Blood, Vol. 94 No. 8 (October 15), 1999:
pp. 2895-2900
ABO Blood Group Antigens on Human Plasma von Willebrand Factor After
ABO-Mismatched Bone Marrow Transplantation
Taei Matsui,
Taketo Shimoyama,
Masanori Matsumoto,
Yoshihiro Fujimura,
Yoshinobu Takemoto,
Masahiro Sako,
Jiharu Hamako, and
Koiti Titani
From the Division of Biomedical Polymer Science, Institute for
Comprehensive Medical Science, Fujita Health University; Department of
Medical Information Technology, Fujita Health University College,
Toyoake, Aichi, Japan; Department of Blood Transfusion Medicine, Nara
Medical University, Kashihara, Nara, Japan; 2nd Department of Internal
Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; and the
Department of Pediatrics, Osaka City General Hospital, Miyakojima-ku,
Osaka, Japan.
von Willebrand factor (vWF) is synthesized exclusively by
endothelial cells and megakaryocytes, and stored in the intracellular granules or constitutively secreted into plasma. ABO blood group antigens are covalently associated with asparagine-linked sugar chains
of plasma vWF. The effect of ABO-mismatched bone marrow transplantation
(BMT) or blood stem cell transplantation (BSCT) on the expression of
ABO blood group antigens on the vWF was examined to obtain information
on the origin of these antigens. In ABO-mismatched (HLA-matched)
groups, 8 cases of BMT and 4 cases of BSCT were examined. In all cases,
the ABO blood groups on red blood cells were gradually converted to the
donor's type within 80 to 90 days after the transplantation. The blood
group antigens on the vWF were consistent with the recipient's blood
group for the period monitored by enzyme-linked immunosorbent assay
(ELISA). When vWF was isolated from normal platelets and examined for
the blood group antigens using ELISA or immunoblotting, it showed few
antigens. However, vWF extracted from veins expressed blood group
antigens. These findings indicate that platelet (megakaryocyte)-derived vWF does not contain blood group antigens and that these antigens may
be specifically associated with vWF synthesized in endothelial cells
and secreted into plasma. Furthermore, it is possible that the
persistence of the recipient's blood group antigens on plasma glycoproteins such as vWF, independent of the donor-derived
erythrocytes, after ABO-mismatched stem cell transplantation, may
influence the immunological system in the production of anti-blood
group antibodies resulting in the establishment of immunological
tolerance in the recipient plasma.
