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Blood, 15 February 2007, Vol. 109, No. 4, pp. 1752-1755.
Prepublished online as a Blood First Edition Paper on October 12, 2006; DOI 10.1182/blood-2006-05-025106.


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Brief Report

Donor antibodies to HNA-3a implicated in TRALI reactions prime neutrophils and cause PMN-mediated damage to human pulmonary microvascular endothelial cells in a two-event in vitro model

Christopher C. Silliman1,3, Brian R. Curtis4, Patricia M. Kopko5, Samina Y. Khan2, Marguerite R. Kelher3, Randy M. Schuller6, Baindu Sannoh2, and Daniel R. Ambruso1,2

1 Bonfils Blood Center and the 2 Departments of Pediatrics and 3 Surgery, University of Colorado at Denver School of Medicine; 4 Blood Center of Southeastern Wisconsin, Milwaukee; 5 BloodSource, Sacramento, CA; 6 American Red Cross–North Central Blood Services, St Paul, MN

Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortality. Antibodies to HNA-3a are commonly implicated in TRALI. We hypothesized that HNA-3a antibodies prime neutrophils (PMNs) and cause PMN-mediated cytotoxicity through a two-event pathogenesis. Isolated HNA-3a+ or HNA-3a PMNs were incubated with plasma containing HNA-3a antibodies implicated in TRALI, and their ability to prime the oxidase was measured. Human pulmonary microvascular endothelial cells (HMVECs) were activated with endotoxin or buffer, HNA-3a+ or HNA-3a PMNs were added, and the coculture was incubated with plasma ± antibodies to HNA-3a. PMN-mediated damage was measured by counting viable HMVECs/mm2. Plasma containing HNA-3a antibodies primed the fMLP-activated respiratory burst of HNA-3a+, but not HNA-3a, PMNs and elicited PMN-mediated damage of LPS-activated HMVECs when HNA-3a+, but not HNA-3a, PMNs were used. Thus, antibodies to HNA-3a primed PMNs and caused PMN-mediated HMVEC cytotoxicity in a two-event model identical to biologic response modifiers implicated in TRALI.


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