Fetal and neonatal alloimmune thrombocytopenia: No evidence of systemic inflammation as a modulator of disease severity. Could placental inflammation be key?

被引:3
作者
Boehm, David [1 ]
Wienzek-Lischka, Sandra [1 ,2 ]
Cooper, Nina [1 ,2 ]
Berghoefer, Heike [1 ]
Mueller, Katja [1 ]
Bayat, Behnaz [1 ]
Bein, Gregor [1 ,2 ]
Sachs, Ulrich J. [1 ,2 ,3 ,4 ]
机构
[1] Justus Liebig Univ, Inst Clin Immunol Transfus Med & Haemostasis, Giessen, Germany
[2] Univ Hosp Giessen & Marburg, German Ctr Fetomaternal Incompatibil DZFI, Giessen, Germany
[3] Univ Hosp Giessen & Marburg, Dept Thrombosis & Haemostasis, Giessen, Germany
[4] Univ Hosp Giessen & Marburg, Dept Thrombosis & Haemostasis, Langhansstr 2, D-35392 Giessen, Germany
关键词
fetal; neonatal alloimmune thrombocytopenia; placental inflammation; sFlt-1; SOLUBLE CD14; PROTEIN; MARKER; LIPOPOLYSACCHARIDE; PREGNANCY; PLASMA;
D O I
10.1111/bjh.19009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In fetal/neonatal alloimmune thrombocytopenia (FNAIT), maternal alloantibodies against paternal human platelet antigens (HPA) cross the placenta and lead to platelet destruction. The extent of thrombocytopenia varies among neonates, and inflammation may constitute an important trigger. A set of stable inflammatory markers was measured in serum samples from neonates with low platelet counts, of which n = 50 were diagnosed with FNAIT due to anti-HPA-1a antibodies and n = 50 were thrombocytopenic without detectable maternal HPA antibodies. Concentrations of C-reactive protein, soluble CD14, procalcitonin, and sFlt-1 did not differ between the two cohorts. There was no correlation between C-reactive protein or soluble CD14 and the platelet count, but a negative correlation between procalcitonin concentrations and the neonatal platelet count in both cohorts. sFlt-1 concentration and the platelet count were correlated in FNAIT cases exclusively. None of the inflammatory markers was statistically different between cases with and without intracranial haemorrhage. We were unable to identify systemic inflammation as a relevant factor for thrombocytopenia in FNAIT. The antiangiogenic enzyme sFlt-1, released by the placenta, did correlate with the platelet count in FNAIT cases. Our findings may give rise to the hypothesis that placental inflammation rather than systemic inflammation modulates disease severity in FNAIT.
引用
收藏
页码:304 / 310
页数:7
相关论文
共 34 条
[1]   C-reactive protein: a marker of neonatal stress? [J].
Bellieni, C. V. ;
Liuzzo, L. P. ;
Giomi, S. ;
Tei, M. ;
Stazzoni, G. ;
Bertrando, S. ;
Cornacchione, S. ;
Braconi, F. ;
Zurli, L. ;
Buonocore, G. .
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, 2014, 27 (06) :612-615
[2]   Elevated levels of lipopolysaccharide-binding protein and soluble CD14 in plasma in neonatal early-onset sepsis [J].
Berner, R ;
Fürll, B ;
Stelter, F ;
Dröse, J ;
Müller, HP ;
Schütt, C .
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY, 2002, 9 (02) :440-445
[3]   Autocrine-paracrine VEGF loops potentiate the maturation of megakaryocytic precursors through Flt1 receptor [J].
Casella, I ;
Feccia, T ;
Chelucci, C ;
Samoggia, P ;
Castelli, G ;
Guerriero, R ;
Parolini, I ;
Petrucci, E ;
Pelosi, E ;
Morsilli, O ;
Gabbianelli, M ;
Testa, U ;
Peschle, C .
BLOOD, 2003, 101 (04) :1316-1323
[4]   Placental Complement Activation in Fetal and Neonatal Alloimmune Thrombocytopenia: An Observational Study [J].
de Vos, Thijs W. ;
Winkelhorst, Dian ;
Baelde, Hans J. ;
Dijkstra, Kyra L. ;
van Bergen, Rianne D. M. ;
van der Meeren, Lotte E. ;
Nikkels, Peter G. J. ;
Porcelijn, Leendert ;
van der Schoot, C. Ellen ;
Vidarsson, Gestur ;
Eikmans, Michael ;
Kapur, Rick ;
van der Keur, Carin ;
Trouw, Leendert A. ;
Oepkes, Dick ;
Lopriore, Enrico ;
van der Hoorn, Marie-Louise P. ;
Bos, Manon ;
de Haas, Masja .
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 2021, 22 (13)
[5]   Placental histological lesions in fetal and neonatal alloimmune thrombocytopenia: A retrospective cohort study of 21 cases [J].
Dubruc, Estelle ;
Lebreton, Frederique ;
Giannoli, Catherine ;
Rabilloud, Muriel ;
Huissoud, Cyril ;
Devouassoux-Shisheboran, Mojgan ;
Allias, Fabienne .
PLACENTA, 2016, 48 :104-109
[6]   Diagnosis of Neonatal Sepsis: The Role of Inflammatory Markers [J].
Eichberger, Julia ;
Resch, Elisabeth ;
Resch, Bernhard .
FRONTIERS IN PEDIATRICS, 2022, 10
[7]   Procalcitonin versus C-reactive protein: review of kinetics and performance for diagnosis of neonatal sepsis [J].
Eschborn, Samantha ;
Weitkamp, Joern-Hendrik .
JOURNAL OF PERINATOLOGY, 2019, 39 (07) :893-903
[8]   Endometrial VEGF induces placental sFLT1 and leads to pregnancy complications [J].
Fan, Xiujun ;
Rai, Anshita ;
Kambham, Neeraja ;
Sung, Joyce F. ;
Singh, Nirbhai ;
Petitt, Matthew ;
Dhal, Sabita ;
Agrawal, Rani ;
Sutton, Richard E. ;
Druzin, Maurice L. ;
Gambhir, Sanjiv S. ;
Ambati, Balamurali K. ;
Cross, James C. ;
Nayak, Nihar R. .
JOURNAL OF CLINICAL INVESTIGATION, 2014, 124 (11) :4941-4952
[9]   Pro- versus anti-inflammatory cytokine profile in patients with severe sepsis: A marker for prognosis and future therapeutic options [J].
Gogos, CA ;
Drosou, E ;
Bassaris, HP ;
Skoutelis, A .
JOURNAL OF INFECTIOUS DISEASES, 2000, 181 (01) :176-180
[10]  
Greco Marilena, 2018, J Clin Med Res, V10, P700, DOI 10.14740/jocmr3505w