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The Association of Human Leukocyte DQB1*02:01 Allele with Foetus and Neonatal Alloimmune Thrombocytopenia

Mubarak Alwadai, Denise E. Jackson*

Background: Foetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) is a condition resulted from the destruction of foetal Human Platelet Antigen (HPA-1a) by maternal antibodies. HLA-DQB1*02:01 allele is implicated in FNAIT but did not draw much attention. We conducted this study to investigate the correlation of HLA-DQB1*02:01 to FNAIT.

Study design and methods: We searched electronic databases to collect relevant studies (from inception to August 2021). Studies reported HLA-DQB1*02:01 genotype were included. HPA-1bb mothers who had confirmed FNAIT babies were called responders. HPA-1bb mothers who had been pregnant with HPA-1ab baby but did not develop FNAIT were called non-responders.

Results: Five eligible studies were included. Data were extracted to generate forest plots which show Odds Ratio (ORs), P-values, and 95% confidence intervals (ICs). Total number of responders and non-responders was 189 and 85 respectively. 143 of 189 responders (76%) were found to possess HLA-DQB1*02:01. In non-responders, only 29 of 85 (34%) were found to have HLA-DQB1*02:01. The odds ratios mean (95% C.I.) was statically significant (OR=6.60, P-value ≤ 0.001). This indicates that there is a strong association of HLA-DQB1*02:01 with responders. Therefore, we assume that HLA-DQB1*02:01 could be used as a complementary predictive risk factor with HLADRB3* 01:01.

Conclusion: There is an obvious correlation of HLA-DQB1*02:01 with FNAIT. Future studies are needed to investigate the possibility of using HLA-DQB1*02:01 as a complementary risk predictor.