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Aim  To assess the role of human platelet antigens (HPA), P-selectin gene ( SELP ) polymorphisms, and HPA and  SELP  haplotypes with factor V ( FV ) R506Q in ischemic pediatric stroke (IPS) subtypes: cerebral sinovenous thrombosis (CSVT), perinatal (PAIS), and childhood (CAIS) arterial ischemic stroke.    Methods  This case-control study enrolled 150 children with confirmed IPS and 150 age- and sex-matched controls.  FV  R506Q and HPA-1 were genotyped with CVD StripAssay®, HPA-2 and HPA-3 with real-time polymerase chain reaction,  SELP  S290N, V599L, and T715P with high resolution melting analysis, and  SELP  N562D with sequence-specific polymerase chain reaction.    Results  HPA-1b allele (odds ratio [OR] 2.75, 95% confidence interval [CI] 1.02-7.42,  P  = 0.048) and HPA-1a2a3b (OR 5.46, 95% CI 1.51-19.76,  P  = 0.011), HPA-1b2a3a (OR 7.00, 95% CI 1.25-39.13,  P  = 0.028), and HPA-1b2b3a (OR 11.39, 95% CI 1.39-92.95,  P  = 0.024) haplotypes increased the risk for CSVT. HPA-3b allele was significantly associated with 2-fold lower risk for PAIS (OR 0.49, 95% CI 0.26-0.89,  P  = 0.020) and CAIS (OR 0.47, 95% CI 0.26-0.86,  P  = 0.014) and non-significantly associated with increased risk for CSVT (OR 6.43, 95% CI 0.83-50.00,  P  = 0.022). HPA-1a2b3a haplotype was significantly associated with CAIS (OR 6.76, 95% CI 2.13-21.44,  P  = 0.001). The inclusion of  FV  R506Q in  SELP  haplotype analysis increased the risk for PAIS 4-fold in QNDVT carriers (OR 8.14, 95% CI 0.93-71.33,  P  = 0.060) compared with NDVT haplotype (OR 2.45, 95% CI 0.98-6.18,  P  = 0.058), but the result was not significant.    Conclusion  Individual HPAs, and particularly HPA haplotypes, are involved in IPS subtypes pathogenesis. A possible risk-inducing synergistic effect of  SELP  haplotypes with  FV  R506Q is restricted to PAIS only.

Role of platelet gene polymorphisms in ischemic pediatric stroke subtypes: a case-control study