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Human neutrophil antigen 3 genotype impacts neutrophil-mediated endothelial cell cytotoxicity in a two-event model of TRALI. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2022; 20:465-474. [PMID: 35848624 PMCID: PMC9726621 DOI: 10.2450/2022.0013-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Antibodies against human neutrophil antigen (HNA)-3a are associated with severe cases of transfusion-related acute lung injury (TRALI). The HNA-3 system is located on choline transporter-like 2 (CTL-2) protein. CTL-2 is encoded by the gene SLC44A2 and a single-nucleotide polymorphism c.461G>A results in two antigens: HNA-3a and HNA-3b. Three HNA-3 genotypes/ phenotypes exist: HNA-3aa, HNA-3bb, and HNA-3ab. Two different pathways of anti-HNA-3a TRALI have been described: a two-hit neutrophil-dependent pathway and a one-hit neutrophil-independent pathway. However, it is not clear whether HNA-3ab heterozygous patients have a lower risk of anti-HNA-3a-mediated TRALI compared to HNA-3aa homozygous patients. MATERIALS AND METHODS Healthy volunteers were genotyped for HNA-3 by real-time polymerase chain reaction, and phenotyped for HNA-3a by granulocyte immunofluorescence test (GIFT) and granulocyte agglutination test (GAT) against two donor sera containing anti-HNA-3a antibodies. The two sera were also used in in vitro models of human pulmonary microvascular endothelial cell (HLMVEC) cytotoxicity to investigate pathways of TRALI development. RESULTS For both anti-HNA-3a sera, GIFT results matched the genotype, with a lower GIFT ratio for HNA-3ab neutrophils compared to HNA-3aa neutrophils, whereas GAT results showed no difference in agglutination. HLMVEC cytotoxicity was not observed in a one-hit neutrophil-independent model but was observed in a two-hit neutrophil-dependent model. Differences in cytotoxicity were observed between the two anti-HNA-3a sera used. Consistent with reduced HNA-3a antigen density as measured by GIFT, HNA-3ab neutrophils mediated less HLMVEC cytotoxicity than HNA-3aa neutrophils. CONCLUSION HNA-3 genotype and HNA-3a antigen expression impacted the severity of anti-HNA-3a-mediated HLMVEC cytotoxicity in a two-hit neutrophil-dependent model of TRALI. Different HNA-3a antibodies might also impact the magnitude of HLMVEC cytotoxicity.
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Tung JP, Chiaretti S, Dean MM, Sultana AJ, Reade MC, Fung YL. Transfusion-related acute lung injury (TRALI): Potential pathways of development, strategies for prevention and treatment, and future research directions. Blood Rev 2022; 53:100926. [DOI: 10.1016/j.blre.2021.100926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/01/2021] [Accepted: 12/30/2021] [Indexed: 02/08/2023]
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Zirka G, Robert P, Tilburg J, Tishkova V, Maracle CX, Legendre P, van Vlijmen BJM, Alessi MC, Lenting PJ, Morange PE, Thomas GM. Impaired adhesion of neutrophils expressing Slc44a2/HNA-3b to VWF protects against NETosis under venous shear rates. Blood 2021; 137:2256-2266. [PMID: 33556175 DOI: 10.1182/blood.2020008345] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/11/2021] [Indexed: 12/16/2022] Open
Abstract
Genome-wide association studies linked expression of the human neutrophil antigen 3b (HNA-3b) epitope on the Slc44a2 protein with a 30% decreased risk of venous thrombosis (VT) in humans. Slc44a2 is a ubiquitous transmembrane protein identified as a receptor for von Willebrand factor (VWF). To explain the link between Slc44a2 and VT, we wanted to determine how Slc44a2 expressing either HNA-3a or HNA-3b on neutrophils could modulate their adhesion and activation on VWF under flow. Transfected HEK293T cells or neutrophils homozygous for the HNA-3a- or HNA-3b-coding allele were purified from healthy donors and perfused in flow chambers coated with VWF at venous shear rates (100 s-1). HNA-3a expression was required for Slc44a2-mediated neutrophil adhesion to VWF at 100 s-1. This adhesion could occur independently of β2 integrin and was enhanced when neutrophils were preactivated with lipopolysaccharide. Moreover, specific shear conditions with high neutrophil concentration could act as a "second hit," inducing the formation of neutrophil extracellular traps. Neutrophil mobilization was also measured by intravital microscopy in venules from SLC44A2-knockout and wild-type mice after histamine-induced endothelial degranulation. Mice lacking Slc44a2 showed a massive reduction in neutrophil recruitment in inflamed mesenteric venules. Our results show that Slc44a2/HNA-3a is important for the adhesion and activation of neutrophils in veins under inflammation and when submitted to specific shears. The fact that neutrophils expressing Slc44a2/HNA-3b have a different response on VWF in the conditions tested could thus explain the association between HNA-3b and a reduced risk for VT in humans.
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Affiliation(s)
- Gaïa Zirka
- Aix-Marseille University, INSERM, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Center for CardioVascular and Nutrition Research (C2VN), Marseille, France
| | - Philippe Robert
- Aix-Marseille University, Centre National de la Recherche Scientifique (CNRS), INSERM, Adhesion and Inflammation Laboratory, Marseille, France
- Laboratoire d'Immunologie, Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre Hospitalier Universitaire de la Conception, Marseille, France
| | - Julia Tilburg
- Einthoven Laboratory for Experimental Vascular Medicine, Division of Thrombosis and Hemostasis, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Victoria Tishkova
- Aix-Marseille University, CNRS, Centre Interdisciplinaire de Nanoscience de Marseille (CINaM), Marseille, France
| | - Chrissta X Maracle
- Einthoven Laboratory for Experimental Vascular Medicine, Division of Thrombosis and Hemostasis, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Paulette Legendre
- INSERM, Unité Mixte de Recherche en Santé (UMR-S) 1176, Université Paris-Sud, Université Paris-Saclay, Le Kremlin- Bicêtre, France; and
| | - Bart J M van Vlijmen
- Einthoven Laboratory for Experimental Vascular Medicine, Division of Thrombosis and Hemostasis, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Marie-Christine Alessi
- Aix-Marseille University, INSERM, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Center for CardioVascular and Nutrition Research (C2VN), Marseille, France
- Laboratoire d'Hématologie, AP-HM, Centre Hospitalier Universitaire de la Timone, Marseille, France
| | - Peter J Lenting
- INSERM, Unité Mixte de Recherche en Santé (UMR-S) 1176, Université Paris-Sud, Université Paris-Saclay, Le Kremlin- Bicêtre, France; and
| | - Pierre-Emmanuel Morange
- Aix-Marseille University, INSERM, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Center for CardioVascular and Nutrition Research (C2VN), Marseille, France
- Laboratoire d'Hématologie, AP-HM, Centre Hospitalier Universitaire de la Timone, Marseille, France
| | - Grace M Thomas
- Aix-Marseille University, INSERM, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Center for CardioVascular and Nutrition Research (C2VN), Marseille, France
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Recapitulation of posttransfusion purpura by cross-strain platelet immunization in mice. Blood Adv 2021; 4:287-295. [PMID: 31968077 DOI: 10.1182/bloodadvances.2019000661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/13/2019] [Indexed: 02/07/2023] Open
Abstract
Posttransfusion purpura (PTP) is an uncommon but life-threatening condition characterized by profound thrombocytopenia occurring ∼1 week after a blood transfusion. The hallmark of PTP is a potent immunoglobulin G antibody specific for a transfused platelet-specific alloantigen, usually located on glycoprotein IIb/IIIa (GPIIb/IIIa; αIIb/β3 integrin). It is widely thought that this alloantibody somehow causes the thrombocytopenia, despite absence from host platelets of the alloantigen for which it is specific. In studies described here, we found that cross-strain platelet immunization in mice commonly induces GPIIb/IIIa-specific alloantibodies combined with platelet-specific autoantibodies and varying degrees of thrombocytopenia, and we identified 1 strain combination (129S1Svlm/PWKPhJ) in which 95% of immunized mice made both types of antibody and developed severe thrombocytopenia. There was a strong inverse correlation between autoantibody strength and platelet decline (P < .0001) and plasma from mice that produced autoantibodies caused thrombocytopenia when transfused to syngeneic animals, arguing that autoantibodies were the cause of thrombocytopenia. The findings define a model in which a routine alloimmune response to platelets regularly transitions to an autoimmune reaction capable of causing severe thrombocytopenia and support the hypothesis that PTP is an autoimmune disorder.
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Lopes LB, Abbas SA, Moritz E, Martins JO, Chiba AK, Langhi DM, Bordin JO. Antibodies to human neutrophil antigen HNA-3b implicated in cases of neonatal alloimmune neutropenia. Transfusion 2018; 58:1264-1270. [DOI: 10.1111/trf.14524] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/03/2018] [Accepted: 01/04/2018] [Indexed: 01/14/2023]
Affiliation(s)
- Larissa Barbosa Lopes
- Disciplina de Hematologia e Hemoterapia da Universidade Federal de São Paulo, UNIFESP; São Paulo Brazil
| | - Samira Ali Abbas
- Disciplina de Hematologia e Hemoterapia da Universidade Federal de São Paulo, UNIFESP; São Paulo Brazil
| | - Elyse Moritz
- Disciplina de Hematologia e Hemoterapia da Universidade Federal de São Paulo, UNIFESP; São Paulo Brazil
| | - Juliana Oliveira Martins
- Disciplina de Hematologia e Hemoterapia da Universidade Federal de São Paulo, UNIFESP; São Paulo Brazil
| | - Akemi Kuroda Chiba
- Disciplina de Hematologia e Hemoterapia da Universidade Federal de São Paulo, UNIFESP; São Paulo Brazil
| | - Dante Mário Langhi
- Disciplina de Hematologia e Hemoterapia da Universidade Federal de São Paulo, UNIFESP; São Paulo Brazil
| | - José O. Bordin
- Disciplina de Hematologia e Hemoterapia da Universidade Federal de São Paulo, UNIFESP; São Paulo Brazil
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Falk G, Winans CG, Bowens K, Bougie DW, Curtis BR, Aster RH. An unexpected development after surgery-post-transfusion purpura! Am J Hematol 2016; 91:848-51. [PMID: 27159228 DOI: 10.1002/ajh.24414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/03/2016] [Accepted: 05/05/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Gavin Falk
- Department of General Surgery; Cleveland Clinic Foundation; Cleveland Ohio
| | - Charles G Winans
- Department of General Surgery; Cleveland Clinic Foundation; Cleveland Ohio
| | - Krista Bowens
- Platelet and Neutrophil Immunology; Blood Center of Wisconsin; Milwaukee Wisconsin
| | - Daniel W Bougie
- Blood Research Institute, Blood Center of Wisconsin; Milwaukee Wisconsin
| | - Brian R. Curtis
- Platelet and Neutrophil Immunology; Blood Center of Wisconsin; Milwaukee Wisconsin
| | - Richard H. Aster
- Blood Research Institute, Blood Center of Wisconsin; Milwaukee Wisconsin
- Department of Medicine, Medical College of Wisconsin; Milwaukee Wisconsin
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Chen Q, Srivastava K, Ardinski SC, Lam K, Huvard MJ, Schmid P, Flegel WA. Full-length nucleotide sequences of 30 common SLC44A2 alleles encoding human neutrophil antigen-3. Transfusion 2016; 56:729-36. [PMID: 26437811 PMCID: PMC4783217 DOI: 10.1111/trf.13300] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 07/07/2015] [Accepted: 07/30/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Human neutrophil antigen-3a (HNA-3a) alloantibodies can cause severe transfusion-related acute lung injury. The frequencies of the single-nucleotide polymorphisms (SNPs) indicative of the two clinically relevant HNA-3a/b antigens are known in many populations. In this study, we determined the full-length nucleotide sequence of common SLC44A2 alleles encoding the choline transporter-like protein-2 that harbors HNA-3a/b antigens. STUDY DESIGN AND METHODS A method was devised to determine the full-length coding sequence (CDS) and adjacent intron sequences from genomic DNA by eight polymerase chain reaction amplifications covering all 22 SLC44A2 exons. Samples from 200 African American, 96 Caucasian, two Hispanic, and four Asian blood donors were analyzed. We developed a decision tree to determine alleles (confirmed haplotypes) from the genotype data. RESULTS A total of 10 SNPs were detected in the SLC44A2 CDS. The noncoding sequences harbored an additional 28 SNPs (one in the 5'-untranslated region [UTR]; 23 in the introns; and four in the 3'-UTR). No SNP indicative of a nonfunctional allele was detected. The nucleotide sequences for 30 SLC44A2 alleles (haplotypes) were confirmed. There may be 66 haplotypes among the 604 chromosomes screened. CONCLUSIONS We found 38 SNPs, including one novel SNP, in 8192 nucleotides covering the CDS of the SLC44A2 gene among 302 blood donors. Population frequencies of these SNPs were established for African Americans and Caucasians. Because alleles encoding HNA-3b are more common than non-functional SLC44A2 alleles, we confirmed our previous postulate that African American donors are less likely to form HNA-3a antibodies compared to Caucasians.
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Affiliation(s)
- Qing Chen
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Kshitij Srivastava
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Stefanie C Ardinski
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Kevin Lam
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Michael J Huvard
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Pirmin Schmid
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Willy A Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
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