{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:20:39Z","timestamp":1788909639761,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is caused by antibodies against human platelet antigens (HPA). However, in many cases that meet clinical criteria for the condition, maternal sera do not have HPA antibodies. In studies examining whether human leukocyte antigen (HLA) antibodies cause FNAIT, the results are limited and inconclusive. This study sought to examine whether clinically suspected FNAIT cases with absent maternal HPA antibodies had different HLA antibody strength and specificity compared to controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>A retrospective case\u2013control study assessed class I HLA antibody strength and specificity in cases submitted for testing to Versiti, Wisconsin. There were 813 cases that met initial screening criteria, but written consent could only be obtained for 50. After review of medical records and expert panel review, 31 cases with clinical criteria of FNAIT and maternal HLA but not HPA antibodies were included. Each case was matched for maternal age, gestational age at delivery, parity, and race\/ethnicity to two controls from unaffected pregnancies that had maternal serum HLA antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>FNAIT cases were found to have both significantly higher HLA antibody strength, measured by mean fluorescence index (MFI), and broader HLA antibody specificity at antigen epitope level, compared to matched controls (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). <jats:italic>p<\/jats:italic>\u2010values remained significant after controlling for parity and gestational age at delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Additional studies are needed to further examine whether the strong HLA antibodies identified in HPA\u2010antibody\u2010negative cases directly cause neonatal thrombocytopenia and whether prenatal treatment may be warranted in select cases to prevent recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17342","type":"journal-article","created":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T04:53:33Z","timestamp":1681188813000},"page":"1141-1149","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["<scp>HLA<\/scp> antibodies in fetal and neonatal alloimmune thrombocytopenia"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3643-0195","authenticated-orcid":false,"given":"Zachary A.","family":"Colvin","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Schiller","sequence":"additional","affiliation":[{"name":"Platelet &amp; Neutrophil Immunology Lab and Blood Research Institute Versiti Wisconsin  Milwaukee Wisconsin USA"},{"name":"Histocompatibility &amp; Immunogenetics Lab Versiti Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9836-4659","authenticated-orcid":false,"given":"Shirng\u2010Wern","family":"Tsaih","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-2445","authenticated-orcid":false,"given":"Ruchika","family":"Sharma","sequence":"additional","affiliation":[{"name":"Platelet &amp; Neutrophil Immunology Lab and Blood Research Institute Versiti Wisconsin  Milwaukee Wisconsin USA"},{"name":"Division Hematology\/Oncology\/BMT, Department of Pediatrics Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7302-0449","authenticated-orcid":false,"given":"Rachael F.","family":"Grace","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber\/Boston Children's Cancer and Blood Disorders Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0299-9589","authenticated-orcid":false,"given":"Jennifer J.","family":"McIntosh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9553-9081","authenticated-orcid":false,"given":"Brian R.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Platelet &amp; 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