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Flesch BK, Reil A, Nogués N, Canals C, Bugert P, Schulze TJ, Huiskes E, Porcelijn L, Höglund P, Ratcliffe P, Schönbacher M, Kerchrom H, Kellershohn J, Bayat B. Multicenter Study on Differential Human Neutrophil Antigen 2 Expression and Underlying Molecular Mechanisms. Transfus Med Hemother 2020; 47:385-395. [PMID: 33173457 DOI: 10.1159/000505523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/18/2019] [Indexed: 12/29/2022] Open
Abstract
Background The human neutrophil antigen 2 (HNA-2), which is expressed on CD177, is undetectable in 3-5% of the normal population. Exposure of these HNA-2<sub>null</sub> individuals to HNA-2-positive cells can cause immunization and pro-duction of HNA-2 antibodies, which can induce immune neutropenia and transfusion-related acute lung injury. In HNA-2-positive individuals, neutrophils are divided into a CD177<sup>pos.</sup> and a CD177<sup>neg.</sup> subpopulation. The molecular background of HNA-2 deficiency and the bimodal expression pattern, however, are not completely decoded. Study Design An international collaboration was conducted on the genetic analysis of HNA-2-phenotyped blood samples, including HNA-2-deficient individuals, mothers, and the respective children with neonatal immune neutropenia and regular blood donors. Results From a total of 54 HNA-2<sub>null</sub> individuals, 43 were homozygous for the CD177 *787A>T substitution. Six carried the CD177 *c.1291G>A single nucleotide polymorphism. All HNA-2-positive samples with >40% CD177<sup>pos.</sup> neutrophils carried the *787A wild-type allele, whereas a lower rate of CD177<sup>pos.</sup> neutrophils was preferentially associated with *c.787AT heterozygosity. Interestingly, only the *c.787A allele sequence was detected in complementary DNA (cDNA) sequence analysis carried out on all *c.787AT heterozygous individuals. However, cDNA analysis after sorting of CD177<sup>pos.</sup> and CD177<sup>neg.</sup> neutrophil subsets from HNA-2-positive individuals showed identical sequences, which makes regulatory elements within the promoter unlikely to affect CD177 gene transcription in different CD177 neutrophil subsets. Conclusion This comprehensive study clearly demonstrates the impact of single nucleotide polymorphisms on the expression of HNA-2 on the neutrophil surface but challenges the hypothesis of regulatory epigenetic effects being implicated in the bimodal CD177 expression pattern.
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Affiliation(s)
- Brigitte K Flesch
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany.,German Red Cross Blood Service West, Hagen, Germany
| | | | - Núria Nogués
- Immunohematology Laboratory, Blood and Tissue Bank, Barcelona, Spain
| | - Carme Canals
- Immunohematology Laboratory, Blood and Tissue Bank, Barcelona, Spain
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service of Baden-Württemberg, Hessen gGmbH, Mannheim, Germany
| | - Torsten J Schulze
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service of Baden-Württemberg, Hessen gGmbH, Mannheim, Germany.,Institute Springe, German Red Cross Blood Service NSTOB, Springe, Germany
| | - Elly Huiskes
- Department of Immunohematology Diagnostics, Sanquin, Amsterdam, The Netherlands
| | - Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin, Amsterdam, The Netherlands
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Ratcliffe
- Center for Hematology and Regenerative Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marlies Schönbacher
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Hans Kerchrom
- Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Josina Kellershohn
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
| | - Behnaz Bayat
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
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Flesch BK, Reil A. Molecular Genetics of the Human Neutrophil Antigens. Transfus Med Hemother 2018; 45:300-309. [PMID: 30498408 PMCID: PMC6257083 DOI: 10.1159/000491031] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/17/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Antibodies to human neutrophil antigens (HNAs) have been implicated in transfusion-related acute lung injury and allo- and autoimmune neutropenia. To date, five HNA systems are assigned, and during the last decades enormous efforts have been undertaken to identify the underlying genes and to characterize the antigens. This review of the literature will provide the current genetic, molecular and functional information on HNAs. RECENT FINDINGS New information on alleles and antigens has been added to nearly each of the five HNA systems. HNA-1d has been added as the antithetical epitope to HNA-1c that is located on the glycoprotein encoded by FCGR3B*02 but not by FCGR3B. FCGR3B*04 and *05 now are included as new alleles. A CD177*787A>T substitution was demonstrated as the main reason for the HNA-2-negative phenotype on neutrophils. The target glycoprotein of HNA-3 antibodies could be identified as choline transporter-like protein 2 (CTL2) encoded by SLC44A2. The conformation sensitive epitope discriminates between arginine and glutamine at position 152 resulting in HNA-3a and HNA-3b. An additional Leu151Phe substitution can impair HNA-3a antibody binding. Recently an alloantibody against HNA-4b which discriminates from HNA-4a by an Arg61His exchange of the glycoprotein encoded by the ITGAM gene was reported in neonatal alloimmune neutropenia. An update of the current HNA nomenclature based on the new findings was provided in 2016 by the ISBT Granulocyte Immunobiology Working Party nomenclature subcommittee. CONCLUSIONS The molecular basis of each of the five HNA antigen systems has been decoded during the past decades. This enables reliable molecular typing strategies, antibody detection and specification as well as development of new assays based on recombinant antigens. However, research on HNA alleles, antigens, and antibodies is not finally terminated and also in the future will add new findings.
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Lalezari P. Neutrophil-specific antigens, immunobiology, and implications in transfusion medicine and blood disorders. Transfusion 2017; 57:2066-2073. [PMID: 28703920 DOI: 10.1111/trf.14102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 02/15/2017] [Accepted: 02/15/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Parviz Lalezari
- Neurological Surgery Research Laboratory, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
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Chen Q, Srivastava K, Liu Z, Xiao J, Huang C, Sun J, Li M, Flegel WA. Genotype frequency of human neutrophil antigen-3 polymorphisms in the Yi, Han, and Tibetan populations of China. Transfusion 2016; 56:737-42. [PMID: 26593331 PMCID: PMC4783214 DOI: 10.1111/trf.13413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 09/26/2015] [Accepted: 10/04/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Human neutrophil antigen-3 (HNA-3) alloantibodies can cause fatal transfusion-related acute lung injury (TRALI). Most frequencies of SLC44A2 alleles encoding the HNA-3a/b antigens have been established in Han individuals by polymerase chain reaction with sequence-specific priming (PCR-SSP). We sequenced SLC44A2 gene fragments and determined allele frequencies in three ethnicities of China. STUDY DESIGN AND METHODS Genomic DNA was extracted from 448 samples of 100 blood donors of Yi ethnicity in Xichang, Liangshan; 248 Han in Nanjing, Jiangsu; and 100 Tibetan in Lhasa, Tibet. A PCR-SSP was applied to determine the phase of two single-nucleotide polymorphisms (SNPs); SLC44A2 haplotypes were constructed. RESULTS In the 567 nucleotides of the SLC44A2 gene covered by our sequencing approach in Han individuals, we detected the known 331-44G>A (rs12972963) and 461G>A (rs2288904) polymorphisms. In the 243 nucleotides sequenced in Yi and Tibetan populations, we detected the known 461G>A and 503-15T>C (rs1560711) polymorphisms. A PCR-SSP for the common HNA-3a/b SNP was 100% concordant. The frequencies of the HNA-3a allele were 0.58, 0.66, and 0.69 in Yi, Han (Nanjing), and Tibetan, respectively (0.42, 0.34, and 0.31 for HNA-3b). CONCLUSIONS The Yi population of China had the highest frequency of blood donors at risk of harboring anti-HNA-3a compared to any population studied so far. We confirmed that the underlying SLC44A2*2 allele is more common in China than in any European or African populations.
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Affiliation(s)
- Qing Chen
- Jiangsu Province Blood Center, Nanjing
- Soochow University, Suzhou, Jiangsu, China
| | - Kshitij Srivastava
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Zhong Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Science & Peking Union Medical College, Chengdu, Sichuan, China
| | | | | | - Jun Sun
- Jiangsu Province Blood Center, Nanjing
| | - Min Li
- Institute of Dermatology, Chinese Academy of Medical Science & Peking Union Medical College
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, China
| | - Willy Albert Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland
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Veldhuisen B, Porcelijn L, Ellen van der Schoot C, de Haas M. Molecular typing of human platelet and neutrophil antigens (HPA and HNA). Transfus Apher Sci 2014; 50:189-99. [PMID: 24685245 DOI: 10.1016/j.transci.2014.02.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Genotyping is an important tool in the diagnosis of disorders involving allo-immunisation to antigens present on the membranes of platelets and neutrophils. To date 28 human platelet antigens (HPAs) have been indentified on six polymorphic glycoproteins on the surface of platelets. Antibodies against HPAs play a role in foetal and neonatal alloimmune thrombocytopenia (FNAIT), post-transfusion purpura (PTP) and refractoriness to donor platelets. The 11 human neutrophil antigens (HNAs) described to date have been indentified on five polymorphic proteins on the surface of granulocytes. Antibodies to HNAs are implicated with foetal and neonatal alloimmune neutropenia (FNAIN), autoimmune neutropenia (AIN) and transfusion related acute lung injury (TRALI). In this report, we will review the molecular basis and techniques currently available for the genotyping of human platelet and neutrophil antigens.
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Affiliation(s)
- Barbera Veldhuisen
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands; Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Leendert Porcelijn
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands
| | - C Ellen van der Schoot
- Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Masja de Haas
- Sanquin Diagnostic Services, Department of Diagnostic Immunohematology, Amsterdam, The Netherlands
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Fung YL, Silliman CC. The role of neutrophils in the pathogenesis of transfusion-related acute lung injury. Transfus Med Rev 2009; 23:266-83. [PMID: 19765516 DOI: 10.1016/j.tmrv.2009.06.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Transfusion-related acute lung injury (TRALI) is the major cause of transfusion related morbidity and mortality, world wide. Efforts to reduce or eliminate this serious complication of blood transfusion are hampered by an incomplete understanding of its pathogenesis. Currently, TRALI is thought to be mediated by donor alloantibodies directed against host leukocytes or the result of 2 distinct clinical events. For both proposed mechanisms, the neutrophil is the key effector cell. This article reviews TRALI pathophysiology, explores the role of the neutrophil, details practical information for appropriate diagnosis and promotes further studies into the pathogenesis of TRALI.
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Affiliation(s)
- Yoke Lin Fung
- Australian Red Cross Blood Service, Brisbane, Queensland, Australia.
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8
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Nguyen XD, Flesch B, Sachs UJ, Kroll H, Klüter H, Müller-Steinhardt M. Rapid screening of granulocyte antibodies with a novel assay: flow cytometric granulocyte immunofluorescence test. Transfusion 2009; 49:2700-8. [PMID: 19659676 DOI: 10.1111/j.1537-2995.2009.02330.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND White blood cell (WBC)-associated antibodies can lead to severe pulmonary transfusion reactions (transfusion-related acute lung injury [TRALI]). Investigation of a large number of blood donor samples using the standard granulocyte immunofluorescence test (GIFT) and granulocyte agglutination test (GAT) proved to be difficult to perform due to the time-consuming process and the large quantity of test cells required. This study describes the novel flow cytometric GIFT (Flow-GIFT) method for a rapid detection of granulocyte antibodies by flow cytometric analysis. STUDY DESIGN AND METHODS A total of 141 sera were analyzed for the presence of granulocyte antibodies that were previously associated with suspected TRALI. As test cells whole blood samples from human neutrophil antigen (HNA)-typed donors were isolated using cell sedimentation in a ficoll density gradient. WBCs were incubated with the respective serum and binding of antibodies to the test cells was detected using fluorescein isothiocyanate-conjugated anti-human antibody. Standard GIFT and GAT were performed as reference methods. RESULTS Seven sera containing anti-HNA-3a, CD16, and HLA Class I were negative in the standard GIFT and eight sera containing anti-HNA-2a, anti-CD16, and anti-HLA Class I were not detected in the GAT. The novel Flow-GIFT was able to detect all granulocyte antibodies, which were only detectable in a combination of standard GIFT and GAT. In serial dilution tests, the Flow-GIFT detected the antibodies at higher dilutions than the reference methods GIFT and GAT. CONCLUSION The Flow-GIFT method permits rapid detection of granulocyte antibodies requiring fewer donor test cells. This method is ideal for automation and will potentially open the way for screening of granulocyte antibodies in a large donor population.
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Affiliation(s)
- Xuan Duc Nguyen
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, Red-Cross Blood Service of Baden-Württemberg-Hessen, Mannheim, Germany.
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9
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Moritz E, Norcia ÂMMI, Cardone JDB, Kuwano ST, Chiba AK, Yamamoto M, Bordin JO. Human neutrophil alloantigens systems. AN ACAD BRAS CIENC 2009; 81:559-69. [DOI: 10.1590/s0001-37652009000300019] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Accepted: 04/27/2009] [Indexed: 11/21/2022] Open
Abstract
Neutrophil alloantigens are involved in a variety of clinical conditions including immune neutropenias, transfusion-related acute lung injury (TRALI), refractoriness to granulocyte transfusions and febrile transfusion reactions. In the last decade, considerable progress has been made in the characterization of the implicated antigens. Currently, seven antigens are assigned to five human neutrophil antigen (HNA) systems. The HNA-1a, HNA-1b and HNA-1c antigens have been identified as polymorphic forms of the neutrophil Fcγ receptor IIIb (CD16b), encoded by three alleles. Recently, the primary structure of the HNA-2a antigen was elucidated and the HNA-2a-bearing glycoprotein was identified as a member of the Ly-6/uPAR superfamily, which has been clustered as CD177. The HNA-3a antigen is located on a 70-95 kDa glycoprotein; however, its molecular basis is still unknown. Finally, the HNA-4a and HNA-5a antigens were found to be caused by single nucleotide mutations in the αM (CD11b) and αL (CD11a) subunits of the leucocyte adhesion molecules (β2 integrins). Molecular and biochemical characterization of neutrophil antigenshave expanded our diagnostic tools by the introduction of genotyping techniques and immunoassays for antibody identification. Further studies in the field of neutrophil immunology will facilitate the prevention and management of transfusion reactions and immune diseases caused by neutrophil antibodies.
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11
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Terasaki PI, Mickey MR, Vredevoe DL, Goyette DR. Serotyping for Homotransplantation IV Grouping and Evaluation of Lymphotoxic Sera*. Vox Sang 2009. [DOI: 10.1111/j.1423-0410.1966.tb04613.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE This review describes alloantigens currently listed in the human neutrophil alloantigen (HNA) system. MATERIAL AND METHODS Review of the literature. RESULTS Neutrophil antigens are implicated in a variety of clinical conditions including neonatal immune neutropenia, transfusion-related acute lung injury, refractoriness to granulocyte transfusions, febrile transfusion reactions, immune neutropenia after bone marrow transplantation, autoimmune neutropenia and drug-induced immune neutropenia. Seven antigens have been listed in the HNA system that are assigned to five antigen groups. Six antigens have been characterized biochemically and molecularly so that their primary structure is now known. As shown by regularly performed international granulocyte immunology workshops, a combination of granulocyte agglutination and immunofluorescence tests together with a panel of typed cells is currently the best means of detection. CONCLUSIONS Most of the HNA antigens have been well-characterized so that HNA typing as well as the detection of the corresponding antibodies are now reliably possible. This will improve diagnostics of neutrophil antibody-mediated clinical conditions as well as the prevention of transfusion-related acute lung injury.
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Affiliation(s)
- J Bux
- Blood Service West of the German Red Cross, Feithstrasse 182, 58097 Hagen, Germany.
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13
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Bux J. Alloantigene auf Granulozyten. TRANSFUSIONSMEDIZIN 2004. [DOI: 10.1007/978-3-662-10597-9_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Davoren A, Curtis BR, Shulman IA, Mohrbacher AF, Bux J, Kwiatkowska BJ, McFarland JG, Aster RH. TRALI due to granulocyte-agglutinating human neutrophil antigen-3a (5b) alloantibodies in donor plasma: a report of 2 fatalities. Transfusion 2003; 43:641-5. [PMID: 12702187 DOI: 10.1046/j.1537-2995.2003.00374.x] [Citation(s) in RCA: 139] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND TRALI is usually an immunologic reaction to WBC antibodies in infused plasma and ranks second only to ABO mismatch as a cause of transfusion-associated death. Implicated donors are usually multiparous women (>/=3 pregnancies). STUDY DESIGN AND METHODS Two fatal cases of TRALI were evaluated by reviewing clinical and laboratory findings and characterizing alloantibodies present in donor plasma. Investigation for WBC antibodies was by lymphocytotoxicity (LCT), FlowPRA (FlowPRA, One Lambda, Inc.) and granulocyte immunofluorescence and agglutination assays. Patient 1 was a 62-year-old man with chronic T-cell lymphocytic leukemia, and Patient 2 was a 54-year-old woman undergoing a cadaveric kidney transplant. Both patients developed acute respiratory distress and hypotension during (Patient 1) and approximately 30 minutes after (Patient 2) transfusion. Fulminant pulmonary edema ensued in both cases necessitating mechanical ventilation and both patients died within 24 hours of the onset of respiratory complications. RESULTS The donors of the implicated blood components were women with a history of two pregnancies but no blood transfusions. Weak apparently panreactive granulocyte antibodies were detected with flow cytometry. However, in the granulocyte agglutination test, strong antibodies specific for human neutrophil antigen (HNA)-3a (5b) were identified in both donors. CONCLUSION It is concluded that female blood donors with only two previous pregnancies can form clinically important granulocyte-reactive alloantibodies leading to fatal TRALI reactions in recipients. The sometimes devastating consequences of TRALI should prompt the development of strategies to prevent or reduce its incidence. Further research is warranted to investigate recipient and donor factors responsible for TRALI, including whether 5b (HNA-3a) alloantibodies are especially prone to cause severe reactions, and to better characterize the HNA-3a (5b) antigen, particularly at the molecular level.
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Affiliation(s)
- A Davoren
- Blood Center of Southeastern Wisconsin, PO Box 2178, Milwaukee, WI 53201-2178,USA.
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de Haas M, Muniz-Diaz E, Alonso LG, van der Kolk K, Kos M, Buddelmeijer L, Porcelijn L, von dem Borne AE. Neutrophil antigen 5b is carried by a protein, migrating from 70 to 95 kDa, and may be involved in neonatal alloimmune neutropenia. Transfusion 2000; 40:222-7. [PMID: 10686007 DOI: 10.1046/j.1537-2995.2000.40020222.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Neutrophil antigen 5b has been described as involved in transfusion reactions and not in neonatal alloimmune neutropenia. CASE REPORT Anti-5b was found in the serum of a mother of a persistently neutropenic newborn, who had several bacterial infections. The neutropenia responded to treatment with recombinant human granulocyte-colony-stimulating factor. Immunoprecipitation experiments performed with this and three other 5b antisera identified a protein, migrating from 70 to 95 kDa, as carrier of 5b. The observed pattern of migration may point to heavy glycosylation of this protein. RESULTS Six 5b-negative donors were identified among 54 screened white donors, for a 5b gene frequency of 0.66. CONCLUSION Alloimmunization to 5b in pregnancy is rare. In the patients with neonatal neutropenia analyzed in the last decade, this was the first case discovered.
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Affiliation(s)
- M de Haas
- Central Laboratory of the Netherlands Red Cross, Amsterdam.
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Alloantigene auf Granulozyten. TRANSFUSIONSMEDIZIN 1996. [DOI: 10.1007/978-3-662-10599-3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Grimminger F, Kreusler B, Schneider U, von Witzleben E, Walmrath D, Neppert J, Seeger W. Human leukoagglutinating antibody evokes cooperative leukotriene synthesis in pulmonary microvasculature. Model of transfusion-related acute lung injury. Circ Res 1991; 68:503-12. [PMID: 1991353 DOI: 10.1161/01.res.68.2.503] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Leukoagglutinating antibodies have been implicated in the development of transfusion-related acute lung injury. In the present study, human neutrophil leukotriene generation was provoked by an anti-5b immunoglobulin G, isolated from a multiparous donor plasma that caused noncardiogenic lung edema during transfusion therapy. In 5b-positive polymorphonuclear neutrophils (PMNs), the antibody stimulated marked arachidonic acid metabolism, dependent on the presence of plasma as the complement source. Quantity and profile of lipid mediators (leukotriene B4 and its omega-oxidation products, 5-hydroxyeicosatetraenoic acid, and nonenzymatic hydrolysis products of leukotriene A4) corresponded to those repeatedly described after PMN in vitro stimulation with the artificial calcium ionophore A23187. Anti-5b challenge of PMNs sequestered in the microvasculature of perfused rabbit lungs did, however, induce a markedly modified metabolite profile. Nonenzymatic hydrolysis products of leukotriene A4 were not detected, and 5-hydroxyeicosatetraenoic acid was markedly reduced. In contrast, cysteinyl leukotrienes were measured as predominant compounds, with rapid appearance of leukotriene C4 and more protracted generation of leukotriene E4. Leukotriene B4 and its omega-oxidation products were released with similar kinetics, but in lower amounts, as compared with the isolated PMN stimulation. Anti-5b challenge of PMNs coincubated with pulmonary artery endothelial cells in vitro, but not stimulation of either cell type alone, provoked marked generation of cysteinyl leukotrienes. These findings suggest modulation of PMN 5-lipoxygenase metabolism in favor of leukotriene A4 transfer to adjacent acceptor cells with subsequent enzymatic conversion to cysteinyl leukotrienes under conditions of lung vascular sequestration. Endothelial cells appear to serve as predominant cooperative cells under circumstances of blood-free lung perfusion. PMN-related transcellular eicosanoid synthesis may be involved in the pathogenesis of transfusion-evoked acute lung injury.
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Affiliation(s)
- F Grimminger
- Department of Internal Medicine, Justus-Liebig University, Giessen, FRG
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Nordhagen R, Conradi M, Drömtorp SM. Pulmonary reaction associated with transfusion of plasma containing anti-5b. Vox Sang 1986; 51:102-7. [PMID: 3095987 DOI: 10.1111/j.1423-0410.1986.tb00223.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A patient developed an acute respiratory distress syndrome with lung infiltrates during a transfusion of plasma. The transfused plasma was shown to contain a potent leucocyte agglutinating antibody of IgG type with anti-5b specificity, reactive with the patient's cells. A review of the literature on similar transfusion-related syndromes showed an association with more of less well-defined white cell antibodies, mainly in the donors' plasma. The majority of donors were multiparous women. The anti-5b in our donor was demonstrated only by granulocyte agglutination technique, as previously described antibodies in the five system. A long incubation procedure (20-25 h) seemed to be optimal for granulocyte agglutination.
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Lalezari P, Murphy GB, Allen FH. NB1, a new neutrophil-specific antigen involved in the pathogenesis of neonatal neutropenia. J Clin Invest 1971; 50:1108-15. [PMID: 5552408 PMCID: PMC292033 DOI: 10.1172/jci106582] [Citation(s) in RCA: 121] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A new human antigen is reported which is present only on blood neutrophils. A neutrophil-specific antigen, designated NA1, has previously been identified in two unrelated families, and was shown to be involved in fetomaternal incompatibility and the development of isoimmune neonatal neutropenia in five newborns. In the present paper, a second antigen, designated NB1, is identified in four families with seven affected children. Antibodies that react with this second antigen are shown to produce selective agglutination of neutrophils but not other blood cells. They are neither absorbed by cells prepared from solid tissues nor by non-neutrophilic blood cells. By family and population studies, NB is shown to be distinct from NA, representing an independent genetic locus. 68% of the New York population are homozygous for NB1, 29% heterozygous, and 3% negative. The NB locus is shown to be independent from those of HL-A and other known leukocyte antigens. No evidence for linkage between NA, NB, and red cell antigens was obtained.
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Terasaki PI, Von Diepow M, Davidson CJ, Mickey MR. Serotyping for homotransplantation. XXIV. Heart transplantation. Am J Cardiol 1969; 24:500-7. [PMID: 4897730 DOI: 10.1016/0002-9149(69)90492-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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23
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Rosenfield RE, Rubinstein P, Lalezari P, Dausset J, Rood JJ. Hemagglutination by Human Anti-Leukocyte Serums. Vox Sang 1967. [DOI: 10.1111/j.1423-0410.1967.tb03792.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lalezari P, Bernard GE. An isologous antigen-antibody reaction with human neutrophiles, related to neonatal neutropenia. J Clin Invest 1966; 45:1741-50. [PMID: 5926443 PMCID: PMC292858 DOI: 10.1172/jci105480] [Citation(s) in RCA: 63] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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