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Srivastava K, Yin Q, Makuria AT, Rios M, Gebremedhin A, Flegel WA. CD59 gene: 143 haplotypes of 22,718 nucleotides length by computational phasing in 113 individuals from different ethnicities. Transfusion 2024. [PMID: 38817044 DOI: 10.1111/trf.17869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/22/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND CD59 deficiency due to rare germline variants in the CD59 gene causes disabilities, ischemic strokes, neuropathy, and hemolysis. CD59 deficiency due to common somatic variants in the PIG-A gene in hematopoietic stem cells causes paroxysmal nocturnal hemoglobinuria. The ISBT database lists one nonsense and three missense germline variants that are associated with the CD59-null phenotype. To analyze the genetic diversity of the CD59 gene, we determined long-range CD59 haplotypes among individuals from different ethnicities. METHODS We determined a 22.7 kb genomic fragment of the CD59 gene in 113 individuals using next-generation sequencing (NGS), which covered the whole NM_203330.2 mRNA transcript of 7796 base pairs. Samples came from an FDA reference repository and our Ethiopia study cohorts. The raw genotype data were computationally phased into individual haplotype sequences. RESULTS Nucleotide sequencing of the CD59 gene of 226 chromosomes identified 216 positions with single nucleotide variants. Only three haplotypes were observed in homozygous form, which allowed us to assign them unambiguously as experimentally verified CD59 haplotypes. They were also the most frequent haplotypes among both cohorts. An additional 140 haplotypes were imputed computationally. DISCUSSION We provided a large set of haplotypes and proposed three verified long-range CD59 reference sequences, based on a population approach, using a generalizable rationale for our choice. Correct long-range haplotypes are useful as template sequences for allele calling in high-throughput NGS and precision medicine approaches, thus enhancing the reliability of clinical diagnostics. Long-range haplotypes can also be used to evaluate the influence of genetic variation on the risk of transfusion reactions or diseases.
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Affiliation(s)
- Kshitij Srivastava
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Qinan Yin
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Addisalem Taye Makuria
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
- Department of Pathology and Laboratory Services, ECU Health Medical Center, Greenville, North Carolina, USA
| | - Maria Rios
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Amha Gebremedhin
- School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Willy Albert Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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2
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Sarmoko, Ramadhanti M, Zulkepli NA. CD59: Biological function and its potential for drug target action. GENE REPORTS 2023. [DOI: 10.1016/j.genrep.2023.101772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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3
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Gassner C, Wagner FF. Blood Groups and Their Correlation with Hereditary Disease. Transfus Med Hemother 2022; 49:1-3. [PMID: 35221862 PMCID: PMC8832200 DOI: 10.1159/000521418] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 10/02/2023] Open
Affiliation(s)
- Christoph Gassner
- Institute of Translational Medicine, Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Franz F. Wagner
- German Red Cross Blood Service NSTOB, Springe, Germany
- MVZ am Clementinenkrankenhaus, Springe, Germany
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4
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Weinstock C. Association of Blood Group Antigen CD59 with Disease. Transfus Med Hemother 2022; 49:13-24. [PMID: 35221864 PMCID: PMC8832213 DOI: 10.1159/000521174] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/25/2021] [Indexed: 08/01/2023] Open
Abstract
In 2014, the membrane-bound protein CD59 became a blood group antigen. CD59 has been known for decades as an inhibitor of the complement system, located on erythrocytes and on many other cell types. In paroxysmal nocturnal haemoglobinuria (PNH), a stem cell clone with acquired deficiency to express GPI-anchored molecules, including the complement inhibitor CD59, causes severe and life-threatening disease. The lack of CD59, which is the only membrane-bound inhibitor of the membrane attack complex, contributes a major part of the intravascular haemolysis observed in PNH patients. This crucial effect of CD59 in PNH disease prompted studies to investigate its role in other diseases. In this review, the role of CD59 in inflammation, rheumatic disease, and age-related macular degeneration is investigated. Further, the pivotal role of CD59 in PNH and congenital CD59 deficiency is reviewed.
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5
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Flegel WA, Srivastava K. When recombinant proteins can replace rare red cells in immunohematology workups. Transfusion 2021; 61:2204-2212. [PMID: 34060094 DOI: 10.1111/trf.16507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Willy A Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Kshitij Srivastava
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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6
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Inherited glycosylphosphatidylinositol defects cause the rare Emm-negative blood phenotype and developmental disorders. Blood 2021; 137:3660-3669. [PMID: 33763700 DOI: 10.1182/blood.2020009810] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/08/2021] [Indexed: 12/17/2022] Open
Abstract
Glycosylphosphatidylinositol (GPI) is a glycolipid that anchors >150 proteins to the cell surface. Pathogenic variants in several genes that participate in GPI biosynthesis cause inherited GPI deficiency disorders. Here, we reported that homozygous null alleles of PIGG, a gene involved in GPI modification, are responsible for the rare Emm-negative blood phenotype. Using a panel of K562 cells defective in both the GPI-transamidase and GPI remodeling pathways, we show that the Emm antigen, whose molecular basis has remained unknown for decades, is carried only by free GPI and that its epitope is composed of the second and third ethanolamine of the GPI backbone. Importantly, we show that the decrease in Emm expression in several inherited GPI deficiency patients is indicative of GPI defects. Overall, our findings establish Emm as a novel blood group system, and they have important implications for understanding the biological function of human free GPI.
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7
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Byrne KM, Mercado CMC, Nnabue TN, Paige TD, Flegel WA. Inhibition of blood group antibodies by soluble substances. Immunohematology 2019; 35:19-22. [PMID: 30908075 PMCID: PMC6436639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The presence of multiple alloantibodies or an antibody to a highprevalance antigen in a patient sample can pose challenges in antibody identification. The pattern of reactivity seen on an antibody panel may show various strengths of reactivity by different methods of testing or same strength of reactivity at one or more phases of testing. To ensure proper identification, multiple investigative tools may be used. We review one of these methods-inhibition by soluble substances-which has become an expansion of our toolbox within the past 10 years. Alloantibodies can be inhibited using specific soluble substances. These soluble substances occur naturally in various fluids or can be manufactured. When a patient sample contains multiple antibodies, clinically significant or not, inhibition of one may help determine specificities of others. Specific inhibition of a particular antibody will also help to confirm its presence.
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Affiliation(s)
- Karen M Byrne
- SBB Program Education Coordinator, National Institutes of Health (NIH) Clinical Center, Department of Transfusion Medicine, 10 Center Drive, Bethesda, MD
| | | | - Thaddeus N Nnabue
- Training Technologist, Transfusion Medicine, Walter Reed National Military Medical Center
| | - Traci D Paige
- SBB Program Director and Supervisor of Transfusion Services, National Institutes of Health (NIH) Clinical Center, Department of Transfusion Medicine, Bethesda, MD
| | - Willy A Flegel
- SBB Program Medical Director, Chief of Laboratory Services Section, National Institutes of Health (NIH) Clinical Center, Department of Transfusion Medicine, Bethesda, MD
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8
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Anliker M, Schmidt CQ, Harder MJ, Ganchev G, von Zabern I, Höchsmann B, Schrezenmeier H, Weinstock C. Complement activation by human red blood cell antibodies: hemolytic potential of antibodies and efficacy of complement inhibitors assessed by a sensitive flow cytometric assay. Transfusion 2018; 58:2992-3002. [PMID: 30367826 DOI: 10.1111/trf.14893] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/09/2018] [Accepted: 05/13/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Therapeutic intervention strategies in complement-mediated hemolytic diseases are still inappropriate, and lethal events cannot be reliably prevented. As an in vitro model of intravascular hemolysis, a sensitive flow cytometric assay was designed using red blood cells (RBCs) of patients with paroxysmal nocturnal hemoglobinuria (PNH) as target cells. Complement activation by human allo- and autoantibodies directed against RBC antigens and the effect of different complement inhibitors were studied. STUDY DESIGN AND METHODS RBCs of patients with a PNH III RBC clone of more than 20% were coated with different human allo- or autoantibodies. Hemolysis was initiated with pooled normal human AB serum with or without the addition of complement inhibitors. Loss of PNH III RBCs was estimated by flow cytometry. RESULTS RBC antibodies of 174 different patients representing 37 different specificities were tested for their potency to activate complement. In correlation with blood group specificities roughly three different patterns were observed: 1) strong and regular, 2) sporadic, and 3) weak or absent complement activation. Remarkably strong complement activators were among antibodies directed against high-prevalence blood group antigens. The C5 inhibitor eculizumab abrogated mild but not strong complement activation, even in presence of excess inhibitor. However, this residual complement activity could be further depressed by combining eculizumab with other inhibitors. CONCLUSION The PNH hemolysis assay offers a sensitive tool for in vitro analyses of classical pathway-mediated complement activation. The recognition of additive effects of complement inhibitors may guide novel intervention strategies against unwanted complement damage.
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Affiliation(s)
- Markus Anliker
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany.,Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital Innsbruck, Innsbruck, Austria
| | - Christoph Q Schmidt
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Markus J Harder
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Georgi Ganchev
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
| | - Inge von Zabern
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
| | - Britta Höchsmann
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
| | - Hubert Schrezenmeier
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
| | - Christof Weinstock
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
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9
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Li XF, Lin FQ, Li JP. Identification of c.238 A>G (p.Arg80Gly) of CD59 blood group gene. Transfusion 2018; 58:3033-3034. [PMID: 30325039 DOI: 10.1111/trf.14960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/14/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Xiao-Feng Li
- Transfusion Medicine Institute, Liaoning Blood Center, Shenyang, Liaoning, China.,Liaoning Provincial Key Laboratory for Blood Safety Research, Shenyang, Liaoning, China
| | - Feng-Qiu Lin
- Transfusion Medicine Institute, Liaoning Blood Center, Shenyang, Liaoning, China.,Liaoning Provincial Key Laboratory for Blood Safety Research, Shenyang, Liaoning, China
| | - Jian-Ping Li
- Transfusion Medicine Institute, Liaoning Blood Center, Shenyang, Liaoning, China.,Liaoning Provincial Key Laboratory for Blood Safety Research, Shenyang, Liaoning, China.,Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning, China.,Transfusion Medicine Institute, Harbin Blood Center, Harbin, Heilongjiang, China
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10
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Molecular immunohaematology round table discussions at the AABB Annual Meeting, Orlando 2016. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2018. [PMID: 29517973 DOI: 10.2450/2018.0260-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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11
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Blaha J, Schwarz K, Fischer C, Schauwecker P, Höchsmann B, Schrezenmeier H, Anliker M. The Monoclonal Anti-CD157 Antibody Clone SY11B5, Used for High Sensitivity Detection of PNH Clones on WBCs, Fails to Detect a Common Polymorphic Variant Encoded byBST-1. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 94:652-659. [DOI: 10.1002/cyto.b.21625] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 12/28/2017] [Accepted: 01/08/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Johanna Blaha
- Institute for Transfusion Medicine; University of Ulm; Ulm Germany
| | - Klaus Schwarz
- Institute for Transfusion Medicine; University of Ulm; Ulm Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Ulm Germany
| | - Claudia Fischer
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Ulm Germany
| | - Peter Schauwecker
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Ulm Germany
| | - Britta Höchsmann
- Institute for Transfusion Medicine; University of Ulm; Ulm Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Ulm Germany
| | - Hubert Schrezenmeier
- Institute for Transfusion Medicine; University of Ulm; Ulm Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Ulm Germany
| | - Markus Anliker
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Ulm Germany
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12
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Red blood cells: Supercarriers for drugs, biologicals, and nanoparticles and inspiration for advanced delivery systems. Adv Drug Deliv Rev 2016; 106:88-103. [PMID: 26941164 DOI: 10.1016/j.addr.2016.02.007] [Citation(s) in RCA: 227] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 12/19/2022]
Abstract
Red blood cells (RBCs) constitute a unique drug delivery system as a biologic or hybrid carrier capable of greatly enhancing pharmacokinetics, altering pharmacodynamics (for example, by changing margination within the intravascular space), and modulating immune responses to appended cargoes. Strategies for RBC drug delivery systems include internal and surface loading, and the latter can be performed both ex vivo and in vivo. A relatively new avenue for RBC drug delivery is their application as a carrier for nanoparticles. Efforts are also being made to incorporate features of RBCs in nanocarriers to mimic their most useful aspects, such as long circulation and stealth features. RBCs have also recently been explored as carriers for the delivery of antigens for modulation of immune response. Therefore, RBC-based drug delivery systems represent supercarriers for a diverse array of biomedical interventions, and this is reflected by several industrial and academic efforts that are poised to enter the clinical realm.
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13
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Storry JR, Castilho L, Chen Q, Daniels G, Denomme G, Flegel WA, Gassner C, de Haas M, Hyland C, Keller M, Lomas-Francis C, Moulds JM, Nogues N, Olsson ML, Peyrard T, van der Schoot CE, Tani Y, Thornton N, Wagner F, Wendel S, Westhoff C, Yahalom V. International society of blood transfusion working party on red cell immunogenetics and terminology: report of the Seoul and London meetings. ACTA ACUST UNITED AC 2016; 11:118-122. [PMID: 29093749 DOI: 10.1111/voxs.12280] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Working Party has met twice since the last report: in Seoul, South Korea 2014, and in London, UK 2015, both in association with the International Society of Blood Transfusion (ISBT) Congress. As in previous meetings, matters pertaining to blood group antigen nomenclature were discussed. Eleven new blood group antigens were added to seven blood group systems. This brings the current total of blood group antigens recognized by the ISBT to 346, of which 308 are clustered within 36 blood groups systems. The remaining 38 antigens are currently unassigned to a known blood group system.
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Affiliation(s)
- J R Storry
- Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Lund, Sweden
| | - L Castilho
- University of Campinas/Hemocentro, Campinas, Brazil
| | - Q Chen
- Jiangsu Province Blood Center, Nanjing, China
| | - G Daniels
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant, Bristol, UK
| | - G Denomme
- Blood Center of Wisconsin, Milwaukee, WI, USA
| | - W A Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, USA
| | - C Gassner
- Blutspende Zurich, Zurich, Switzerland
| | - M de Haas
- Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
| | - C Hyland
- Australian Red Cross Blood Services, Brisbane, Qld, Australia
| | - M Keller
- American Red Cross Blood Services, Philadelphia, PA, USA
| | | | | | - N Nogues
- Banc de Sang i Teixits, Barcelona, Spain
| | - M L Olsson
- Department of Laboratory Medicine, Division of Hematology and Transfusion Medicine, Lund University, Lund, Sweden
| | - T Peyrard
- Institut National de la Transfusion Sanguine, Département Centre National de Référence pour les Groupes Sanguins, Inserm UMR_S1134, Paris, France
| | | | - Y Tani
- Osaka Red Cross Blood Center, Osaka, Japan
| | - N Thornton
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - F Wagner
- Red Cross Blood Service NSTOB, Springe, Germany
| | - S Wendel
- Blood Bank, Hospital Sirio-Libanes, São Paulo, Brazil
| | - C Westhoff
- New York Blood Center, New York, NY, USA
| | - V Yahalom
- NBGRL Magen David Adom, Ramat Gan, Israel
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14
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Emin M, Wang G, Castagna F, Rodriguez-Lopez J, Wahab R, Wang J, Adams T, Wei Y, Jelic S. Increased internalization of complement inhibitor CD59 may contribute to endothelial inflammation in obstructive sleep apnea. Sci Transl Med 2016; 8:320ra1. [PMID: 26738794 PMCID: PMC5485919 DOI: 10.1126/scitranslmed.aad0634] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Obstructive sleep apnea (OSA), characterized by intermittent hypoxia (IH) during transient cessation of breathing, triples the risk for cardiovascular diseases. We used a phage display peptide library as an unbiased approach to investigate whether IH, which is specific to OSA, activates endothelial cells (ECs) in a distinctive manner. The target of a differentially bound peptide on ECs collected from OSA patients was identified as CD59, a major complement inhibitor that protects ECs from the membrane attack complex (MAC). A decreased proportion of CD59 is located on the EC surface in OSA patients compared with controls, suggesting reduced protection against complement attack. In vitro, IH promoted endothelial inflammation predominantly via augmented internalization of CD59 and consequent MAC deposition. Increased internalization of endothelial CD59 in IH appeared to be cholesterol-dependent and was reversed by statins in a CD59-dependent manner. These studies suggest that reduced complement inhibition may mediate endothelial inflammation and increase vascular risk in OSA patients.
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Affiliation(s)
- Memet Emin
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Gang Wang
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Francesco Castagna
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Josanna Rodriguez-Lopez
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Romina Wahab
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Jing Wang
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Tessa Adams
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Ying Wei
- Division of Biostatistics, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | - Sanja Jelic
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA,Corresponding author.
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15
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Lane WJ, Westhoff CM, Uy JM, Aguad M, Smeland-Wagman R, Kaufman RM, Rehm HL, Green RC, Silberstein LE. Comprehensive red blood cell and platelet antigen prediction from whole genome sequencing: proof of principle. Transfusion 2015; 56:743-54. [PMID: 26634332 PMCID: PMC5019240 DOI: 10.1111/trf.13416] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/15/2015] [Accepted: 10/14/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND There are 346 serologically defined red blood cell (RBC) antigens and 33 serologically defined platelet (PLT) antigens, most of which have known genetic changes in 45 RBC or six PLT genes that correlate with antigen expression. Polymorphic sites associated with antigen expression in the primary literature and reference databases are annotated according to nucleotide positions in cDNA. This makes antigen prediction from next-generation sequencing data challenging, since it uses genomic coordinates. STUDY DESIGN AND METHODS The conventional cDNA reference sequences for all known RBC and PLT genes that correlate with antigen expression were aligned to the human reference genome. The alignments allowed conversion of conventional cDNA nucleotide positions to the corresponding genomic coordinates. RBC and PLT antigen prediction was then performed using the human reference genome and whole genome sequencing (WGS) data with serologic confirmation. RESULTS Some major differences and alignment issues were found when attempting to convert the conventional cDNA to human reference genome sequences for the following genes: ABO, A4GALT, RHD, RHCE, FUT3, ACKR1 (previously DARC), ACHE, FUT2, CR1, GCNT2, and RHAG. However, it was possible to create usable alignments, which facilitated the prediction of all RBC and PLT antigens with a known molecular basis from WGS data. Traditional serologic typing for 18 RBC antigens were in agreement with the WGS-based antigen predictions, providing proof of principle for this approach. CONCLUSION Detailed mapping of conventional cDNA annotated RBC and PLT alleles can enable accurate prediction of RBC and PLT antigens from whole genomic sequencing data.
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Affiliation(s)
- William J Lane
- Department of Pathology.,Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | | | - Heidi L Rehm
- Department of Pathology.,Harvard Medical School, Boston, Massachusetts.,Laboratory for Molecular Medicine.,Partners Healthcare Personalized Medicine, Boston, Massachusetts
| | - Robert C Green
- Division of Genetics, Department of Medicine.,Harvard Medical School, Boston, Massachusetts.,Partners Healthcare Personalized Medicine, Boston, Massachusetts
| | - Leslie E Silberstein
- Division of Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital
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16
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Flegel WA. Pathogenesis and mechanisms of antibody-mediated hemolysis. Transfusion 2015; 55 Suppl 2:S47-58. [PMID: 26174897 DOI: 10.1111/trf.13147] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND The clinical consequences of antibodies to red blood cells (RBCs) have been studied for a century. Most clinically relevant antibodies can be detected by sensitive in vitro assays. Several mechanisms of antibody-mediated hemolysis are well understood. Such hemolysis after transfusion is reliably avoided in a donor-recipient pair, if one individual is negative for the cognate antigen to which the other has the antibody. STUDY DESIGN AND RESULTS Mechanisms of antibody-mediated hemolysis were reviewed based on a presentation at the Strategies to Address Hemolytic Complications of Immune Globulin Infusions Workshop addressing intravenous immunoglobulin (IVIG) and ABO antibodies. The presented topics included the rates of intravascular and extravascular hemolysis; immunoglobulin (Ig)M and IgG isoagglutinins; auto- and alloantibodies; antibody specificity; A, B, A,B, and A1 antigens; A1 versus A2 phenotypes; monocytes-macrophages, other immune cells, and complement; monocyte monolayer assay; antibody-dependent cell-mediated cytotoxicity; and transfusion reactions due to ABO and other antibodies. CONCLUSION Several clinically relevant questions remained unresolved, and diagnostic tools were lacking to routinely and reliably predict the clinical consequences of RBC antibodies. Most hemolytic transfusion reactions associated with IVIG were due to ABO antibodies. Reducing the titers of such antibodies in IVIG may lower the frequency of this kind of adverse event. The only way to stop these events is to have no anti-A or anti-B in the IVIG products.
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Affiliation(s)
- Willy A Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland
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17
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Abstract
The severe clinical symptoms of inherited CD59 deficiency confirm the importance of CD59 as essential complement regulatory protein for protection of cells against complement attack, in particular protection of hematopoietic cells and human neuronal tissue. Targeted complement inhibition might become a treatment option as suggested by a case report. The easy diagnostic approach by flow cytometry and the advent of a new treatment option should increase the awareness of this rare differential diagnosis and lead to further studies on their pathophysiology.
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18
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Abstract
Blood group genotyping has many advantages over conventional phenotyping for both blood donors and patients, and a number of high-throughput methods have now been developed. However, these are limited by a requirement for existing knowledge of the relevant blood group gene polymorphisms, and rare or novel mutations will not be detected. These mutations could be successfully identified by DNA sequencing of the blood group genes, and such an approach has been made feasible by the introduction of Next Generation Sequencing (NGS) technology. NGS enables many genes from multiple samples to be sequenced in parallel, resulting in sequencing information that could be used to obtain accurate blood group phenotype predictions in both blood donors and patients.
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Affiliation(s)
- Louise Tilley
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK.
| | - Shane Grimsley
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
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