Human platelet antigen antibody induction in uncomplicated pregnancy is associated with HLA sensitization.

Abstract:

BACKGROUND:Alloimmunization against human platelet antigens (HPAs) during pregnancy is rare but can lead to severe bleeding disorders, such as fetal and neonatal alloimmune thrombocytopenia. STUDY DESIGN AND METHODS:In a cohort of 241 uncomplicated pregnancies, we investigated the immunogenicity of HPA mismatches and correlated HLA sensitization with HPA antibody formation. HPA antibodies were measured with a Luminex-based multiplex assay. RESULTS:HPA mismatches were observed in 109 of 241 pregnancies (45%), but child-specific HPA antibodies were only found in two of 109 cases (2%), indicating a low immunogenicity. Only nine of 241 women (4%) had detectable HPA antibodies. HLA sensitization was identified as a strong and independent predictor for HPA antibody formation (hazard ratio, 10.2; 95% confidence interval, 1.8-193; p = 0.006), whereas the number of pregnancies was not. CONCLUSION:Our observational data indicated a low immunogenicity of HPA and suggest that a broader immune response-inferred by HLA sensitization-is probably associated with HPA antibody induction.

journal_name

Transfusion

journal_title

Transfusion

authors

Reiher VSA,Hönger G,Infanti L,Passweg JR,Hösli I,Frey BM,Gassner C,Meyer S,Buser AS,Holbro A,Schaub S

doi

10.1111/trf.14053

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

1272-1279

issue

5

eissn

0041-1132

issn

1537-2995

journal_volume

57

pub_type

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