A new platelet-specific antigen, Naka, involved in the refractoriness of HLA-matched platelet transfusion

Serum from a thrombocytopenic patient who was refractory to the transfusions of HLA-matched platelets contained a platelet-specific alloantibody, anti-Naka. Immunofluorescence analyses revealed that the Naka antigen defined by the serum was expressed exclusively on platelets and its distribution was different from P1A1, Baka, Yuka or Yukb. Analysis by Dr. von dem Borne's group revealed the Naka was also different from Koa, Kob or Zwb. Family studies showed that the Naka antigen was inherited as an autosomal codominant trait. Its antigen frequency in the Japanese population was over 97%. The results of the enzyme immunoassay using monoclonal antibodies for antigen immobilization showed that the Naka epitope did not appear to reside on GPIIb/IIIa or Ib. The transfusions of Naka-compatible platelets improved the patient's thrombocytopenia.