Abstract
BackgroundFetal and neonatal alloimmune thrombocytopenia (FNAIT) is a bleeding disorder caused by maternal antibodies against paternal human platelet antigens (HPAs) on fetal platelets. Antibodies against HPA-1a are accountable for the majority of FNAIT cases. We have previously shown that high levels of maternal anti-HPA-1a antibodies are associated with clinically significant reduced birth weight in newborn boys. Chronic inflammatory placental lesions are associated with increased risk of reduced birth weight and have previously been reported in connection with FNAIT pregnancies. The HPA-1a epitope is located on integrin β3 that is associated with integrin αIIb (the fibrinogen receptor) on platelets and megakaryocytes. Integrin β3 is also associated with integrin αV forming the αVβ3 integrin heterodimer, the vitronectin receptor, which is expressed on various cell types, including trophoblast cells. It is therefore thinkable that maternal anti-HPA-1a antibodies present during early pregnancy may affect placenta function through binding to the HPA-1a antigen epitope on invasive throphoblasts. The aim of the study was to examine whether interaction of a human anti-HPA-1a monoclonal antibody (mAb) with HPA-1a on trophoblast cells affect adhesion, migration and invasion of extravillous trophoblast cells.MethodsAn in vitro model with human anti-HPA-1a mAb, clone 26.4, and the first trimester extravillous trophoblast cell line HTR8/SVneo was employed. The xCELLigence system was utilized to assess the possible effect of anti-HPA-1a mAb on adhesion and migration of HTR8/SVneo cells. Specially designed chambers precoated with Matrigel were used to assess the effect on the invasive capacity of cells.ResultsWe found that human anti-HPA-1a mAb 26.4 partially inhibits adhesion and migratory capacity of HTR8/SVneo cells.ConclusionsOur findings suggest that anti-HPA-1a antibodies may affect trophoblast functions crucial for normal placental development. Future studies including primary throphoblast cells and polyclonal anti-HPA-1a antibodies are needed to confirm these results.
Highlights
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a bleeding disorder caused by maternal antibodies against paternal human platelet antigens (HPAs) on fetal platelets
A human anti-Human platelet antigen-1a (HPA-1a) monoclonal antibody (mAb) 26.4 binds HPA-1a epitope on HTR8/SVneo cells Integrin β3 expression by HTR8/SVneo cells was assessed with Western blot and flow cytometry techniques
Flow cytometry analysis demonstrated that human anti-HPA-1a mAb bound to intact HTR8/SVneo cells (Fig. 1a)
Summary
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a bleeding disorder caused by maternal antibodies against paternal human platelet antigens (HPAs) on fetal platelets. We have previously shown that high levels of maternal anti-HPA-1a antibodies are associated with clinically significant reduced birth weight in newborn boys. Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is caused by maternal antibodies against alloantigens on fetal platelets. It is a rare, but potentially life threatening disorder with intracranial hemorrhage (ICH) as the most severe complication. We have previously found that high levels of maternal anti-HPA-1a antibodies are associated with clinically significant reduced birth weight in newborn boys [4]. Chronic inflammatory placental lesions like chronic villitis and intervillositis have been reported in association with FNAIT cases [6] and such placental lesions are known to be associated with increased risk of fetal growth restriction
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