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Review
. 2020 Feb;59(1):102712.
doi: 10.1016/j.transci.2019.102712. Epub 2019 Dec 31.

Strategies to develop a prophylaxis for the prevention of HPA-1a immunization and fetal and neonatal alloimmune thrombocytopenia

Mette Kjær  1 , Christof Geisen  2 , Çiğdem Akalın Akkök  3 , Agneta Wikman  4 , Ulrich Sachs  5 , James B Bussel  6 , Kaspar Nielsen  7 , Katarina Walles  8 , Brian R Curtis  9 , Gestur Vidarsson  10 , Kerstin Järås  11 , Bjørn Skogen  12
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Free article
Review

Strategies to develop a prophylaxis for the prevention of HPA-1a immunization and fetal and neonatal alloimmune thrombocytopenia

Mette Kjær et al. Transfus Apher Sci. 2020 Feb.
Free article

Abstract

Anti-HPA-1a-antibodies are the main cause of fetal and neonatal alloimmune thrombocytopenia (FNAIT) which may result in intracranial hemorrhage (ICH) and death among fetuses and newborns. Advances in understanding the pathogenesis of FNAIT and proof of concept for prophylaxis to prevent immunization suggest that development of hyperimmune anti-HPA-1a IgG aimed at preventing immunization against HPA-1a and FNAIT is feasible. Anti-HPA-1a IgG can be obtained either by isolating immunoglobulin from already-immunized women or by development of monoclonal anti-HPA-1a antibodies. Here we discuss recent advances that may lead to the development of a prenatal and postnatal prophylactic treatment for the prevention of HPA-1a-associated FNAIT and life-threatening FNAIT-induced complications.

Keywords: FNAIT; HPA-1a; Prophylaxis.

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Conflict of interest statement

Declaration of Competing Interest MK and BS belong to a group of founders and owners of Prophylix AS, a Norwegian biotech company that produced hyperimmune anti-HPA-1a IgG (NAITgam) April 2019. Further, MK and JB are consultants for Rallybio, a US biotech company that will continue development of NAITgam for prevention FNAIT.

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