Antigen-specific immunotherapy for platelet alloimmune disorders. Hum Immunol 2024 Nov;85(6):111172
Date
11/13/2024Pubmed ID
39520801Pubmed Central ID
PMC11637901DOI
10.1016/j.humimm.2024.111172Scopus ID
2-s2.0-85208290159 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
Fetal/Neonatal Alloimmune Thrombocytopenia (FNAIT) is a significant hematologic disorder arising from maternal immune responses to fetal platelet alloantigens, predominantly Human Platelet Antigen (HPA)-1a. This review first describes the pathogenesis of FNAIT, highlighting the roles of HPA-specific antibodies, particularly HPA-1a, in causing severe thrombocytopenia and intracranial hemorrhage in affected neonates. Current management strategies, including intravenous immunoglobulin and investigational therapies like Nipocalimab, are evaluated for their efficacy and limitations. The review also discusses promising antigen-specific therapies, such as effector-silent monoclonal antibodies and innovative approaches targeting alloantibody-producing B cells. Additionally, the potential of Chimeric Autoantibody Receptor (CAAR) T cell therapy for selective elimination of pathogenic B cells is examined. The necessity for a prophylactic strategy similar to RhD immunoprophylaxis in preventing FNAIT is emphasized, along with the importance of identifying at-risk pregnancies. The development of renewable monoclonal antibodies and suitable animal models are critical steps toward effective prevention and treatment of this disorder.
Author List
Newman DK, Newman PJAuthor
Debra K. Newman PhD Investigator in the Blood Research Institute department at BloodCenter of WisconsinMESH terms used to index this publication - Major topics in bold
AnimalsAntibodies, Monoclonal
Antigens, Human Platelet
B-Lymphocytes
Blood Platelets
Female
Humans
Immunoglobulins, Intravenous
Immunotherapy
Infant, Newborn
Integrin beta3
Isoantibodies
Pregnancy
Thrombocytopenia, Neonatal Alloimmune
