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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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Submitted March 15, 2005
Accepted April 6, 2005
Non-Hemolytic 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
Department of Pathology and Laboratory Medicine, Transfusion Medicine Program, Emory University School of Medicine, Atlanta, GA, USA
* Corresponding author; email: jzimrin{at}emory.edu.
Transfusion of red blood cells (RBC) 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 RBC 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 non-hemolytic antibody-induced RBC antigen loss. RBC from transgenic mHEL mice express surface hen egg lysozyme (HEL) as a transmembrane protein. Transfusion of mHEL RBC into mice immunized with HEL results in selective loss of HEL antigen from donor RBC without affecting other blood group antigens or reducing the circulatory lifespan of the transfused RBC. While this process does not require the presence of a spleen, it requires both anti-RBC IgG antibodies and the FcgammaIII receptor. These studies provide mechanistic insight into the phenomenon of antigen loss during incompatible transfusion in humans.
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