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Mechanisms and prevention of alloimmunization in pregnancy.

Kjeldsen-Kragh, Jens LU and Skogen, Bjørn (2013) In Obstetrical and Gynecological Survey 68(7). p.526-532
Abstract
Transfusion only occasionally gives rise to antibody production, because blood cells per se are not markedly immunogenic. However, the immunological changes that occur during pregnancy increase the risk of alloimmunization against red blood cells, platelets, and/or leukocytes. Fetal-maternal bleeding during pregnancy or in relation to delivery is the antigenic stimuli for immunization against red blood cells, whereas other mechanisms, such as trophoblast-derived microparticles, may also play a role in the production of antibodies against platelets. Antibody-mediated immune suppression has for 4 decades successfully been used for prevention of RhD immunization. Result from a mouse model of fetal and neonatal alloimmune thrombocytopenia... (More)
Transfusion only occasionally gives rise to antibody production, because blood cells per se are not markedly immunogenic. However, the immunological changes that occur during pregnancy increase the risk of alloimmunization against red blood cells, platelets, and/or leukocytes. Fetal-maternal bleeding during pregnancy or in relation to delivery is the antigenic stimuli for immunization against red blood cells, whereas other mechanisms, such as trophoblast-derived microparticles, may also play a role in the production of antibodies against platelets. Antibody-mediated immune suppression has for 4 decades successfully been used for prevention of RhD immunization. Result from a mouse model of fetal and neonatal alloimmune thrombocytopenia (FNAIT) suggests that the same principle may be applied for the prevention of FNAIT. A European Union-funded consortium is presently in the process of developing a hyperimmune anti-human platelet antigen 1a (HPA-1a) immunoglobulin G. The idea is to prevent HPA-1a immunization by administering the drug to nonimmunized HPA-1a-negative women after delivery of an HPA-1a-positive child. The anti-HPA-1a will be purified from plasma collected from women who previously have given birth to a child with FNAIT caused by anti-HPA-1a. If the results of the planned phase III trial are favorable, it is possible that a product for prevention of FNAIT will be available within this decade. (Less)
Please use this url to cite or link to this publication:
author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Obstetrical and Gynecological Survey
volume
68
issue
7
pages
526 - 532
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:23803755
  • scopus:84879860884
ISSN
0029-7828
DOI
10.1097/OGX.0b013e3182947ce4
language
English
LU publication?
yes
id
3967018e-db2f-444b-8dcb-919a5e3185cd (old id 3912957)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23803755?dopt=Abstract
date added to LUP
2016-04-04 07:12:35
date last changed
2022-02-28 03:19:16
@article{3967018e-db2f-444b-8dcb-919a5e3185cd,
  abstract     = {{Transfusion only occasionally gives rise to antibody production, because blood cells per se are not markedly immunogenic. However, the immunological changes that occur during pregnancy increase the risk of alloimmunization against red blood cells, platelets, and/or leukocytes. Fetal-maternal bleeding during pregnancy or in relation to delivery is the antigenic stimuli for immunization against red blood cells, whereas other mechanisms, such as trophoblast-derived microparticles, may also play a role in the production of antibodies against platelets. Antibody-mediated immune suppression has for 4 decades successfully been used for prevention of RhD immunization. Result from a mouse model of fetal and neonatal alloimmune thrombocytopenia (FNAIT) suggests that the same principle may be applied for the prevention of FNAIT. A European Union-funded consortium is presently in the process of developing a hyperimmune anti-human platelet antigen 1a (HPA-1a) immunoglobulin G. The idea is to prevent HPA-1a immunization by administering the drug to nonimmunized HPA-1a-negative women after delivery of an HPA-1a-positive child. The anti-HPA-1a will be purified from plasma collected from women who previously have given birth to a child with FNAIT caused by anti-HPA-1a. If the results of the planned phase III trial are favorable, it is possible that a product for prevention of FNAIT will be available within this decade.}},
  author       = {{Kjeldsen-Kragh, Jens and Skogen, Bjørn}},
  issn         = {{0029-7828}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{526--532}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Obstetrical and Gynecological Survey}},
  title        = {{Mechanisms and prevention of alloimmunization in pregnancy.}},
  url          = {{http://dx.doi.org/10.1097/OGX.0b013e3182947ce4}},
  doi          = {{10.1097/OGX.0b013e3182947ce4}},
  volume       = {{68}},
  year         = {{2013}},
}