Blood, Vol. 95 No. 5 (March 1), 2000:
pp. 1735-1742
Unique processing pathways within recipient antigen-presenting
cells determine IgG immunity against donor platelet MHC antigens
K. W. Annie Bang,
Edwin R. Speck,
Victor S. Blanchette,
John Freedman, and
John W. Semple
Department of Laboratory Medicine and Pathobiology, St. Michael's
Hospital, Division of Hematology/Oncology, The Hospital for Sick
Children, Departments of Pharmacology, Medicine and Pediatrics,
University of Toronto and the Toronto Platelet Immunobiology Group,
Toronto, Ontario, Canada.
Recipient IgG immunity against leukoreduced donor platelets is
dependent on indirect T-cell allorecognition and is suppressed in vivo
by inhibitors (aminoguanidine, AMG) of inducible nitric oxide synthase
(iNOS). To examine recipient processing pathways of donor platelet
antigens, enriched macrophages (antigen-presenting cells [APC]) from
BALB/c (H-2d) mice were pulsed with allogeneic C57BL/6
(H-2b) platelets and transfused weekly into naive BALB/c
mice. Platelet-pulsed APC stimulated IgG antidonor antibody production
in 45% of recipients by the second transfusion and in 100% by the
sixth transfusion; this response was enhanced by pulsing in the
presence of interferon-
. By the sixth transfusion, high-titer IgG1
(mean titer 4990) and IgG2a (1933) isotypes specific for donor major
histocompatibility complex (MHC) class I antigens were detected.
Platelet pulsing in the presence of AMG or colchicine significantly
inhibited the ability of APC to stimulate IgG alloantibodies; only 50%
(P < .005) and 20% (P < .0001) of recipients,
respectively, produced antibodies by the sixth transfusion. AMG
inhibition was reversed by the addition of L-arginine, the
substrate for iNOS. In contrast, pulsing in the presence of
chloroquine, the proteasome inhibitory peptide MG115, or Brefeldin
A enhanced APC immunity (70-100% of recipients antibody positive by
the second transfusion [P < .05]); these agents allowed
the pulsed APC to stimulate IgG2a but inhibited IgG1 production and
this correlated with a reduction in serum interleukin (IL)-4 levels.
The results suggest that for donor platelet antigens to stimulate IgG
alloantibodies, recipient APC use the essential generation of nitric
oxide and a noncytosolic, pH-independent processing pathway, which can
be exploited as an effective immunotherapy target to further
inhibit alloimmunization against leukoreduced platelets.