Immunocytochemical studies of blood group A, H, I, and i antigens in gastric mucosae of infants with normal gastric histology and of patients with gastric carcinoma and chronic benign peptic ulceration

Expression of Histo-blood Group Antigens in Tumor and Adjacent Normal Breast Tissues as Prognostic Markers of Breast Carcinoma

Purpose

Aberrant glycosylation of the histo-blood group antigens (including the angina bullosa haemorrhagica [ABH]) is often observed during malignant transformation in most types of carcinomas. Data concerning their ethnic distributions are diverse which explains why their biological characteristics have to be studied in different populations. Our aim was to analyze the expression of the histo-blood group (specifically the ABH) antigens in breast carcinoma.

Methods

The expression of the histo-blood group (specifically the ABH) antigens was studied in 109 patients with breast carcinoma using immunohistochemistry. Statistical analysis was performed using χ² and Fisher analyses.

Results

The loss of expression of histo-blood group (ABH) antigens in breast carcinoma was observed in 81.13% of patients with blood group O, 37.93% with blood group A, and 96.30% with blood group B. One key finding of this study was that the loss of expression of the ABH antigen was also observed in normal tissues adjacent to the tumor. The loss of expression was associated with higher tumor grade (p < 0.05). Expression of H antigen was observed in 50% of cases with loss of expression of B antigen and was associated with human epidermal growth factor receptor 2 (HER2) overexpression (p < 0.05). The loss of H antigen in patients with blood group O was associated with estrogen receptor expression (p < 0.001). Incompatible A antigen in tumor was expressed in 20.75% of patients with blood group O.

Conclusion

Loss of the ABH antigens correlated with the Scarff-Bloom-Richardson histologic grading. H antigen was associated with HER2 overexpression in breast cancer. However, further studies are needed to determine the role of incompatible A antigen in mammary carcinogenesis.

Helicobacter pylori SabA binding gangliosides of human stomach

Adhesion of Helicobacter pylori to the gastric mucosa is a prerequisite for the pathogenesis of H. pylori related diseases. In this study, we investigated the ganglioside composition of human stomach as the target for attachment mediated by H. pylori SabA (sialic acid binding adhesin). Acid glycosphingolipids were isolated from human stomach and separated into subfractions, which were characterized by mass spectrometry and by binding of antibodies, bacteria, and Solanum tuberosum lectin. H. pylori SabA binding gangliosides were characterized as Neu5Acα3-neolactohexaosylceramide and Neu5Acα3-neolactooctaosylceramide, while the other acid human stomach glycosphingolipids characterized (sulfatide and the gangliosides GM3, GD3, GM1, Neu5Acα3-neolactotetraosylceramide, GD1a and GD1b) were not recognized by the bacteria. Defining H. pylori binding glycosphingolipids of the human gastric mucosa will be useful to specifically target this microbe-host interaction for therapeutic intervention.

Immunohistochemical and genetic exploration of incompatible A blood group antigen expression in invasive micropapillary breast carcinoma: A case report

INTRODUCTION

Invasive Micropapillary Carcinoma (IMPC) of the breast is a relatively rare subtype of invasive ductal carcinoma and represents the most inherently aggressive form. Expression of incompatible blood group A antigen in cancer of type O patients has been reported in several types of cancer, however, the biosynthetic mechanism and the genetic basis remain unclear until today. The aim of the present case report study was to evaluate the expression of incompatible blood group A antigen and to identify the genetic basis of this expression in IMPC of the breast.

MATERIAL AND METHODS

One patient blood group O with Invasive Micropapillary Carcinoma was screened at Pathology Department of University Hospital CHU Ibn Rochd, Casablanca. ABH antigens expression was assessed by immunohistochemistry. ABO genotyping was performed by allele specific primers PCR-ASP and Exon 6 of ABO gene was sequenced with Sanger method.

RESULTS

H antigen was expressed in endothelial and epithelial cells of normal tissue. However, H antigen expression was lost in both invasive micropapillary carcinomas. A antigen was expressed in IMPC with approximately 80% of positive cells. Tumor DNA was genotyped as heterozygous A/O. In normal DNA, we identified a single frameshift deletion c.320delA p.(Glu107Glyfs^*12), which is removed from tumor DNA.

CONCLUSION

Our findings suggest that incompatible A antigen expression in IMPC is due to glycosyltransferase A encoded by an A allele which is derived from O allele with a deletion at the position 320.

Histo-blood group glycans in the context of personalized medicine

BACKGROUND

A subset of histo-blood group antigens including ABO and Lewis are oligosaccharide structures which may be conjugated to lipids or proteins. They are known to be important recognition motifs not only in the context of blood transfusions, but also in infection and cancer development.

SCOPE OF REVIEW

Current knowledge on the molecular background and the implication of histo-blood group glycans in the prevention and therapy of infectious and non-communicable diseases, such as cancer and cardiovascular disease, is presented.

MAJOR CONCLUSIONS

Glycan-based histo-blood groups are associated with intestinal microbiota composition, the risk of various diseases as well as therapeutic success of, e.g., vaccination. Their potential as prebiotic or anti-microbial agents, as disease biomarkers and vaccine targets should be further investigated in future studies. For this, recent and future technological advancements will be of particular importance, especially with regard to the unambiguous structural characterization of the glycan portion in combination with information on the protein and lipid carriers of histo-blood group-active glycans in large cohorts.

GENERAL SIGNIFICANCE

Histo-blood group glycans have a unique linking position in the complex network of genes, oncodevelopmental biological processes, and disease mechanisms. Thus, they are highly promising targets for novel approaches in the field of personalized medicine. This article is part of a Special Issue entitled "Glycans in personalised medicine" Guest Editor: Professor Gordan Lauc.

The aberrant expression of Lewis a antigen in intestinal metaplastic cells of gastric mucosa is caused by augmentation of Lewis enzyme expression

Immunohistochemical staining showed an aberrant expression of Le(a) antigen in the intestinal metaplastic glands of the gastric mucosa of secretors, as reported by others. In this study, we have demonstrated for the first time that the Lewis enzyme is well colocalized with Le(a) antigen, indicating that the Lewis enzyme is responsible for Le(a) antigen synthesis in the gastric mucosa. The staining intensity of the Lewis enzyme was much stronger in the cells with intestinal metaplasia than the cells without metaplasia, regardless of the secretor status. The amount of transcript of the Lewis gene was related to the degree of metaplasia; i.e., the more severe the metaplastic change was, the more abundantly the transcripts of the Lewis gene were expressed. This augmentation of the Lewis enzyme in metaplastic tissues was also confirmed by Western blotting analysis using a specific antibody against the Lewis enzyme. We conclude that intestinal metaplastic change of gastric mucosa is usually accompanied by a marked augmentation of the Lewis enzyme expression, which results in the enhanced expression of Le(a) antigens, particularly in secretors.

The aberrant expression of Lewis a antigen in intestinal metaplastic cells of gastric mucosa is caused by augmentation of Lewis enzyme expression

Immunohistochemical staining showed an aberrant expression of Le(a) antigen in the intestinal metaplastic glands of the gastric mucosa of secretors, as reported by others. In this study, we have demonstrated for the first time that the Lewis enzyme is well colocalized with Le(a) antigen, indicating that the Lewis enzyme is responsible for Le(a) antigen synthesis in the gastric mucosa. The staining intensity of the Lewis enzyme was much stronger in the cells with intestinal metaplasia than the cells without metaplasia, regardless of the secretor status. The amount of transcript of the Lewis gene was related to the degree of metaplasia; i.e., the more severe the metaplastic change was, the more abundantly the transcripts of the Lewis gene were expressed. This augmentation of the Lewis enzyme in metaplastic tissues was also confirmed by Western blotting analysis using a specific antibody against the Lewis enzyme. We conclude that intestinal metaplastic change of gastric mucosa is usually accompanied by a marked augmentation of the Lewis enzyme expression, which results in the enhanced expression of Le(a) antigens, particularly in secretors.

Lectin-binding properties of the antral and body surface mucosa in the human stomach--are the differences relevant for Helicobacter pylori affinity?

Biopsy specimens from histologically normal human gastric mucosa were examined histochemically with the use of lectins. Significant differences were found in the glycoconjugate patterns of the surface mucous cells between the body and the corresponding antrum. Two lectins (Ulex europaeus agglutinin I and Ricinus communis agglutinin I) specific for fucose and galactose residues stained the apical membrane and the intracellular (perinuclear) region of the antral mucosa more strongly than those of the body (P < 0.04). Body and antral biopsies from patients with Helicobacter pylori-positive chronic active gastritis were also studied, but the lectin patterns of Helicobacter pylori-infected body and antrum did not differ. On comparing these chronically infected gastric biopsies with normal antral mucosa, however, significant changes could be seen with the fucose-binding lectin as well as with two other lectins (succinylated concanavalin A and peanut agglutinin). These differences could have been induced directly by bacterial virulence factors or could be due to non-specific reactions to the inflammatory process.

Localization of blood-group-related linear poly-N-acetyllactosamine structure in different human tissues by Griffonia simplicifolia agglutinin-II staining following endo-beta-galactosidase digestion

Endo-beta-galactosidase from Escherichia freundii cleaves polylactosaminyl structures as follows: R-GlcNAc beta I-3Gal beta I-4GlcNac beta I-R' + H2O-->R-GlcNAc beta I-3Gal + GlcNAc beta I-R'. By staining with Griffonia simplicifolia agglutinin-II following the enzyme digestion, the distribution of R-GlcNAc beta I-3Gal beta I-4GlcNAc can be demonstrated in tissue sections. This carbohydrate chain is one of the backbone structures carrying the blood-group-related antigens and, thus, localization of this structure may provide detailed information about the distribution of variants with different backbone structures. Various formalin-fixed, paraffin-embedded tissue sections were stained by Griffonia simplicifolia agglutinin-II with or without prior enzyme digestion and the reactivity of the agglutinin imparted by enzyme digestion was studied in the following tissues and cells: pancreatic acinar cells, gastric surface mucosae, duct cells and mucous cells of salivary glands and tracheal glands, surface epithelium of trachea, goblet cells of large intestine, columnar epithelium of uterine cervical glands, distal and collecting tubules of kidney, certain cells of anterior lobe and colloid of middle lobe of pituitary glands, epithelial reticular cells and Hassall's corpuscles of thymus and Kupffer cells of liver. In gastric surface mucosae, the reactivity of the agglutinin appeared in non-secretor individuals but not in the secretor individuals, and in mucous cells of salivary and tracheal glands the reactivity appeared in Le(a- b-) non-secretor individuals but not in Le(a + b-) non-secretor or secretor individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Semiquantitative immunohistochemical studies of blood group antigen A, B, H, Le(a), Le(b) structures and Ii backbone chains in the normal human cervix and in cervical adenocarcinoma

Epithelia frequently express blood group antigens and these are often perturbed in neoplasia. This study has characterized the range of expression of ABH and Lewis terminal structures and the Ii backbone chains in the normal human cervix by semiquantitative immunohistochemistry. Effects of the secretor gene were defined by determination of salivary secretor status. Modifications of blood group antigen expression in cervical adenocarcinoma were also addressed. Normal cervical squamous and glandular epithelia showed a range of expression of the antigens studied. Lewis-gene-negative cases showed no expression of Lewis antigens. Secretor status had no effect on ABH expression in squamous epithelium, but it did have a marked effect on ABH expression in glands and on Le(b) expression in both squamous and glandular epithelia. Patterns of expression of i chains in squamous epithelium suggest that these may be the carriers of ABH and Lewis antigens in a proportion of cases. Distinct patterns of expression were seen in glandular tubal metaplasia and in endothelium. Adenocarcinomas showed topographical rather than quantitative changes in blood group antigen expression with more extensive luminal expression of ABH, Lewis and Ii structures than that seen in normal glands. This change is distinct from those usually associated with malignancy.

The A1 (B) phenomenon: a monoclonal anti-B (BS-85) demonstrates low levels of B determinants on A1 red cells

A monoclonal anti-B (BS 85) that reacts strongly with red cells from weak B variants (B3, Bint and Bv) has demonstrated the presence of a trace of B on A1 red cells. The agglutination of group A1 red cells by an anti-B antibody is called the A1 (B) phenomenon and is the converse of the B(A) phenomenon seen with certain monoclonal anti-A antibodies. Fragile A1 (B) agglutination is best seen by spin-tube techniques and A1 red cells negative in saline tests are agglutinated by albumin and protease enzyme-enhanced tests, but no reactions are seen with A2 red cells. The A1 (B) reaction is specifically inhibited by B substance, and D-galactose and the galactose-containing sugars melibiose and lactose. Red cells from B variants showed differential inhibition patterns with various sugars. A1 transferase levels were normal even in the strongest A1 (B) reactive blood samples, although the plasma H transferase levels and H status of these red cells were elevated. This is in contrast to the B(A) phenomenon which is associated with elevated levels of B transferase. It is suggested that A1(B) overlapping specificity can occur because of a combination of higher H activity (and thus more H sites) together with normal levels of A transferase activity as they are 20% higher than normal levels of B transferase. The production of anti-B reagents free of the A1 (B) phenomenon with BS-85 is achieved by suitable dilution using quality control tests with protease-treated A1 red cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Histochemical and cytochemical localization of blood group antigens

The oligosaccharide structures of blood group antigens are not the primary gene products; they are constructed in a stepwise manner by adding particular sugar to precursor oligosaccharides via several glycosyltransferases coded for by different blood group genes (Watkins 1966, 1978, 1980). Consequently, final profiles of antigens expressed in each cell type are influenced by many different factors such as the intrinsic composition of glycosyltransferase species which are defined by the genotype of the individuals, relative activity or amount of these enzymes (repression, derepression or induction of the enzymes), competition between enzymes with overlapping substrate specificity, the organization of the enzymes in membranes, utilizability of precursors and specific substrate sugars, and the activity level of degradating enzymes. Changes in the antigen profiles during maturation, differentiation and malignant transformation are thought to be intimately related to the variability of these factors. Although great importance attaches to histo- and cytochemical information on the distribution and levels of glycosyltransferases and messenger RNA corresponding to the relevant enzyme, detailed and precise localization of the blood group antigens and their variants is the base line for analyzing these complex factors. On the basis of individual genotype and histochemical findings about the antigen distribution and the interrelationship between cells and cellular components producing different antigenic structures (cellular and subcellular mosaicism), we can deduce precursor oligosaccharide levels as well as the status of gene activation and its primary product, glycosyltransferases. Thus, these findings are a prerequisite for further analysis at the molecular genetic level. As emphasized in this article, lectin staining or immunostaining methods with MAbs combined with glycosidase digestion procedures are powerful tools for in situ analysis of carbohydrate structures in histochemical systems. Although in some cases valuable results have been obtained by applying the technique, our knowledge concerning the distribution of complex carbohydrate structures is still far from satisfactory. Along with well defined MAbs and lectins, the key to developing our methods further is successful introduction of glycosidases, in particular, endoglycosidases since these reagents are indispensable for analyzing the inner core structures and glycoconjugate species of the blood group antigens. Application of these techniques at the ultrastructural level is an alluring possibility, even though many difficulties must be overcome. Although their functional roles have not yet been determined, a diverse array of macromolecules is known to be decorated with blood group-related antigens.(ABSTRACT TRUNCATED AT 400 WORDS)

Aberrant glycosylation in oral malignant and premalignant lesions

Cell surface carbohydrates serve as differentiation and developmental markers characteristic of different cell and tissue types. The expression of these carbohydrate antigens is often significantly altered in tumors, particularly in those arising from epithelial tissues. Analysis of cell surface carbohydrates in oral epithelium have shown that in normal epithelium they are expressed in a way that shorter carbohydrates are found on basal cells and that these carbohydrate structures are elongated parallel to terminal differentiation. The carbohydrate expression is altered in oral carcinomas and in some oral premalignant lesions. The change in carbohydrate expression can at present be explained by the lack of synthesis of specific glycosyltransferases. We have found mosaicism in the expression of carbohydrate antigens in all tumors and have found that the expression of a specific carbohydrate in the deep invasive parts of the tumor correlates with tumor prognosis.

Gastric dysplasia

The morphological diagnosis of gastric dysplasia is based on the presence of changes in the architecture, cytology and differentiation of the epithelium and mucosal glands. Two morphological types exist: gastric (foveolar) and metaplastic. Definite morphological criteria for gastric dysplasias can be presented. The present morphological grading of dysplasia into mild, moderate or severe is, however, arbitrary and subjective. The available investigations show that dysplasia and overt carcinoma have several biological and epidemiological links that indicate that a dysplasia-cancer sequence operates in the pathogenesis of at least a proportion of gastric carcinomas. The data available in the literature strongly indicate that severe dysplasia is highly predictive for coexisting or shortly appearing carcinoma. The literature on the clinical significance of dysplasia of mild or moderate grade, however, is as yet scanty and inconsistent.

The expression of Lewis antigens in neoplasms of the gastrointestinal tract

The indirect immunoperoxidase technique has been used to demonstrate Lea and Leb antigens in paraffin sections of both morphologically normal gastric and colonic mucosae and their neoplastic counterparts. Expression differed in various regions of the gastrointestinal tract: Leb occurred most frequently in the stomach and Lea most frequently in the colon. Coexpression of Lea and Leb occurred in only 5% of cases of normal mucosa, in 65% of gastric carcinomas and in 82% of carcinomas of the colon. Furthermore, 75% of cases of intestinal metaplasia in gastric mucosa and 30% of tubular adenomas, 50% of villous adenomas and 70% of tubulovillous adenomas in the colon co-expressed Lea and Leb antigens. In this study, the expression of Lewis antigens in carcinoma was found to differ from that of adjacent normal mucosa in 95% of cases of gastric carcinoma and 100% of cases of colonic carcinoma. The differences were shown by antigen acquisition and/or deletion. Similar changes were shown in 88% of cases of intestinal metaplasia in gastric mucosa, 20% of cases of tubular adenomas and 57% of cases of villous and tubulovillous adenomas of colon.

ABH and related histo-blood group antigens; immunochemical differences in carrier isotypes and their distribution

This review summarizes present knowledge of the chemistry of histo-blood group ABH and related antigens. Recent advances in analytical carbohydrate chemistry (particularly mass spectrometry and NMR spectroscopy) and the introduction of monoclonal antibodies (MoAbs) have made it possible to distinguish structural variants of histo-blood group ABH antigens. Polymorphism of ABH antigens is induced by: (i) variations in peripheral core structure, of which four (type 1, 2, 3 and 4) are known in man; (ii) variation in inner core by branching process (blood group iI), leading to variation of unbranched vs. branched ABH determinants; (iii) biosynthetic interaction with other glycosyltransferases (Lewis, P. T/Tn blood systems) capable of acting on the same substrate as the ABH-defined transferases, and finally (iv) the nature of the glycoconjugate (glycolipid, glycoprotein of N- or O-linked type). ABH variants induced by item (i) above have been clearly distinguished qualitatively by MoAbs; e.g., at least six types of A determinants can be distinguished by qualitatively different classes of antibody. The variants induced by item (ii) create mono- vs. bivalent antigens which may be responsible for observed differences in antibody-binding affinity. Detailed studies of the chemistry of these antigens have increased our insight into blood groups, providing the basis for blood group iI and A subgrouping, as well as a relation between the ABH and Lewis, P, and T/Tn systems. A survey of the literature on distribution patterns of ABH variants is presented. It has been assumed that expression of histo-blood group antigens is developmentally regulated. Relationships between histo-blood group expression, development, differentiation and maturation, as well as malignant transformation, are discussed.

Regulation of expression of carbohydrate blood group antigens

The carbohydrate antigens associated with the human ABO and Lewis blood group systems are excellent models for the study of the genetic regulation of glycoconjugate biosynthesis because their expression on erythrocytes and in saliva has been thoroughly investigated in terms of classical genetics and the chemical structures and pathways for the formation of the antigens are now well understood. The primary protein products of the blood group genes are believed to be the glycosyltransferase enzymes that complete the biosynthesis of the determinants. The important controlling factors still to be elucidated are the genetic and environmental influences leading to the tissue specific expression of these antigens. The 3 types of regulation mechanisms discussed in this review are those arising: 1) from the specificity requirements of the glycosyltransferases encoded by the blood group genes; 2) from the competition or co-operation of glycosyltransferases encoded by genes at the same or independent loci; and 3) from the existence and tissue distribution of glycosyltransferases with related, but not identical, substrate specificities.

Immunohistochemical study of blood group activities in the alimentary canal in normal and pathologic conditions with reference to the nature of epithelial mucopolysaccharides

ABO(H)- and Lewis-activities in the human alimentary canal were investigated by the avidin-biotin-peroxidase complex method using commercial mouse monoclonal antibodies in order to clarify (1) the changes apparent in these activities in carcinoma of the digestive tract or premalignant intestinal metaplasia of the stomach and (2) the relationship of the activities to the histochemical properties of epithelial mucins examined by Alcian blue (pH 2.5)/periodic acid-Schiff (PAS) double staining. In intestinal metaplasia, ectopic goblet cells showed various degrees of ABO(H)-activities according to the PAS stainability of mucins and revealed Lea-activity even in a Le(a-b+) group. In carcinoma of the alimentary canal, ABO(H)- and Lewis-activities compatible with the donors' blood groups were located mainly at the PAS-positive cell surface, and in the Golgi bodies and secretions. It was thus concluded that quantitative and/or qualitative changes in blood group activities were closely associated with those of epithelial mucopolysaccharides.

ABO (H) blood group antigen expression in gastric mucosa

The A, B, O (H) blood group antigens (BGA) are glycolipids present in the plasma membranes of many different epithelial cells. Alterations in BGA expression have been described in malignant tumors and premalignant lesions. We have studied ABO (H) BGA expression in paraffin sections of gastric specimens using immunofluorescence techniques with monoclonal antibodies. 102 patients were studied. 15 with normal mucosa (NM); 16 with duodenal ulcer (DU); 23 with gastric ulcer (GU); 11 with pernicious anaemia (PA) and 37 with adenocarcinoma (AC). The expression of BGA in normal gastric mucosa is detected in surface epithelium, mucoid cell neck glands and parietal cells as well as 2/3 of antral glands. BGA expression in DU gastritis is very similar to that seen in NM. In atrophic chronic gastritis associated with GU and PA there is a significant decrease in BGA expression. In patients with PA, BGA expression is greater in antral mucosa than in fundic mucosa. Loss of BGA expression is more pronounced in atrophic chronic gastritis surrounding AC. Intestinal metaplasia shows variable BGA expression. Our results support the hypothesis that loss of BGA expression by epithelial gastric mucosal cells may be related to alterations in cellular differentiation and premalignant potential.

Structure elucidation of blood group B-like and I-active ceramide eicosa- and pentacosasaccharides from rabbit erythrocyte membranes by combined gas chromatography-mass spectrometry; electron-impact and fast-atom-bombardment mass spectrometry; and two-dimensional correlated, relayed-coherence transfer, and nuclear Overhauser effect 500-MHz 1H-n.m.r. spectroscopy

The structures of two glycosphingolipids, a ceramide eicosasaccharide BIrab-3 and a ceramide pentacosasaccharide BIrab-4 with "B-like" and distinct I blood-group activity, isolated in high yield from rabbit erythrocyte membranes, were investigated. The determination of their general structure, alpha-D-Galp-(1----3)-beta-D-Galp-(1----4)-beta-D-GlcpNAc-(1----3)- [alpha-D-Galp-(1----3)-beta-D-Galp-(1----4)-beta-D-Glcp-NAc-(1----6)]-be ta- D-Galp-(1----n4)-beta-D-GlcpNAc-(1----3)-beta-D-Galp-(1----4)-beta-D-Gl cp- (1----1)-ceramide, with n = 3 for BIrab-3 and n = 4 for BIrab-4, was based on the results of methylation analysis, fast-atom-bombardment and electron-impact mass spectrometry, 1D and 2D COSY, RCT, and n.O.e. 1H-N.m.r. spectra, and specific enzymic and chemical degradation.

Expression of blood group antigens A, B, H, Lewis-a, and Lewis-b in fetal, normal, and malignant tissues of the uterine endometrium

Fetal, normal adult, and malignant tissues of the uterine endometrium were examined by immunoperoxidase staining for the blood group antigens (BGA) A, B, H, Lewis-a, and Lewis-b. Antigens A, B, and H compatible with the ABO status of fetuses were detected in 20 of the 22 fetal tissues that were examined. Lewis-b immunoreactivity was also found in 21 fetuses, and Lewis-a was present in a third of the cases. In adult endometrium the expression of BGA H and Lewis-b was considerably lower than in fetal tissues. Malignant endometrial glands extensively reexpressed H and Lewis-b regardless of ABO status. BGA A and B were neither absent nor accumulated in cancer tissues. Thus, H and Lewis-b can be considered as oncofetal antigens since they were frequently expressed in fetal and cancer tissues, but not in normal adult tissues. The increased expression of Lewis-a antigen might be associated with malignant transformation as it was observed only in malignant tissues. However, the functional significance of alterations in BGA expression that may be associated with oncogenesis remains to be investigated.

Fucose-containing antigens in normal and neoplastic human gastric mucosa: a comparative study using lectin histochemistry and blood group immunohistochemistry

The histochemical binding to normal and neoplastic human gastric mucosa of two lectin-peroxidase conjugates which are specific for fucose-containing glycoconjugates is described. The lectins are Ulex europaeus (UEA1) and Lotus tetragonolobus (LTA). Results are compared with ABO and secretor status and the immunohistochemical demonstration of a Type 1 antigen (Lewisa) and two Type 2 antigens (X and H) using monoclonal antibodies. Binding of UEA 1 and LTA to surface mucus cells in normal gastric mucosa is only seen in secretors but is independent of ABO status. In gastric carcinomas lectin binding is reduced. There is a relationship between UEA1 binding and the immunohistochemical demonstration of H Type 2 antigen and secretor activity. In contrast LTA staining is associated with both H Type 2 and Lea antigen but not with secretor status. X antigen is only demonstrable in small amounts. Despite subtle differences in the binding patterns of the two lectins, immunohistochemical studies with monoclonal antibodies against defined oligosaccharides provide greater information. The results of the study are consistent with the hypothesis that competitive interaction between fucosyl and sialyl transferases occurs in gastric malignancy and leads to the expression of abnormal blood group-related antigens.

Detection of blood group antigens in frozen sections of prostatic epithelium

The detection of blood group antigens (BGA) in non-malignant prostates by previous workers has been at best inconsistent. BGA have not before been detected in prostatic carcinomas. In this preliminary study, a variety of anti-BGA reagents, with known specificities that involve the carbohydrate backbone in addition to the BGA specific terminal monosaccharides, were used to study the expression of the A and H (O) BGA in cryostat sections of 16 patients with benign prostatic disease and nine with prostatic cancer. Positive staining, appropriate to the patients' blood group, was seen in all of the benign tissues when anti-BGA reagents that included specificity against type 2 backbone structures were used. Staining was absent, however, if the reagent had only type 1 specificity. The anti-A and anti-H (O) reagents which gave the best staining patterns in benign tissues were used in malignant tissues. No cancer was found to express A antigen but eight of the nine prostatic cancers were positive for the H (O) antigen irrespective of blood group. Using fresh frozen material and appropriate reagents, BGA may be reproducibly detected in the epithelium of all non-malignant prostates, suggesting that a significant component of BGA is probably lipid-based on type 2 carbohydrate backbone chains. Further studies of changes in BGA expression in prostatic cancer are warranted.

Immunohistochemical studies of blood group substance H in colorectal tumors using a monoclonal antibody

With the use of a murine monoclonal antibody with specificity for human blood group substance H, the distribution of this antigen on colorectal carcinomas and adenomatous polyps has been studied by immunohistochemistry. All of the 20 carcinomas studied were found to express H substance regardless of their location in the colon, their pathologic grade, or their clinical stage. Adenomas were variably positive for H substance, and expression of the antigen appeared to correlate with the degree of dysplasia seen on microscopic examination. Normal colonic mucosa, nonadenomatous polyps, and nonepithelial colonic neoplasms studied failed to express H substance. The results suggest that detection of H substance expression may be useful in the diagnosis of colonic malignancies and dysplastic premalignant lesions.

Biological tissue markers in benign and malignant disease of the human prostate

Immunoperoxidase techniques were used to study, the distribution of peanut agglutinin receptors, blood group isoantigens and several epithelial antigens in hyperplasia, adenosis, microcarcinoma and well differentiated adenocarcinoma of the prostate. Intraluminal and luminal surface PNA receptors were seen in all well differentiated carcinomas, 53% of microcarcinomas and 50% of adenosis, while no such sites could be demonstrated in benign hyperplasia. The expected blood group isoantigen was expressed in 75% of benign hyperplasias. When compared to the hyperplastic epithelium nearby, appropriate ABH expression was seen in 60% of adenosis, 47% of microcarcinomas and 25% of well differentiated carcinomas. A keratin antibody specifically labelling the basal cells in the normal prostate identified a subset of well differentiated carcinomas with preferential staining of the apical cytoplasm while microcarcinomas and adenosis were consistently negative. Our study establishes a highly ordered PNA receptor distribution in prostatic epithelia; it confirms early changes in the expression of ABH isoantigens in epithelial proliferative disorders of the prostate; it identifies a subset of keratin-positive well differentiated carcinomas, possibly of different ontogeny.

Blood-group antigen expression during pancreatic cancer induction in hamsters

The expression of blood group-related and tumor-associated antigens was examined in pancreatic adenocarcinomas and in the normal pancreas of hamsters to determine if this expression correlated with the host blood group and/or stage of carcinogenicity, respectively. Pancreatic tumors were induced by 4 weekly treatments of hamsters with N-nitrosobis(2-oxopropyl)amine (BOP) and analyzed immunohistochemically during different stages of tumor progression with polyclonal antibodies (PoAbs) and monoclonal antibodies (MoAbs) against A, B, O and Lewis (Le) isoantigens, including X, Y and CA 19-9 monosialoganglioside (gastrointestinal cancer antigen, GICA), as well as with PoAbs detecting human carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and the beta-subunit of human chronic gonadotropin (beta-HCG). The red blood cells of both control and tumor-bearing hamsters expressed AB and Le(a+b+)-like blood group types, as detected by polyvalent antisera. However, none of the MoAbs reacted with the hamster red blood cells. In the pancreas, all PoAbs against blood group antigens reacted with hyperplastic ducts and ductules at very early stages of carcinogenesis, as well as with neoplastic lesions, but not with normal pancreatic cells, except for the acinar cells, which were stained with PoAb-B, PoAb-Lea and PoAb-Leb. None of the MoAbs showed any affinity for the normal pancreatic cells; however, they reacted to various degrees with induced hyperplastic and neoplastic tissue. Reactivities of several MoAbs with malignant cells were greater than those with hyperplastic lesions: MoAb-B was highly reactive with all induced lesions, MoAb-A less reactive, and MoAb-H and MoAb-Ley (which has 6 sugar chains) detected only some cancer cells. Neither of the two MoAb-Lex (with 5 carbohydrate chains) reacted with carcinoma cells, although they did bind to a few hyperplastic cells. Neither MoAb-Lea and MoAb CA 19-9, nor PoAbs against CEA, AFP and beta-HCG, reacted with any normal, hyperplastic or malignant cells. These results demonstrate the differential reactivity of these PoAbs and MoAbs in normal and malignant pancreatic tissue and show that blood group antigens, especially the B isoantigens, are specific markers for induced pancreatic duct tumors in hamsters.

Expression of blood group antigens in urinary tract tumours: prospective fluorescence study using cryostat sections of fresh frozen tissues

Cryostat sections of fresh frozen tissues were used in a prospective study of blood group H and A antigen fluorescence in 73 transitional cell carcinomas of the bladder. The aim was to evaluate antigen expression without subjecting the tumour tissues to organic solvents that extract blood group active glycolipids. Deletion of the genetically predicted antigen was twice as common in tumours of pT1 or greater stage than those of pTa stage and also twice as common in poorly differentiated than in moderately well differentiated tumours. The considerable heterogeneity and overlap, however, in patterns of reactivity in tumours of various histopathological stages and grades and the effect of secretor status on antigenicity meant that there was no obvious antigenic feature that correlated precisely with invasive stage or differentiation grade. It remains to be determined whether the antigen positive and antigen negative tumours represent different disease entities with differing clinical courses. Our results indicate, however, that studies of the blood group antigens in urinary tract tumours are more likely to be of value in research into biochemical disorders in the neoplastic process than in routine clinical assessment as a guide to treatment.

Lectin histochemistry of galactose and N-acetyl-galactosamine glycoconjugates in normal gastric mucosa and gastric cancer and the relationship with ABO and secretor status

The histochemical binding of four lectin-peroxidase conjugates to normal human gastric mucosa and gastric carcinoma is described. The lectins were peanut agglutinin (PNA) which is specific for galactose residues and soy bean agglutinin (SBA), Dolichos biflorus agglutinin (DBA) and Helix pomatia agglutinin (HPA) which are specific for N-acetylgalactosamine. Binding of PNA to surface mucous cells or normal gastric mucosa occurred in non-secretors but not secretors and was independent of ABO blood group at all sites. PNA binding was unrelated to the immunohistochemical demonstration of Thomsen-Friedenreich (T) antigen. DBA and HPA bound selectively to surface mucous cells in normal gastric mucosa from group A secretors but binding at other sites was independent of ABO status. SBA binding showed no relationship with blood group or secretor status. In gastric cancers the major finding was the occurrence of extensive masking of lectin binding sites by sialic acid which was not seen in normal mucosa. Sialic acid masking was most marked with PNA and least marked with DBA. There was no correlation between lectin binding patterns and the stage or differentiation of tumours. Results are consistent with in vitro studies demonstrating increased sialation of membrane glycoproteins following malignant transformation. Difficulties in interpreting the histochemical demonstration of lectin binding in terms of specific glycoconjugates are discussed.

Blood-group-related carbohydrate antigens are expressed on human milk galactosyltransferase and are immunogenic in rabbits

Immunochemical evidence is presented for the presence of blood-group-related carbohydrate structures on human milk galactosyltransferase and for the occurrence of the corresponding specificities among rabbit antibodies to this enzyme. Although these carbohydrate specificities constitute minor populations among antisera and affinity-purified antibodies to galactosyltransferase, their presence is important in the immunohistochemical approach to enzyme localization, since they give rise to strong reactivities with epithelial cells of the gastrointestinal tract.

UDP-N-acetyl-D-galactosamine as a donor substrate for the glycosyltransferase encoded by the B gene at the human blood group ABO locus

The properties of the enzyme in the serum of blood group B individuals that catalyses the transfer of small amounts of N-acetyl-D-galactosamine to H-active precursor structures were compared with those of the blood group B gene-associated alpha-(1----3)-D-galactosyltransferase and with the blood group A gene-associated alpha-(1----3)-N-acetyl-D-galactosaminyltransferases in the serum of blood group A1 and A2 individuals. The biosynthetic products formed by the enzyme in B serum were identical with the A-active structures synthesised by the A1 and A2 gene-associated alpha-(1----3)-N-acetyl-D-galactosaminyltransferases but the enzyme differed from the A1 and A2 transferases in its apparent Km for UDP-N-acetyl-D-galactosamine, its heat susceptibility, its failure to bind to Sepharose 4B, and its adsorption to H-active sites on group O red cell ghosts under conditions which bind the B transferase but fail to adsorb the A1 and A2 transferases. The correlation between the levels of alpha-(1----3)-D-galactosyltransferase and alpha-(1----3)-N-acetyl-D-galactosaminyltransferase activities in all the group B serum samples tested, the maintenance of the same ratio of activities after successive cycles of binding to group O red cell ghosts, the retention of the ability to convert blood group O to A-active cells after treatment of the serum with Sepharose 4B, and the failure to detect any comparable activity in group O serum samples tested under the same conditions indicated that the enzyme in group B serum that utilises UDP-N-acetyl-D-galactosamine to make blood group A-active structures is the B gene-associated alpha-(1----3)-D-galactosyltransferase.

Lectin binding to human gastric adenocarcinomas and adjacent tissues

The binding of lectins to paraffin sections of nine gastric carcinomas and adjacent mucosa was examined by fluorescence microscopy. A battery of nine lectins was employed, and both intestinal and diffusely infiltrating tumors were tested. Wheat germ agglutinin and Ricinus communis agglutinin I appeared to bind to both mucus and nonmucus glycoproteins; these lectins labeled tumor cells, benign epithelial cells, and nonepithelial tissues strongly and consistently. Peanut agglutin, soybean agglutinin, Dolichos biflorus agglutinin, Bandeiraea simpifolica agglutinin, and Ulex europaeus agglutinin I bound extensively to mucosubstances in vacuoles and apices of benign epithelial cells but often bound to tumor cells focally and in some cases not at all. Neuraminidase digestion enhanced lectin staining in some tumors; but in others, especially those of the diffusely infiltrating type, neuraminidase digestion did not enhance the staining of tumor cells. The results suggest that the decrease in the proportion of tumor cells labeling with lectin relative to superficial epithelial cells can be due either to the oversialylation of mucoproteins or to the loss of glycosylating enzyme activity. Concanavalin A did not bind to mucosubstances in the vacuoles or apices of benign epithelium, but bound to mucus vacuoles of metaplastic epithelium and to coarse cytoplasmic granules in two of the tumors examined. This suggests either the abnormal addition of mannose to mucus glycoprotein or the production of a distinct glycoprotein by some gastric tumors.

Blood group antigens A, B, H, Lea, Leb, and I(Ma) in resting and tetragastrin stimulated gastric juice of patients with non-neoplastic diseases of the stomach

In view of the anomalous expression of blood group and related antigens in the gastric mucosae of patients with malignant and premalignant diseases of the stomach, and the potential clinical value of their measurement, a preliminary study has been performed on the blood group antigens A, B, H, Lea, Leb, and I(Ma) in glycoprotein rich extracts of the resting and tetragastrin stimulated gastric juice of patients without evidence of gastric cancer. The aim has been to assess whether the antigenic profiles known to distinguish the gastric mucosae of secretors from those of non-secretors are reflected in the glycoproteins of gastric juice. Antigenic profiles which distinguish secretors from non-secretors were observed in the stimulated rather than the resting gastric juice as follows: the A, B or H antigens but not I(Ma) were strongly expressed in the glycoproteins of secretors, while I(Ma) was the antigen characteristic of non-secretors. On the other hand, there was considerable overlap in the Lea and Leb antigen values in the resting and stimulated gastric juice of secretors and non-secretors. Among these antigens, I(Ma) is known to appear as a neo-antigen in the gastric mucosae of secretors with malignant and premalignant diseases of the stomach. Thus this antigenic determinant is potentially a clinically useful marker in the gastric juice of 75% of the population who are secretors. The clinical value of the levels of this antigen in the gastric juice now deserves investigation.

Carbohydrate structure in tumor immunity

Researchers have endeavored to define surface alterations associated with neoplasia for at least 25 years. In comparisons of normal tissues with animal and human tumors, cultured cells before and after transformation with oncogenic agents, tumorigenic and nontumorigenic transformed cells, metastatic and nonmetastatic tumor cells, high- and low-metastatic variants, and tumor cells before and after induction of differentiation to a less malignant phenotype, a consistent finding has been some form of alteration in surface carbohydrate structures. These changes in glycolipids, glycoproteins and glycosaminoglycans are reviewed, and their structures are illustrated. Both nucleotide sugar biosynthesis and glycosyltransferase changes have been associated with these alterations. In some cases, alterations in transformed cells were related to growth, rather than transformation. In others, the altered glycoconjugates are truly tumor-associated. There is evidence that cell surface glycoconjugates may function in growth control. Altered carbohydrate structures could also serve as receptors for growth promoting factors and be directly responsible for altered growth control. Recent studies with monoclonal antibodies indicate that the vast majority of antibodies recognizing tumor-associated antigens are detecting altered carbohydrate structures. Mechanisms by which the immune system can recognize these carbohydrate structures are considered, and immune recognition of tumor-associated carbohydrate structural alterations is explored. A number of these hypotheses relating to alterations in glycosylation, growth control, and tumor immunity deserve further investigation.

Relation of blood group carbohydrates to differentiation patterns of normal and pathological odontogenic epithelium

The distribution of epithelial cell surface antigens was studied in normal odontogenic epithelium from 20 fetuses and in odontogenic epithelium from 15 ameloblastomas, 16 odontogenic keratocysts, 15 follicular and 15 radicular cysts. The cell surface carbohydrates were detected using antibodies with reactivity for the blood group antigens A, B, H type 2 (A and B precursor) and N-acetyllactosamine (N-lac, H type 2 precursor) by an immunofluorescence technique. The expression of the blood group carbohydrates differed considerably in normal fetal odontogenic epithelium from that in ameloblastomas and odontogenic cysts. The A, B and H type 2 antigens were demonstrated in odontogenic keratocysts and in follicular and radicular cysts. Expression of the blood group carbohydrates was similar in follicular and radicular cysts but differed from that seen in odontogenic keratocysts by the failure to detect N-lac in the latter. The antigens A, B, H type 2 and N-lac were not expressed in any of the ameloblastomas including types with palisading of basal cells and polarization of basal cell nuclei and types with a plexiform pattern with cuboidal or polyhedral shaped peripheral cells. The findings indicate that epithelium of ameloblastomas can be distinguished from odontogenic cyst epithelium by differences in expression of cell surface carbohydrates with blood group specificity.

Monoclonal antibody localization of A and B isoantigens in normal and malignant fixed human tissues

The expression of human blood group A and B isoantigens in normal and malignant tissues from stomach, colon, and pancreas was analyzed in an immunoperoxidase assay using monoclonal antibodies specific for these isoantigens. Appropriate isoantigen expression was demonstrated in the normal epithelium from the stomach, pancreas, and proximal but not distal colon of blood group A, AB, or B patients. Half of all gastric carcinomas and of proximal colon carcinomas showed complete loss of isoantigen, whereas the adjacent mucosa in these cases continued to express appropriate isoantigen. Isoantigen expression was completely lost in only 13% of pancreatic carcinomas tested. Neither A nor B isoantigen was detected in normal epithelium from the distal colon. By contrast, 85% of carcinomas derived from this site showed reexpression of isoantigen. Inappropriate expression of A isoantigen was detected in pancreatic carcinomas (2/5) but not in gastric or colon carcinomas (0/21). Inappropriate expression of B substance was not detected in any tissue (0/38). Interestingly, differential binding of antibodies to Type 1 versus Type 2 and/or difucosyl versus monofucosyl blood group B substances was manifested by differences in intensity of staining for endothelium and red blood cells.

Blood group antigen expression in nephroblastoma

The histological distribution of A, B, H, Lewis, Pr, i and I blood group antigens (BGA) was studied in 19 nephroblastomas and one mesoblastic nephroma by means of the indirect immunofluorescence technique. In addition to general conclusions about the relatively limited BGA expression in the tumour cells, their histological distribution was found to be related to the differentiation level of these renal embryonic tumours. By comparison with normal embryonic, fetal and adult kidney it was shown that the nephroblastoma differentiation level is not higher than that of a 3-month fetal kidney. Furthermore, i antigen appears to be a non-specific marker of the histiocytic macrophage cells of the nephroblastoma stroma.

Specific cell-surface labeling of polyglycosyl chains in human erythrocytes and HL-60 cells using endo-beta-galactosidase and galactosyltransferase

In order to identify the molecule components carrying polyglycosyl chains on cell surfaces a two-step enzymatic method was developed. In the first step, the cells were incubated with endo-beta-galactosidase to selectively expose terminal N-acetylglucosamine residues of the lactosamine backbone to the chains. In the second step these residues were glycosylated by incubation with galactosyltransferase and radioactive UDP-galactose. As many as 2.5-3.0 X 10(6) residues per cell could be transferred to human erythrocytes. Negligible amounts of labeling occurred if either of the enzymes was omitted from the incubations. Of the label 80% was found in glycoproteins. In accordance with previous observations, bands 3 and 4.5 were found to be the main carriers of polyglycosyl chains. In human promyelotic HL-60 leukemia cells, a major band of apparent molecular weight of 110000-140000 was labeled. In addition, bands of lower molecular weight which appear to have escaped detection by previous methods were also labeled. The novel labeling method was found to be simple to perform, uses commercially available reagents, and leads to the efficient and highly specific labeling of cell surface molecules carrying polyglycosyl chains.

Immune aspects of intestinal metaplasia of the stomach: an immunohistochemical study

Immune characteristics of intestinal metaplasia of the stomach were analyzed by the immunoperoxidase technique in frozen and paraffin-embedded specimens. In fetal and minimally inflamed adult gastric mucosa, secretory component (SC) was absent from epithelial cells. Non-intestinalized gastric mucosa with evident inflammatory changes showed weak SC immunoreactivity at the generative cell zone. Enhanced immunoreactivity of SC with evidence of transepithelial transport of IgA and IgM, but not of IgG, was demonstrated in intestinalized glands of either the complete or incomplete type. The number of inflammatory cells and lymphoid follicles was decreased in intestinalized mucosa when compared with that in non-intestinalized gastritic mucosa; J chain-negative IgG plasma cells and T cells, both of which were fairly abundant in the latter mucosa, were remarkably decreased in the former mucosa, whereas the decrease of J chain-positive IgA or IgM plasma cells was slight or equivocal. In either mucosa, IgA was the most popular immunoglobulin class in plasma cells. IgD plasma cells were very rare. In the germinal centers of lymphoid follicles which were preferentially distributed in non-intestinalized gastritic mucosa, IgM or IgG germinocytes predominated over IgA germinocytes, and a few T cells and NK cells also were present. Intraepithelial lymphoid cells with a T-suppressor phenotype were detected in intestinalized glands. The possibility that intestinal metaplasia is an adaptation to long-standing chronic gastritis is discussed.

Blood group antigens in the normal and neoplastic bladder epithelium

The indirect immunofluorescence technique was used to study the expression of the blood group A and H antigens in fresh-frozen and formalin-fixed paraffin-embedded sections of the bladder mucosa of 21 patients with non-neoplastic diseases of the bladder. Reliable assessment of these antigens could only be made using cryostat sections of fresh-frozen tissues. Also included in this study were tumour tissues of 5 patients with bladder cancer. The blood group A antigen was totally deleted in cryostat sections of the tumour of one patient with aggressive carcinoma and the appropriate antigens were diminished or focally deleted in the four patients with tumours that were non-invasive during one to three years of follow-up. It is concluded that sections of fresh-frozen tissues or sections processed in the absence of glycolipid-extracting solvents should be used for visualising the expression of blood group antigens in bladder tissues and assessing their value as prognosticators of the malignant potential of bladder tumours.

Cellular localization of lectin-affinity in tissue sections of normal human duodenum

Peroxidase (HRP) conjugates of Arachis hypogaea agglutinin (PNA), Dolichos biflorus agglutinin (DBA), Ulex europaeus agglutinin I (UEA I) and Bandeiraea simplicifolia agglutinin I (BSA I) were used to detect the expression of carbohydrate moieties in glyco-conjugates of normal human duodenal mucosa. Lectin histology was performed on sections from paraffin embedded specimens of donor blood groups A, B, AB and 0. While PNA, DBA and UEA I staining appeared to be independent of the donor blood groups, BSA I affinity was restricted to the blood groups B and AB. Neither striated columnar cells nor goblet cells stained with PNA-HRP conjugates. Glyco-conjugates of goblet cell mucins reacted with DBA and UEA I, but staining intensities varied in crypts and villi: positive goblet cells occurred preferentially in upper parts of the crypts and in villi. Striated columnar cells also exhibited variation in staining intensities, with binding of DBA and UEA I observed in the upper half of crypts and in villi, occurring predominantly along the brush border and in apical parts of the cells. Glyco-conjugates synthesized by Brunner's gland cells possessed a great variety of lectin reactivity with the lectins employed. Within a given histological section positive gland areas with different staining intensities beside negative cell populations might reflect different functional states.