A new platelet alloantigen, Swia, located on glycoprotein Ia identified in a family with fetal and neonatal alloimmune thrombocytopenia
Corresponding Author
Hartmut Kroll
Hartmut Kroll, MD, Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, 06847 Dessau, Germany; e-mail: [email protected]. Search for more papers by this authorKorinna Feldmann
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorClaudia Zwingel
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorJochen Hoch
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorRainer Bald
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorGregor Bein
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorBehnaz Bayat
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorSentot Santoso
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorCorresponding Author
Hartmut Kroll
Hartmut Kroll, MD, Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, 06847 Dessau, Germany; e-mail: [email protected]. Search for more papers by this authorKorinna Feldmann
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorClaudia Zwingel
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorJochen Hoch
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorRainer Bald
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorGregor Bein
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorBehnaz Bayat
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorSentot Santoso
From the Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau; the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen; the Institute for Experimental Hematology and Transfusion Medicine, Bonn; and the Department for Prenatal Medicine, Clinics for Gynaecology and Obstetrics, Leverkusen, Germany.
Search for more papers by this authorAbstract
BACKGROUND: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a bleeding disorder caused by transplacental passage of maternal antibodies to fetuses whose platelets (PLTs) express the corresponding human PLT antigen (HPA).
STUDY DESIGNS AND METHODS: We observed a fetus with FNAIT who died from a severe intracranial hemorrhage. Analysis of maternal serum in antigen capture assay with paternal PLTs showed reactivity with PLT glycoprotein (GP)IIb/IIIa (αIIbβ3) and GPIa/IIa (α2β1 integrin), indicating the presence of anti-HPA-1a and an additional alloantibody against GPIa (termed anti-Swia).
RESULTS: By immunochemical studies, the localization of the Swia antigen on GPIa/IIa could be confirmed. Analysis of paternal GPIa full-length cDNA showed a single-nucleotide substitution C3347T in Exon 28 resulting in a Thr1087Met amino acid substitution. Testing of family members by polymerase chain reaction-restriction fragment length polymorphism using MslI endonuclease showed perfect correlation with phenotyping. Extended family and population studies showed that 4 of 10 members of the paternal family but none of 500 unrelated blood donors were Swia carriers. Expression studies on allele-specific transfected Chinese hamster ovary (CHO) cells confirmed that the single-amino-acid substitution Thr1087Met was responsible for the formation of the Swia epitope. Adhesion of CHO cells expressing the Swia alloantigen to immobilized collagens was not impaired compared to the wild-type control and was not inhibited by anti-Swia alloantibodies.
CONCLUSION: In this study we defined a new PLT alloantigen Swia that was involved in a case of additional immunization against HPA-1a. Our observations demonstrate that combinations of PLT-specific alloantibodies may comprise low-frequency alloantigens.
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