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Jeyakanthan M, Meloncelli PJ, Zou L, Lowary TL, Larsen I, Maier S, Tao K, Rusch J, Chinnock R, Shaw N, Burch M, Beddows K, Addonizio L, Zuckerman W, Pahl E, Rutledge J, Kanter KR, Cairo CW, Buriak JM, Ross D, Rebeyka I, West LJ. ABH-Glycan Microarray Characterizes ABO Subtype Antibodies: Fine Specificity of Immune Tolerance After ABO-Incompatible Transplantation. Am J Transplant 2016; 16:1548-58. [PMID: 26602221 DOI: 10.1111/ajt.13625] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 10/18/2015] [Accepted: 11/07/2015] [Indexed: 01/25/2023]
Abstract
Organ transplantation from ABO blood group-incompatible (ABOi) donors requires accurate detection, effective removal and subsequent surveillance of antidonor antibodies. Because ABH antigen subtypes are expressed differently in various cells and organs, measurement of antibodies specific for the antigen subtypes in the graft is essential. Erythrocyte agglutination, the century-old assay used clinically, does not discriminate subtype-specific ABO antibodies and provides limited information on antibody isotypes. We designed and created an ABO-glycan microarray and demonstrated the precise assessment of both the presence and, importantly, the absence of donor-specific antibodies in an international study of pediatric heart transplant patients. Specific IgM, IgG, and IgA isotype antibodies to nonself ABH subtypes were detected in control participants and recipients of ABO-compatible transplants. Conversely, in children who received ABOi transplants, antibodies specific for A subtype II and/or B subtype II antigens-the only ABH antigen subtypes expressed in heart tissue-were absent, demonstrating the fine specificity of B cell tolerance to donor/graft blood group antigens. In contrast to the hemagglutination assay, the ABO-glycan microarray allows detailed characterization of donor-specific antibodies necessary for effective transplant management, representing a major step forward in precise ABO antibody detection.
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Affiliation(s)
- M Jeyakanthan
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - P J Meloncelli
- Alberta Glycomics Centre and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada
| | - L Zou
- Alberta Glycomics Centre and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada
| | - T L Lowary
- Alberta Glycomics Centre and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada
| | - I Larsen
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - S Maier
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - K Tao
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - J Rusch
- Pediatrtic Cardiology, Loma Linda University Medical Center, Loma Linda, CA
| | - R Chinnock
- Pediatrtic Cardiology, Loma Linda University Medical Center, Loma Linda, CA
| | - N Shaw
- Pediatric Cardiology, Great Ormond Street Hospital for Sick Children, London, UK
| | - M Burch
- Pediatric Cardiology, Great Ormond Street Hospital for Sick Children, London, UK
| | - K Beddows
- Division of Pediatric Cardiology, Columbia University, New York, NY
| | - L Addonizio
- Division of Pediatric Cardiology, Columbia University, New York, NY
| | - W Zuckerman
- Division of Pediatric Cardiology, Columbia University, New York, NY
| | - E Pahl
- Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - J Rutledge
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - K R Kanter
- Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - C W Cairo
- Alberta Glycomics Centre and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada
| | - J M Buriak
- National Institute for Nanotechnology, University of Alberta, Edmonton, Alberta, Canada
| | - D Ross
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.,Alberta Transplant Institute, University of Alberta, Edmonton, Alberta, Canada
| | - I Rebeyka
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.,Alberta Transplant Institute, University of Alberta, Edmonton, Alberta, Canada
| | - L J West
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Alberta Transplant Institute, University of Alberta, Edmonton, Alberta, Canada.,Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, Alberta, Canada
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Jeyakanthan M, Tao K, Zou L, Meloncelli PJ, Lowary TL, Suzuki K, Boland D, Larsen I, Burch M, Shaw N, Beddows K, Addonizio L, Zuckerman W, Afzali B, Kim DH, Mengel M, Shapiro AMJ, West LJ. Chemical Basis for Qualitative and Quantitative Differences Between ABO Blood Groups and Subgroups: Implications for Organ Transplantation. Am J Transplant 2015; 15:2602-15. [PMID: 26014598 DOI: 10.1111/ajt.13328] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/01/2015] [Accepted: 03/20/2015] [Indexed: 01/25/2023]
Abstract
Blood group ABH(O) carbohydrate antigens are carried by precursor structures denoted type I-IV chains, creating unique antigen epitopes that may differ in expression between circulating erythrocytes and vascular endothelial cells. Characterization of such differences is invaluable in many clinical settings including transplantation. Monoclonal antibodies were generated and epitope specificities were characterized against chemically synthesized type I-IV ABH and related glycans. Antigen expression was detected on endomyocardial biopsies (n = 50) and spleen (n = 11) by immunohistochemical staining and on erythrocytes by flow cytometry. On vascular endothelial cells of heart and spleen, only type II-based ABH antigens were expressed; type III/IV structures were not detected. Type II-based ABH were expressed on erythrocytes of all blood groups. Group A1 and A2 erythrocytes additionally expressed type III/IV precursors, whereas group B and O erythrocytes did not. Intensity of A/B antigen expression differed among group A1 , A2 , A1 B, A2 B and B erythrocytes. On group A2 erythrocytes, type III H structures were largely un-glycosylated with the terminal "A" sugar α-GalNAc. Together, these studies define qualitative and quantitative differences in ABH antigen expression between erythrocytes and vascular tissues. These expression profiles have important implications that must be considered in clinical settings of ABO-incompatible transplantation when interpreting anti-ABO antibodies measured by hemagglutination assays with reagent erythrocytes.
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Affiliation(s)
- M Jeyakanthan
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.,Canadian National Transplant Research Program, Edmonton, Alberta, Canada.,Alberta Transplant Institute, Edmonton, Alberta, Canada
| | - K Tao
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Alberta Transplant Institute, Edmonton, Alberta, Canada
| | - L Zou
- Alberta Glycomics Centre, Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada
| | - P J Meloncelli
- Alberta Glycomics Centre, Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada
| | - T L Lowary
- Alberta Glycomics Centre, Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada
| | - K Suzuki
- Alberta Diabetes Institute Molecular Biology Core, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - D Boland
- Southern Alberta Cancer Research Institute Antibody Services, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - I Larsen
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Alberta Transplant Institute, Edmonton, Alberta, Canada
| | - M Burch
- Pediatric Cardiology, Great Ormond Street Hospital, London, United Kingdom
| | - N Shaw
- Pediatric Cardiology, Great Ormond Street Hospital, London, United Kingdom
| | - K Beddows
- Division of Pediatric Cardiology, Columbia University, New York
| | - L Addonizio
- Division of Pediatric Cardiology, Columbia University, New York
| | - W Zuckerman
- Division of Pediatric Cardiology, Columbia University, New York
| | - B Afzali
- Department of Laboratory Medicine and Pathology, Edmonton, Alberta, Canada
| | - D H Kim
- Alberta Transplant Institute, Edmonton, Alberta, Canada.,Division of Medicine, Department of Cardiology, University of Alberta, University of Alberta, Edmonton, Alberta, Canada
| | - M Mengel
- Canadian National Transplant Research Program, Edmonton, Alberta, Canada.,Alberta Transplant Institute, Edmonton, Alberta, Canada.,Department of Laboratory Medicine and Pathology, Edmonton, Alberta, Canada
| | - A M J Shapiro
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.,Canadian National Transplant Research Program, Edmonton, Alberta, Canada.,Alberta Transplant Institute, Edmonton, Alberta, Canada
| | - L J West
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.,Canadian National Transplant Research Program, Edmonton, Alberta, Canada.,Alberta Transplant Institute, Edmonton, Alberta, Canada.,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
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Ferry DR, Anderson M, Beddows K, Mayer P, Price L, Jankowski J. Phase II trial of gefitinib (ZD1839) in advanced adenocarcinoma of the oesophagus incorporating biopsy before and after gefitinib. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- D. R. Ferry
- New Cross Hospital, Wolverhampton, United Kingdom; University of Leicester, Leicester, United Kingdom
| | - M. Anderson
- New Cross Hospital, Wolverhampton, United Kingdom; University of Leicester, Leicester, United Kingdom
| | - K. Beddows
- New Cross Hospital, Wolverhampton, United Kingdom; University of Leicester, Leicester, United Kingdom
| | - P. Mayer
- New Cross Hospital, Wolverhampton, United Kingdom; University of Leicester, Leicester, United Kingdom
| | - L. Price
- New Cross Hospital, Wolverhampton, United Kingdom; University of Leicester, Leicester, United Kingdom
| | - J. Jankowski
- New Cross Hospital, Wolverhampton, United Kingdom; University of Leicester, Leicester, United Kingdom
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