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The aim of this study was to identify human leucocyte antigen (HLA) alleles potentially associated with VITT susceptibility. Specific HLA class II alleles were detected with significantly higher frequency in VITT patients compared with Italian controls: <jats:italic>DPB1*17:01<\/jats:italic>, <jats:italic>DQA1*05:01<\/jats:italic>, and <jats:italic>DRB1*11:04<\/jats:italic>. In silico analysis revealed increased affinity of <jats:italic>DRB1*11:04<\/jats:italic> for a platelet factor 4 (PF4)\u2010derived peptide, ITSLEVIKA, that contains two amino acids present in the specific binding site of anti\u2010PF4 antibodies from VITT patients. Our findings show for the first time a genetic predisposition to developing anti\u2010PF4 antibodies in response to Ad\u2010vector vaccines.<\/jats:p>","DOI":"10.1111\/bjh.19838","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T03:14:26Z","timestamp":1730085266000},"page":"290-295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association of human leucocyte antigen loci with vaccine\u2010induced immune thrombotic thrombocytopenia: Potential role of the interaction between platelet factor 4\u2010derived peptides and <scp>MHC<\/scp>\u2010<scp>II<\/scp>"],"prefix":"10.1111","volume":"206","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4921-8687","authenticated-orcid":false,"given":"Eleonora","family":"Petito","sequence":"first","affiliation":[{"name":"Section of Internal and Cardiovascular Medicine, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0333-0948","authenticated-orcid":false,"given":"Loredana","family":"Bury","sequence":"additional","affiliation":[{"name":"Section of Internal and Cardiovascular Medicine, Department of Medicine and Surgery University of Perugia  Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Antunes Heck","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Sadler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0942-2819","authenticated-orcid":false,"given":"Erica","family":"De Candia","sequence":"additional","affiliation":[{"name":"Hemorrhagic and Thrombotic Diseases Center Fondazione Policlinico Universitario A. 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