Rapid detection of HPA-1 alloantibodies by platelet antigens immobilized onto microbeads.

BACKGROUND: Neonatal alloimmune thrombocytopenia (NAIT) is one of the most common bleeding disorders in neonates. It occurs when alloantibodies from an immunized mother react with paternally inherited alloantigens, mostly human platelet antigen 1a (HPA-1a), on the fetal platelets (PLTs). Currently, monoclonal antibody-immobilized PLT antigen (MAIPA) assay represents the standard technique for the serologic diagnosis of NAIT. MAIPA is time-consuming, however, and limited by the availability of monoclonal antibodies (MoAbs). Here, a gel antigen-specific assay (GASA) was developed, which allows rapid detection of HPA-1 alloantibodies without the use of MoAbs. STUDY DESIGN AND METHODS: Glycoprotein (GP) IIb/IIIa was purified by affinity chromatography from outdated PLT concentrates derived from HPA-1aa or HPA-1bb donors. Purified GPs were biotinylated, immobilized onto streptavidin beads, and used for the analysis of HPA-1a alloantibodies by a microtyping system. HPA-1a serum samples derived from mothers with NAIT (n = 36) and from posttransfusion purpura patients (n = 2) as well as HPA-1b (n = 4), HPA-5b (n = 2), HPA-3a (n = 4), and HLA Class I (n = 2) alloantiserum samples from multitransfused patients were investigated in GASA and MAIPA assays. RESULTS: GASA was able to detect all HPA-1a and -1b alloantibodies recognized by MAIPA. Cross-reactivity with other PLT-reactive alloantibodies was not observed. Interestingly, 3 of 36 serum samples, which showed only moderate reactivity in MAIPA, reacted strongly in GASA. CONCLUSION: GASA has proved to be a rapid method for the detection of HPA-1a alloantibodies and maybe useful for PLT antibody screening, especially in initial assessment of suspected NAIT cases.

A novel agglutination test for antigen-specific detection of platelet antibodies.

A simple and rapid antigen-specific assay for the identification antibodies to platelets is lacking, yet. Red-dyed polystyrene microbeads were coated with monoclonal antibodies to various platelet glycoprotein complexes, and used for the detection of platelet autoantibodies and alloantibodies. The results were largely identical with those obtained by monoclonal antibody-specific immobilization of platelet antigen assay (MAIPA). The new test is reliable yet less complex and time-consuming than the currently available assays, and it can be implemented in any routine laboratory.

A simple and practical assay for the antigen-specific detection of platelet antibodies.

BACKGROUND: The antigen-specific assays currently used for characterization of platelet (PLT)-reactive auto- and alloantibodies are too technically complex and impracticable for most routine laboratories. Here, a novel antigen-specific particle assay (ASPA) for PLTs similar to that of red blood cells is described. STUDY DESIGN AND METHODS: PLTs were solubilized and then incubated with red-dyed polystyrene particles coated with monoclonal antibodies (MoAbs) to various PLT glycoprotein complexes. These particles were directly tested for coating with autoantibodies (n = 8) or indirectly tested for serum autoantibodies (n = 33) or alloantibodies against HPA-1a (n = 4) or HPA-5b (n = 5). Serum samples from healthy blood donors (n = 100) served as negative controls. RESULTS: Negative reactions were clearly distinguishable from positive reactions, and the results of the particle assay were in concordance with those obtained by the standard MoAb-specific immobilization of PLT antigen assay (MAIPA) in all cases with alloanti-bodies. In three patients, only the ASPA was able to detect autoantibodies that were completely undetectable by the MAIPA. In contrast, in only one patient, the MAIPA detected autoantibodies that the ASPA failed to detect. CONCLUSION: In our opinion, the new ASPA is reliable, yet less complex and time-consuming than the currently available assays, and it can be implemented in any routine laboratory.

A simple and practical agglutination assay for the detection of human anti-mouse antibodies.

BACKGROUND AND OBJECTIVES: Human anti-mouse antibodies (HAMAs) are relatively common in human serum and may interfere with therapeutic and diagnostic mouse monoclonal antibodies (MoAbs). We developed a simple particle agglutination test (PaGIA) for the detection of HAMAs. DESIGN AND METHODS: Red-dyed high density particles were coated with monoclonal mouse IgG. These particles were incubated in the reaction chamber of a gel-card together with serum samples obtained from healthy blood donors (n=32), and patients with clinically proven autoimmune thrombocytopenia (AITP; n=26). Positive reactions were defined by a layer of particles on top of the gel or agglutinated particles dispersed throughout the gel matrix. Furthermore, MoAb-coated particles were subjected to flow cytometry and the results were compared with the new HAMA PaGIA. RESULTS: HAMAs were detectable in 33% of serum samples tested (n=58). Results from flow cytometric analysis revealed a high parallel to those obtained by the PaGIA. Interestingly, we observed an increased incidence of HAMAs in AITP patients (42%) compared to healthy blood donors (26%). INTERPRETATION AND CONCLUSION: The new HAMA PaGIA allows a specific and easy, rapid detection of HAMAs and is suitable for large scale testing.