Platelet antigens. The role of human platelet alloantigens (HPA) in blood transfusion and transplantation. 2002

Primoz Rozman
Blood Transfusion Centre of Slovenia, Department of Immunohematology, Ljubljana.

In this review, we describe the platelet surface molecules with special focus on the polymorphic glycoproteins giving rise to the human platelet alloantigen (HPA) system. We list the platelet glycoprotein complexes GPIa/IIa, GPIIb/IIIa, GPIb/V/IX and some other molecules, the corresponding genes that encode them and we describe their polymorphisms as well as their physiological function. Based on data obtained by serological and molecular methods, we explain how ancestral HPA alloepitopes have developed into the modern variants. We also describe the tissue distribution of these proteins, which seems to be wider than thought initially, and discuss the significance of the HPA encoding genes distribution in various populations. Methods for their determination are then described briefly Since HPA alloepitopes can induce antibodies with resulting clinical conditions such as: post-transfusion refractoriness to platelets (PTR); post-transfusion thrombocytopenic purpura (PTTP); and fetomaternal alloimmune thrombocytopenia (FMAIT), the mechanism of this alloimmunization and its prevention is described. Although the humoral arm is more important from the clinical viewpoint, the activation of the cytotoxic arm by HPA alloepitopes is also possible. These polymorphisms also seem to have a role in certain other clinical circumstances, therefore their impact on cardiovascular diseases and haemostatic disorders as well as their role in the transplantation of solid organs and bone marrow is addressed. We conclude that during the last decades, the research of the platelet membrane molecules contributed considerably to the diagnostics, prevention and therapy of the blood coagulation and haemostatic disorders, to the management of the neonatal thrombocytopenias, transfusion-related thrombocytopenias, refractoriness to platelet transfusions and autoimmune disorders. It also changed our view on the role of HPA alloepitopes in bone marrow and solid organ transplantation. In the future, this accumulated knowledge will be useful for the development of the cell-based therapies and immune modulation of both acquired and hereditary diseases.

UI MeSH Term Description Entries
D007114 Immunization Deliberate stimulation of the host's immune response. ACTIVE IMMUNIZATION involves administration of ANTIGENS or IMMUNOLOGIC ADJUVANTS. PASSIVE IMMUNIZATION involves administration of IMMUNE SERA or LYMPHOCYTES or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). Immunologic Stimulation,Immunostimulation,Sensitization, Immunologic,Variolation,Immunologic Sensitization,Immunological Stimulation,Sensitization, Immunological,Stimulation, Immunologic,Immunizations,Immunological Sensitization,Immunological Sensitizations,Immunological Stimulations,Sensitizations, Immunological,Stimulation, Immunological,Stimulations, Immunological,Variolations
D007519 Isoantigens Antigens that exist in alternative (allelic) forms in a single species. When an isoantigen is encountered by species members who lack it, an immune response is induced. Typical isoantigens are the BLOOD GROUP ANTIGENS. Alloantigens,Alloantigen,Isoantigen
D008297 Male Males
D008958 Models, Molecular Models used experimentally or theoretically to study molecular shape, electronic properties, or interactions; includes analogous molecules, computer-generated graphics, and mechanical structures. Molecular Models,Model, Molecular,Molecular Model
D010980 Platelet Membrane Glycoproteins Surface glycoproteins on platelets which have a key role in hemostasis and thrombosis such as platelet adhesion and aggregation. Many of these are receptors. PM-GP,Platelet Glycoprotein,Platelet Membrane Glycoprotein,PM-GPs,Platelet Glycoproteins,Glycoprotein, Platelet,Glycoprotein, Platelet Membrane,Glycoproteins, Platelet,Glycoproteins, Platelet Membrane,Membrane Glycoprotein, Platelet,Membrane Glycoproteins, Platelet,PM GP
D011110 Polymorphism, Genetic The regular and simultaneous occurrence in a single interbreeding population of two or more discontinuous genotypes. The concept includes differences in genotypes ranging in size from a single nucleotide site (POLYMORPHISM, SINGLE NUCLEOTIDE) to large nucleotide sequences visible at a chromosomal level. Gene Polymorphism,Genetic Polymorphism,Polymorphism (Genetics),Genetic Polymorphisms,Gene Polymorphisms,Polymorphism, Gene,Polymorphisms (Genetics),Polymorphisms, Gene,Polymorphisms, Genetic
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D001791 Blood Platelet Disorders Disorders caused by abnormalities in platelet count or function. Thrombocytopathy,Blood Platelet Disorder,Disorder, Blood Platelet,Disorders, Blood Platelet,Platelet Disorder, Blood,Platelet Disorders, Blood,Thrombocytopathies
D001792 Blood Platelets Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. Platelets,Thrombocytes,Blood Platelet,Platelet,Platelet, Blood,Platelets, Blood,Thrombocyte
D001803 Blood Transfusion The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed) Blood Transfusions,Transfusion, Blood,Transfusions, Blood

Related Publications

Primoz Rozman
October 2007, Zhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical genetics,
Primoz Rozman
June 1993, Nouvelle revue francaise d'hematologie,
Primoz Rozman
January 2010, Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology,
Primoz Rozman
September 1995, Transfusion medicine (Oxford, England),
Copied contents to your clipboard!