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The human platelet antigen-1a (HPA-1a) is the most common alloantigenic target in fetal and neonatal alloimmune thrombocytopenia (NAIT). Treatment currently depends on the outcome in previous pregnancies. HPA-1 specific T cell responses were determined in 14 HPA-1a alloimmunized women during or after pregnancies affected by NAIT. Peripheral blood mononuclear cells were incubated with peptides encompassing the Leu33Pro polymorphism (residues 20-39 and 24-45 in both Leu33 (HPA-1a) and Pro33 (HPA-1b) forms) or control recall antigens in the presence of autologous sera and T cell proliferation was measured by (3)H-thymidine incorporation. Control antenatal and postpartum sera suppressed T cell proliferation and use of such sera was avoided. Most patients (86%) responded to the HPA-1a peptides with 64% also having weaker T cell proliferation to the HPA-1b peptides; 14% had no activity towards any peptide despite responding to control antigens. Administration of IVIG during pregnancy appeared to reduce T cell reactivity to HPA-1 peptides. Postnatal anti-HPA-1a T cell responses from women who had a severe history of NAIT (an intracranial haemorrhage in a previous fetus) were greater than those from women with a mild history. This assay may have the potential to predict disease severity if performed prior to or early in pregnancy.

Original publication

DOI

10.1111/j.1365-2249.2005.02903.x

Type

Journal article

Journal

Clin Exp Immunol

Publication Date

10/2005

Volume

142

Pages

92 - 102

Keywords

Antigens, Human Platelet, Cell Division, Epitopes, Female, Humans, Infant, Newborn, Isoantibodies, Leukocytes, Mononuclear, Peptide Fragments, Polymorphism, Genetic, Pregnancy, Pregnancy Complications, Hematologic, Purpura, Thrombocytopenic, Idiopathic, T-Lymphocytes