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 Blood, 1 August 2005, Vol. 106, No. 3, pp. 1105-1112.
Prepublished online as a Blood First Edition Paper on April 14, 2005; DOI 10.1182/blood-2005-03-1040.

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TRANSFUSION MEDICINE

Nonhemolytic antibody-induced loss of erythrocyte surface antigen

James C. Zimring, Gregory A. Hair, Traci E. Chadwick, Seema S. Deshpande, Kimberly M. Anderson, Christopher D. Hillyer, and John D. Roback

From the Transfusion Medicine Program, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA.

Transfusion of red blood cells (RBCs) into patients with anti–donor RBC antibodies (crossmatch-incompatible transfusion) can result in lethal antibody-mediated hemolysis. Less well appreciated is the ability of anti-RBC antibodies to specifically remove their target antigen from donor RBCs without compromising cell survival or adversely affecting the transfusion recipient. In an effort to elucidate the mechanistic details of this process, we describe the first animal model of nonhemolytic antibody-induced RBC antigen loss. RBCs from transgenic mHEL mice express surface hen egg lysozyme (HEL) as a transmembrane protein. Transfusion of mHEL RBCs into mice immunized with HEL results in selective loss of HEL antigen from donor RBCs without affecting other blood group antigens or reducing the circulatory life span of the transfused RBCs. While this process does not require the presence of a spleen, it requires both anti-RBC immunoglobulin G (IgG) antibodies and the Fc{gamma}III receptor. These studies provide mechanistic insight into the phenomenon of antigen loss during incompatible transfusion in humans.


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