K.); (R.A.F.-S.); (N.S.)
| | - Nikolaos Stergiopulos
- Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (D.S.S.A.); (F.C.); (T.L.); (C.M.E.K.); (R.A.F.-S.); (N.S.)
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3
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Arneth B. Neonatal Immune Incompatibilities between Newborn and Mother. J Clin Med 2020; 9:E1470. [PMID: 32422924 PMCID: PMC7291300 DOI: 10.3390/jcm9051470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/29/2020] [Accepted: 05/07/2020] [Indexed: 02/01/2023] Open
Abstract
Background: Incompatibilities between the mother and unborn baby can cause complications that must be identified early to initiate the appropriate treatment. For example, neonatal alloimmune thrombocytopenia (NAIT), neonatal alloimmune neutropenia (NAIN), and morbus hemolyticus neonatorum affect children worldwide. Aim: This literature review aims to depict the similarities and differences between these three disorders from a clinical and mechanistic point of view. Material and Methods: The current literature review entailed conducting a systematic search to locate articles on the three conditions. Different electronic databases, including PsycINFO, PubMed, Web of Science, and CINAHL, were searched using the search terms "neonatal alloimmune thrombocytopenia", "neonatal alloimmune neutropenia", "morbus hemolyticus neonatorum", "NAIT", "FNAIT", "fetal", "NAIN", and "hemolytic disease of the newborn". Results: This review shows that these three diseases are caused by incompatibilities between the maternal and fetal immune systems. Furthermore, these conditions can lead to severe complications that hinder fetal development and cause death if not well managed. Discussion: The current literature review shows that NAIT, NAIN, and morbus hemolyticus neonatorum are rare conditions that occur when the mother produces antibodies against the fetal immune system. Thus, there is a need for the early detection of these conditions to initiate appropriate treatment before the child experiences adverse effects. Conclusion: The development of NAIT, NAIN, and morbus hemolyticus neonatorum is linked to the production of antibodies against the fetal immune system and fetal antigens. Further studies are required to determine potential interventions to reduce the risk of developing these three conditions.
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Affiliation(s)
- Borros Arneth
- Institute for Laboratory Medicine, Pathobiochemistry and Molecular Diagnostics, Hospital of the Universities of Giessen and Marburg, Justus Liebig University, 35339 Giessen, Germany;
- Institute for Laboratory Medicine, Pathobiochemistry and Molecular Diagnostics, Hospital of the Universities of Giessen and Marburg, Philipps University Marburg, Baldingerstraße 1, 35033 Marburg, Germany
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Jallu V, Beranger T, Bianchi F, Casale C, Chenet C, Ferre N, Philippe S, Quesne J, Martageix C, Petermann R. Cab4b, the first human platelet antigen carried by glycoprotein IX discovered in a context of severe neonatal thrombocytopenia. J Thromb Haemost 2017; 15:1646-1654. [PMID: 28561420 DOI: 10.1111/jth.13744] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Indexed: 11/28/2022]
Abstract
Essentials Life-threatening maternofetal thrombocytopenias mostly depend on αIIb β3 antigens. We performed serological, genomic and in vitro studies of two life-threatening thrombocytopenias. Identification of a c.368C>T variation leading to Pro123Leu substitution in GPIX. A rare GPIX variant reported in a genomic database define a new alloantigen. SUMMARY Background After three miscarriages, a 39-year-old woman gave birth, with a 1-year interval, to two severely thrombocytopenic neonates (4 ×109 L-1 and 33 ×109 L-1 ) with intracranial hemorrhages. Transfusion of platelet concentrates corrected the thrombocytopenia. The outcome was favorable for the first child, but the second one died 10 days after cesarean delivery (31 weeks of gestation + 6 days). Methods Serologic studies were performed with mAb-specific immobilization of platelet antigens and flow cytometry techniques. Human platelet alloantigen (HPA) genotyping was performed with the BioArray HPA BeadChip and PCR-sequence-specific primer techniques. Genomic DNA was studied by direct sequencing of PCR products. The mutant glycoprotein (GP) was expressed in transiently transfected HEK293 cells. Results In MAIPA assay, the maternal serum faintly reacted with GPIbIX from paternal and child 1 platelets, but not with maternal or panel platelets. No maternofetal incompatibility was found in the 22 known HPA systems, tested except for HPA-1b in child 2. A new alloantigen carried by GPIbIX was suspected. Genomic sequencing revealed a paternal GPIX variation (NM_000174.4:c.368C>T). The father and children were heterozygous and incompatible with the mother, who was NM_000174.4:c.368C homozygous. The maternal serum reacted with the GPIX NP_000165.1:p.Leu123 form coexpressed with GPIb in transfected HEK293 cells. The NM_000174.4:c.368T allele (rs202229101) has a minor allele frequency of 0.0002, and was not detected in 120 French subjects (families with fetal and neonatal alloimmune thrombocytopenia [FNAIT]), suggesting that it is rarely implicated in alloimmunization. Conclusion The NP_000165.1:p.Leu123 allele named Cab4b is the first platelet alloantigen described on GPIX. In the absence of other known maternofetal incompatibility, the child 1 case suggests that anti-Cab4b alloantibodies can induce severe thrombocytopenias.
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Affiliation(s)
- V Jallu
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - T Beranger
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - F Bianchi
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - C Casale
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - C Chenet
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - N Ferre
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - S Philippe
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - J Quesne
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - C Martageix
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - R Petermann
- Département d'Immunologie Plaquettaire, Institut National de la Transfusion Sanguine (INTS), Paris, France
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Wu G, Zhou Y, Li L, Zhong Z, Li H, Li H, Yu M, Shen W, Ni H. Platelet Immunology in China: Research and Clinical Applications. Transfus Med Rev 2017; 31:118-125. [DOI: 10.1016/j.tmrv.2016.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 12/29/2022]
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Zhou H, Ding H, Chen Y, Li X, Ye X, Nie Y. Simultaneous genotyping of HPA-17w to -21w by PCR-SSP in Chinese Cantonese. Platelets 2014; 26:186-9. [PMID: 24617330 DOI: 10.3109/09537104.2014.887668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Studies have reported the polymorphism of human platelet antigen (HPA)-17w, -18w, -19w, -20w, and -21w. However, the distribution of these five antigens in Chinese Cantonese is still unknown. In this study, we designed new sequence-specific primers for HPA-19w to -21w and used published primers for HPA-17w and -18w to develop a polymerase chain reaction with the sequence-specific primers (PCR-SSP) method for simultaneously genotyping HPA-17w to -21w. A total of 820 unrelated Cantonese apheresis platelet donors in Guangzhou were involved in this study. Among the five HPAs, complete a/a homozygosity was observed for HPA-17w to -20w with an allele frequency of 1.0000. For HPA-21w, nine individuals (9/820, 1.10%) were found to be HPA-21a/bw heterozygous and the allele frequencies of HPA-21a and HPA-21bw were 0.9945 (1631/1640) and 0.0055 (9/1640), respectively. The reliability of the PCR-SSP method was determined by comparing with the genotyping results by DNA sequencing, and no inconsistencies were observed between the two methods. This study provides a reliable PCR-SSP method for simultaneously genotyping HPA-17w to -21w and could improve HPA-matched platelet transfusion in Chinese Cantonese.
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Affiliation(s)
- Haojie Zhou
- Department of Quality Management, Guangzhou Blood Center , Guangzhou , China and
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7
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Veldhuisen B, Porcelijn L, Ellen van der Schoot C, de Haas M. Molecular typing of human platelet and neutrophil antigens (HPA and HNA). Transfus Apher Sci 2014; 50:189-99. [PMID: 24685245 DOI: 10.1016/j.transci.2014.02.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Genotyping is an important tool in the diagnosis of disorders involving allo-immunisation to antigens present on the membranes of platelets and neutrophils. To date 28 human platelet antigens (HPAs) have been indentified on six polymorphic glycoproteins on the surface of platelets. Antibodies against HPAs play a role in foetal and neonatal alloimmune thrombocytopenia (FNAIT), post-transfusion purpura (PTP) and refractoriness to donor platelets. The 11 human neutrophil antigens (HNAs) described to date have been indentified on five polymorphic proteins on the surface of granulocytes. Antibodies to HNAs are implicated with foetal and neonatal alloimmune neutropenia (FNAIN), autoimmune neutropenia (AIN) and transfusion related acute lung injury (TRALI). In this report, we will review the molecular basis and techniques currently available for the genotyping of human platelet and neutrophil antigens.
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Affiliation(s)
- Barbera Veldhuisen
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands; Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Leendert Porcelijn
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands
| | - C Ellen van der Schoot
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Masja de Haas
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands
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8
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Curtis BR, McFarland JG. Human platelet antigens - 2013. Vox Sang 2013; 106:93-102. [PMID: 24102564 DOI: 10.1111/vox.12085] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 08/12/2013] [Accepted: 08/21/2013] [Indexed: 01/25/2023]
Abstract
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.
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Affiliation(s)
- B R Curtis
- Platelet & Neutrophil Immunology Laboratory, BloodCenter of Wisconsin, Milwaukee, WI, USA
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Salomon O, Rosenberg N. Predicting risk severity and response of fetal neonatal alloimmune thrombocytopenia. Br J Haematol 2013; 162:304-12. [PMID: 23672281 DOI: 10.1111/bjh.12372] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Fetal neonatal alloimmune thrombocytopenia (FNAIT) is a devastating bleeding disorder in the fetus or neonate caused by transplacental transport of maternal alloantibodies to paternal-derived antigen on fetal platelets. In Caucasians, up to 80% of FNAIT cases result from maternal immunization to human platelet antigen (HPA)-1a. New methods have developed facilitating detection of common and private antibodies against HPAs triggering FNAIT. Understanding the pathogenesis of FNAIT made it possible to develop a novel strategy to treat this disorder. To date, recombinant monoclonal antibodies directed against the β3 integrin and Fc receptors have been tested in a mouse model of FNAIT, and seem to be promising. Whether those novel treatments will eventually replace the conventional high dose immunoglobulin G in women with FNAIT is yet unknown.
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Affiliation(s)
- Ophira Salomon
- Amalia Biron Research Institute of Thrombosis and Haemostasis, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Israel.
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Peterson JA, McFarland JG, Curtis BR, Aster RH. Neonatal alloimmune thrombocytopenia: pathogenesis, diagnosis and management. Br J Haematol 2013; 161:3-14. [PMID: 23384054 DOI: 10.1111/bjh.12235] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Neonatal alloimmune thrombocytopenia, (NAIT) is caused by maternal antibodies raised against alloantigens carried on fetal platelets. Although many cases are mild, NAIT is a significant cause of morbidity and mortality in newborns and is the most common cause of intracranial haemorrhage in full-term infants. In this report, we review the pathogenesis, clinical presentation, laboratory diagnosis and prenatal and post-natal management of NAIT and highlight areas of controversy that deserve the attention of clinical and laboratory investigators.
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Affiliation(s)
- Julie A Peterson
- Blood Research Institute, BloodCenter of Wisconsin, Milwaukee, WI 53226-3548, US.
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Peterson JA, Kanack A, Nayak D, Bougie DW, McFarland JG, Curtis BR, Aster RH. Prevalence and clinical significance of low-avidity HPA-1a antibodies in women exposed to HPA-1a during pregnancy. Transfusion 2012; 53:1309-18. [PMID: 23003125 DOI: 10.1111/j.1537-2995.2012.03903.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent studies suggest that HPA-1a-specific, low-avidity maternal antibodies not detectable by conventional methods can cause neonatal alloimmune thrombocytopenia (NAIT). We performed studies to further define the incidence and clinical significance of this type of antibody. STUDY DESIGN AND METHODS Surface plasmon resonance analysis was used to detect low-avidity antibodies in HPA-1a-negative, "antibody-negative" mothers of suspected NAIT cases. The ability of antibodies detected to promote immune destruction of human platelets (PLTs) was examined in a newly developed NOD/SCID mouse model. RESULTS Among 3478 suspected cases of NAIT, 677 HPA-1a-negative mothers were identified. HPA-1a-specific antibodies were detected by conventional antibody testing in 616 cases (91%). Low-avidity HPA-1a-specific antibodies were identified in 18 of the remaining 61 cases (9%). Clinical follow-up on 13 cases showed that eight were referred because of suspected NAIT and five because the mother's sister had previously had an infant with NAIT. Only six infants born to the 13 sensitized mothers had clinically significant thrombocytopenia at birth. Three of four low-avidity antibodies tested in the mouse caused accelerated clearance of HPA-1a/a but not HPA-1b/b PLTs. Only 3 of 12 mothers with low-avidity HPA-1a antibodies were positive for HLA-DRB3*0101. CONCLUSIONS The findings confirm previous reports that low-avidity HPA-1a antibodies can cause NAIT but show that the presence of such an antibody does not predict that an infant will be affected. The low incidence of HLA-DRB3*0101 in this cohort (p < 0.0001) suggests that women negative for DRB3*0101 may be predisposed to produce low-avidity HPA-1a antibodies.
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Affiliation(s)
- Julie A Peterson
- Blood Research Institute and Platelet & Neutrophil Immunology Laboratory, BloodCenter of Wisconsin, Milwaukee,WI 53226-3548, USA.
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