Review
Obstetrics & Gynecology
James B. Bussel, Emilie L. Vander Haar, Richard L. Berkowitz
Summary: Advances in managing fetal and neonatal alloimmune thrombocytopenia may include screening all antepartum patients, noninvasively testing fetal human platelet antigen 1 genotype, developing a prophylactic product equivalent to Rh immune globulin, and creating neonatal Fc receptor inhibitors as potential therapies.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2021)
Article
Hematology
Thijs W. de Vos, Leendert Porcelijn, Suzanne Hofstede-van Egmond, Eva Pajkrt, Dick Oepkes, Enrico Lopriore, C. Ellen van der Schoot, Dian Winkelhorst, Masja de Haas
Summary: Fetal neonatal alloimmune thrombocytopenia (FNAIT) is a condition caused by maternal alloantibodies targeting human platelet antigens, which can result in severe bleeding in the unborn child. While anti-HPA-1a-mediated FNAIT tends to have a more severe clinical outcome, anti-HPA-5b may also be associated with severe neonatal bleeding symptoms. Further research, including a prospective study, is needed to fully understand the natural history of anti-HPA-5b mediated FNAIT.
BRITISH JOURNAL OF HAEMATOLOGY
(2021)
Article
Hematology
Tomoko Kiyokawa, Kazuya Mimura, Keisuke Nagamine, Kotarosumitomo Nakayama, Mikiko Horiuchi, Tamayo Morikawa, Mika Hosokawa, Mayumi Nakao, Masayuki Endo, Tadashi Kimura, Hisashi Kato, Yoshiaki Tomiyama, Hirokazu Kashiwagi
Summary: A Japanese woman with anti-HPA-4b and anti-HPA-5b alloantibodies gave birth to a baby with severe FNAIT. During subsequent pregnancies, significant decrease of anti-HPA-4b titer was observed in late pregnancy and recovered after delivery of HPA-4b incompatible siblings, while high titer of anti-HPA-5b was persistent throughout all three pregnancies. These findings suggest that anti-HPA-5b may be mainly responsible for severe FNAIT in this case.
INTERNATIONAL JOURNAL OF HEMATOLOGY
(2023)
Review
Hematology
Julia Alm, Yalin Duong, Sandra Wienzek-Lischka, Nina Cooper, Sentot Santoso, Ulrich J. Sachs, Volker Kiefel, Gregor Bein
Summary: Most cases of FNAIT are caused by maternal anti-HPA-1a antibodies, while anti-HPA-5b antibodies are the second most common antibodies. However, there is no evidence supporting the idea that anti-HPA-5b antibodies cause severe thrombocytopenia or bleeding complications.
BRITISH JOURNAL OF HAEMATOLOGY
(2022)
Article
Hematology
Zachary A. Colvin, Jennifer Schiller, Shirng-Wern Tsaih, Ruchika Sharma, Rachael F. Grace, Jennifer J. McIntosh, Brian R. Curtis
Summary: This study examined whether suspected cases of fetal and neonatal alloimmune thrombocytopenia (FNAIT) without maternal human platelet antigens (HPA) antibodies had different human leukocyte antigen (HLA) antibody strength and specificity compared to controls. The results showed that FNAIT cases had significantly higher HLA antibody strength and broader HLA antibody specificity compared to matched controls.
Article
Immunology
Zoltan Szittner, Arthur E. H. Bentlage, A. Robin Temming, David E. Schmidt, Remco Visser, Suzanne Lissenberg-Thunnissen, Juk Yee Mok, Wim J. E. van Esch, Myrthe E. Sonneveld, Erik L. de Graaf, Manfred Wuhrer, Leendert Porcelijn, Masja de Haas, C. Ellen van der Schoot, Gestur Vidarsson
Summary: The core fucosylation in anti-HPA-1a IgG greatly influences its binding to leukocyte IgG-Fc receptors IIIa/b. A cellular surface plasmon resonance imaging technique was developed to quantify the biological activity of IgG antibodies targeting cells.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Hematology
Xiuzhang Xu, Dawei Chen, Xin Ye, Wenjie Xia, Yaori Xu, Yangkai Chen, Yuan Shao, Jing Deng, Haoqiang Ding, Jing Liu, Jiali Wang, Heyu Ni, Yongshui Fu, Sentot Santoso
Summary: Recent studies have shown that maternal anti-CD36 antibodies are a common cause of FNAIT in Asian and African populations, but little is known about the pathomechanism and antenatal treatment. A novel mouse model demonstrated that the fetal death rate due to anti-CD36 antibodies can be reduced by IVIG or antibody therapy.
Article
Pediatrics
Florian Point, Louis Terriou, Thameur Rakza, Elodie Drumez, Gauthier Alluin, Charles Garabedian, Veronique Houfflin-Debarge
Summary: Maternal immune thrombocytopenia (ITP) can cause neonatal thrombocytopenia (nTP) and increase the risk of neonatal hemorrhagic complications. Risk factors such as maternal splenectomy and previous severe nTP have been confirmed, while others like maternal platelet count are still inconclusive. The study identified additional risk factors for severe nTP, such as maternal treatment during pregnancy and low maternal platelet count at delivery.
Article
Immunology
Paula Ames, Nelli Baal, Martin Speckmann, Gabriela Michel, Judith Ratke, Christina Klesser, Nina Cooper, Daisuke Takahashi, Behnaz Bayat, Gregor Bein, Sentot Santoso
Summary: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a serious bleeding condition caused by maternal anti-HPA-1a antibodies reacting with fetal platelets. In this study, a flow cytometry-based phagocytosis assay called WHOPPA was developed to analyze the platelet phagocytosis in whole blood. The study found that monocytes, specifically the CD14(+)CD16(-) subset, had the highest phagocytosis rate for the opsonized platelets.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Hematology
Lingjun Wang, Lizhen Li, Chaoyang Li, Yu Hou, Miao Xu, Yafei Yu, Xiaofei Ni, Ruting Wang, Haoyi Wang, Lin Wang, Jun Peng, Ming Hou
Summary: This study investigated the impact of previous HBV exposure on disease severity and treatment response in ITP patients. The results suggest that anti-HBc positivity may be a predictor for poor response to ITP-specific treatments and is associated with increased disease severity and longer hospitalization.
BRITISH JOURNAL OF HAEMATOLOGY
(2022)
Article
Hematology
Sunil Lakhwani, Alberto Lopez-Las Heras, Pablo Rodriguez-Garcia, Sandra Iraheta, Taida Martin-Santos, Maria Jose Rodriguez-Salazar, Patricia Machado, Miguel-Teodoro Hernandez
Summary: The report retrospectively reviews the use of IM Anti-D treatment in 74 adult patients, and concludes that it is an effective and safe treatment option for immune thrombocytopenia.
BRITISH JOURNAL OF HAEMATOLOGY
(2023)
Article
Hematology
Linda Schoenborn, Thomas Thiele, Lars Kaderali, Albrecht Guenther, Till Hoffmann, Sabrina Edigna Seck, Kathleen Selleng, Andreas Greinacher
Summary: In an observational study on vaccine-induced thrombotic thrombocytopenia (VITT), it was found that the platelet-activating antibodies in most patients are transient, and it is safe for VITT patients to receive a second dose of COVID-19 mRNA vaccine.
Article
Gastroenterology & Hepatology
Naho Ikeda, Hiromichi Shoji, Tamaki Ikuse, Natsuki Ohkawa, Kosuke Kashiwagi, Yukika Saito, Toshiaki Shimizu
Summary: The association between Helicobacter pylori (H. pylori) infection and chronic immune thrombocytopenia (ITP) is well-established in adults but remains controversial in children. We report a case of neonatal passive ITP due to maternal H. pylori-associated ITP, suggesting that maternal H. pylori infection can lead to the production of platelet autoantibodies that destroy antibody-sensitized platelets in both the mother and neonate. Pregnant women diagnosed with H. pylori-associated ITP should receive eradication therapy to prevent their neonates from developing passive ITP.
Article
Physiology
Rima Dardik, Ophira Salomon
Summary: Maternal anti-HPA-1a antibodies impair endothelial cell function by increasing apoptosis and permeability, with endothelial cells from different vascular beds showing varying susceptibility to these pathological effects elicited by the antibodies. Examination of the effect of maternal anti-HPA-1a antibodies on endothelial cell permeability may predict potential intracranial hemorrhage associated with fetal/neonatal alloimmune thrombocytopenia.
JOURNAL OF VASCULAR RESEARCH
(2021)
Article
Hematology
Kundan Mishra, Suman Kumar, Kanwaljeet Singh, Aditya Jandial, Rajeev Sandal, Kamal Kant Sahu, Sanjeev Khera, Rajiv Kumar, Rajan Kapoor, Sanjeevan Sharma, Jasjit Singh, Satyaranjan Das, Tathagat Chatterjee, Ajay Sharma, Velu Nair
Summary: This retrospective study analyzed the response and safety profile of using anti-D in patients with severe immune thrombocytopenia (ITP) in developing countries. The results showed that anti-D treatment significantly increased platelet counts and had a good response rate in different phases and populations of ITP, with a good safety profile.
ANNALS OF HEMATOLOGY
(2022)