Are maternal antiplatelet antibodies a prothrombotic condition leading to miscarriage?

Abstract

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a condition characterized by thrombocytopenia in the newborn. If severe, the thrombocytopenia can lead to intracranial hemorrhage. FNAIT arises when maternal antibodies specific for platelet antigens, most commonly b3 integrin, cross the placenta and destroy fetal platelets. Surprisingly, few cases of FNAIT are associated with antibodies specific for the platelet antigen GPIba, which is a common target in patients with immune thrombocytopenia. In this issue of the JCI, Li et al. have identified a potential reason for this - they find that in the majority of pregnant mice, anti-GPIba antibodies enhance platelet activation and accelerate thrombus formation in the placenta and that this leads to miscarriage.