Experimental study on incidence of anti-CD36 antibodies in puerperae and platelet apoptosis induced by anti-CD36 antibodies
-
摘要: 目的:了解广西南宁地区产妇抗CD36抗体的发生率,探讨抗CD36抗体对血小板凋亡的影响。方法:对广西南宁地区303例产妇血样采用流式细胞术(FCM)筛查血小板同种抗体,采用快速血小板抗原单克隆抗体特异性免疫固定检测技术(F-MAIPA)进行血小板抗体特异性鉴定;对含有抗CD36抗体的产妇采用FCM技术检测其血小板及单核细胞上的CD36抗原表达,并采用FCM技术及酶联免疫吸附试验(ELISA)对抗CD36抗体诱导血小板凋亡进行检测。同时对娩出的新生儿监测血小板计数、观察临床表现,记录治疗过程。结果:广西南宁地区303例产妇共有11例产生抗CD36抗体,抗CD36抗体发生率为3.63%,且均为Ⅰ型CD36缺失;其中有2例含抗CD36抗体的产妇血清能诱导血小板凋亡。经临床监测,11例含抗CD36抗体的产妇所娩出的新生儿均出现不同程度的血小板减少、皮肤针尖样皮下出血点,但无颅内出血及其他内脏出血表现,经静脉注射丙种球蛋白/类固醇激素治疗后血小板上升至正常范围。结论:广西南宁地区产妇抗CD36抗体发生以壮族产妇居多。含抗CD36抗体的产妇娩出的新生儿被证实为抗CD36介导的新生儿同种免疫血小板减少症。部分抗CD36抗体能诱导血小板凋亡,其结构特征有待研究。Abstract: Objective: To detect and analyze the incidence of anti-CD36 antibodies produced by puerperae in Nan-ning, and investigate the effect of anti-CD36 antibody on platelet apoptosis.Methods: Anti-CD36 antibodies were detected and identified by flow cytometry(FCM) and fast monoclonal antibody-specific immobilization of platelet antigens(F-MAIPA) from 303 puerpera cases in Nanning. The CD36 antigen expression on platelets and monocytes of the puerperae who contained anti-CD36 antibodies were detected by FCM; platelet apoptosis induced by anti-CD36 antibodies were analyzed by FCM and ELISA; the platelet count, clinical manifestation and the treatment of the newborns were monitored.Results: Among the 303 puerpera cases, 11 cases who were typeⅠCD36 deficiency were detected anti-CD36 antibodies in their sera, the incidence of anti-CD36 antibody was 3.63%. 2 sera(case 6 and 8) in the 11 cases contained anti-CD36 antibodies could induce platelet apoptosis. All the newborns delivered by 11 cases presented with thrombocytopenia and needle-like subcutaneous haemorrhage, but no intracranial hemorrhage or other visceral hemorrhage. After intravenous immunoglobulin/steroid therapy, platelet count of these newborns was increased to the normal range.Conclusion: The occurrence of anti-CD36 antibody from puerperae in Nanning is mainly in Zhuang population. The 11 newborns are approved to be neonatal alloimmune thrombocytopenia caused by anti-CD36 antibodies. Some anti-CD36 antibodies could induce platelet apoptosis, and its structural characteristics need to be studied.
-
Key words:
- anti-CD36 antibody /
- puerpera /
- platelet apoptosis
-
-
[1] Le Toriellec E,Muralitharan V,Chadebech P,et al.New molecular basis associated with CD36-negative phenotype in the sub-Saharan African population[J].Transfusion,2020,60(11):2482-2488.
[2] Liu J,Shao Y,Ding H,et al.Distribution of CD36 deficiency in different Chinese ethnic groups[J].Hum Immunol,2020,81(7):366-371.
[3] Lo SC,Lin KH,Hsieh HH,et al.Genetic variations of CD36 and low platelet CD36 expression-a risk factor for lipemic plasma donation in Taiwanese apheresis donors[J].Vox Sang,2016,110(3):236-243.
[4] 钟周琳,申卫东,周燕,等.广西地区汉、壮和瑶族人群CD36缺失结构实验分析和特征研究[J].中国输血杂志,2014,27(1):14-17.
[5] 周映君,韦喜敢,周吉成,等.CD36抗原缺失与血小板输注无效关系的研究进展[J].临床血液学杂志,2016,29(5):851-854.
[6] Audia S,Mahévas M,Samson M,et al.Pathogenesis of immune thrombocytopenia[J].Autoimmun Rev,2017,16(6):620-632.
[7] De Silva E,Kim H.Drug-induced thrombocytopenia:Focus on platelet apoptosis[J].Chem Biol Interact,2018,284:1-11.
[8] Cohn CS.Platelet transfusion retractoriness:how do I diagnose and manage?[J].Hematology Am Soc Hematol Educ Program,2020,2020(1):527-532.
[9] 周燕,李丽兰,钟周琳,等.造血干细胞移植术后抗-CD36抗体介导的血小板输注无效症和相关病例的实验研究[J].中国实验血液学杂志,2018,26(2):541-546.
[10] Wu G,Zhou Y,Li L,et al.Platelet immunology in China:research and clinical applications[J].Transfus Med Rev,2017,31(2):118-125.
[11] Quach ME,Chen W,Li R.Mechanisms of platelet clearance and translation to improve platelet storage[J].Blood,2018,131(14):1512-1521.
[12] Lebois M,Josefsson EC.Regulation of platelet lifespan by apoptosis[J].Platelet,2016,27(6):497-504.
[13] Meng X,Liu W,Yang H,et al.Ticagrelor prevents tumor metastasis via inhibiting cell proliferation and promoting platelet apoptosis[J].Anticancer Drugs,2020,31(10):1012-1017.
[14] 周燕,吴国光.血小板凋亡的研究现状及其实验室诊断[J].中国输血杂志,2019,32(2):208-212.
-
计量
- 文章访问数: 364
- PDF下载数: 89
- 施引文献: 0
下载: