title: Fetal and neonatal alloimmune thrombocytopenia.
abstract: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is an alloimmune disorder resulting from platelet opsonization by maternal antibodies that destroy fetal platelets. The major risk of FNAIT is severe bleeding, particularly intracranial hemorrhage. Miscarriage has also been reported but the incidence requires further study. Analogous to adult autoimmune thrombocytopenia (ITP), the major target antigen in FNAIT is the platelet membrane glycoprotein (GP)IIbIIIa. FNAIT caused by antibodies against platelet GPIbα or other antigens has also been reported, but the reported incidence of the anti-GPIbα-mediated FNAIT is far lower than in ITP. To date, the maternal immune response to fetal platelet antigens is still not well understood and it is unclear why bleeding is more severe in FNAIT than in ITP. In this review, we introduce the pathogenesis of FNAIT, particularly those new discoveries from animal models, and discuss possible improvements for the diagnosis, therapy, and prevention of this devastating disease.
authors.affiliation: Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Toronto Platelet Immunobiology Group, Toronto, ON, Canada; Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada; Canadian Blood Services, Toronto, ON, Canada.
authors.forename: Darko
authors.initials: D
authors.lastname: Zdravic
authors.affiliation: Toronto Platelet Immunobiology Group, Toronto, ON, Canada; Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada; Canadian Blood Services, Toronto, ON, Canada.
authors.forename: Issaka
authors.initials: I
authors.lastname: Yougbare
authors.affiliation: Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Toronto Platelet Immunobiology Group, Toronto, ON, Canada; Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Vadasz
authors.affiliation: Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Toronto Platelet Immunobiology Group, Toronto, ON, Canada; Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada.
authors.forename: Conglei
authors.initials: C
authors.lastname: Li
authors.affiliation: Toronto Platelet Immunobiology Group, Toronto, ON, Canada; Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada.
authors.forename: Alexandra H
authors.initials: AH
authors.lastname: Marshall
authors.affiliation: Toronto Platelet Immunobiology Group, Toronto, ON, Canada; Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada; Canadian Blood Services, Toronto, ON, Canada.
authors.forename: Pingguo
authors.initials: P
authors.lastname: Chen
authors.affiliation: Toronto Platelet Immunobiology Group, Toronto, ON, Canada; Department of Clinical Immunology and Transfusion Medicine, University and Regional Laboratories Region Skåne, Lund, Sweden.
authors.forename: Jens
authors.initials: J
authors.lastname: Kjeldsen-Kragh
authors.affiliation: Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Toronto Platelet Immunobiology Group, Toronto, ON, Canada; Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada; Canadian Blood Services, Toronto, ON, Canada; Department of Clinical Immunology and Transfusion Medicine, University and Regional Laboratories Region Skåne, Lund, Sweden; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Physiology, University of Toronto, Toronto, ON, Canada. Electronic address: nih@smh.ca.
authors.forename: Heyu
authors.initials: H
authors.lastname: Ni
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018743:Perinatal Care / Q000379:methods; D011247:Pregnancy; D011296:Prenatal Diagnosis; D054098:Thrombocytopenia, Neonatal Alloimmune / Q000175:diagnosis / Q000209:etiology / Q000276:immunology / Q000628:therapy
keywords: Antibody-induced immune suppression; Fetal and neonatal alloimmune thrombocytopenia; Intraveneous immunoglobulin G; Platelets; β3 integrin and GPIbα