[The Br(a)/Br(b) alloantigen system in thrombocytes].
Platelet specific alloantibodies cause neonatal alloimmune thrombocytopenia (NAIT), posttransfusion purpura (PTP) and may be found in patients who are refractory to HLA-matched platelet transfusion. Most platelet alloantigen systems comprise two alleles: Zw(a)/Zw(b), Ko(a)/Ko(b), Bak(a)/Bak(b), Yuk(a)/Yuk/b). The corresponding antibodies are detected with the platelet immunofluorescence test, radioimmunoprecipitation, immunoblot, and with a glycoprotein-specific immunoassay. Epitopes of the Zw-, Bak-, and Yuk-alloantigen systems are localized on the GPIIb/IIIa complex. Recently, we characterized antibodies against two alleles of a new alloantigen system (Bra/Brb). Anti-Bra is the second most important antibody to cause NAIT, following Anti-Zwa. Anti-Brb was found in three polytransfused patients. The Br-antibodies may be detected using a glycoprotein-specific enzyme immunoassay (MAIPA assay) and radioimmunoprecipitation. The frequency of the Br-phenotypes in our population is Br(a+b-) 1%, Br(a+b+) 20%, Br(a-b+) 79%. The number of binding sites for Anti-Bra is 2000/platelet on homozygous and 1000/platelet on heterozygous platelets. The Br-alloantigens are localized on GPIa, which is identical with the alpha chain of VLA-2 on activated T-lymphocytes.
Kiefel
V
V
Institut für Klinische Immunologie und Transfusionsmedizin, Justus-Liebig-Universität Giessen.
Santoso
S
S
Mueller-Eckhardt
C
C
D016824:Antigens, Human Platelet; D001788:Blood Grouping and Crossmatching / Q000379:methods; D001792:Blood Platelets / Q000276:immunology*; D001803:Blood Transfusion; D005260:Female; D005455:Fluorescent Antibody Technique; D006580:Genetic Carrier Screening; D006801:Humans; D007124:Immunoenzyme Techniques; D007231:Infant, Newborn; D007519:Isoantigens / Q000032:analysis* / Q000235:genetics; D008297:Male; D013921:Thrombocytopenia / Q000097:blood / Q000175:diagnosis* / Q000235:genetics
C055973:5b alloantigen, human; D016824:Antigens, Human Platelet; D007519:Isoantigens
Das Br(a)/Br(b) Alloantigensystem auf Thrombozyten.