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Blood, 15 June 2007, Vol. 109, No. 12, pp. 5355-5362.
Prepublished online as a Blood First Edition Paper on February 22, 2007; DOI 10.1182/blood-2006-11-059899.
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Submitted November 27, 2006
Accepted February 17, 2007
IgM and IgA anti-erythrocyte autoantibodies induce anemia in a mouse model through multivalency-dependent hemagglutination but not through complement activation
Lucie Baudino, Liliane Fossati-Jimack, Christelle Chevalley, Eduardo Martinez-Soria, Marc J. Shulman, and Shozo Izui*
Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
Rheumatology Section, Imperial College School of Medicine, London, United Kingdom
Department of Immunology, University of Toronto, Ontario, Canada
* Corresponding author; email: shozo.izui{at}medecine.unige.ch.
By generating IgM and IgA switch variants of the 34-3C IgG2a anti-red blood cell (RBC) autoantibody, we evaluated the pathogenic activity of these two isotypes in view of the Fc-associated effector functions, i.e. complement activation and polyvalency-dependent agglutination. We found that polymeric forms of 34-3C IgM and IgA anti-RBC autoantibody were as pathogenic as IgG2a, which was the most pathogenic among four different IgG subclasses, while their monomeric variants completely lacked pathogenic effects. Histological examination showed that 34-3C IgM and IgA autoantibodies caused anemia as a result of multivalency-dependent hemaggultination and subsequent sequestration of RBC in the spleen, in contrast to Fc receptor- and complement receptor-mediated erythrophagocytosis by Kupffer cells with IgG isotypes. In addition, the development of anemia induced by IgM and IgA isotypes of 34-3C antibody and by two additional IgM anti-RBC monoclonal autoantibodies was not inhibited at all in C3-deficient mice, indicating the lack of involvement of complement activation in the pathogenesis of IgM- and IgA-induced anemia. Our data demonstrate a remarkably high pathogenic potential of polymeric forms of IgM and IgA anti-RBC autoantibodies owed to their ability to induce hemagglutination, but completely independent of complement activation.

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