Association of ABO blood groups with ovarian reserve, and outcomes after assisted reproductive technology: systematic review and meta-analyses

BACKGROUND

There has been an interest in the relationship between ABO blood groups and infertility. Many studies have investigated the association of ABO blood groups with diminished ovarian reserve (DOR), ovarian hyperstimulation syndrome (OHSS), and outcomes of assisted reproductive technology (ART), with controversial results.

METHODS

A systematic review and meta-analysis was conducted to evaluating the association of ABO blood groups with DOR, OHSS, and outcomes of ART.

RESULTS

Thirteen studies performed between 2010 and 2018 were included in this meta-analysis. DOR, OHSS, live birth rate (LBR), clinical pregnancy rate (CPR), miscarriage rate (MR) were reported in 9, 2, 4, 3, 2 studies, respectively. The combined results showed similar risk of DOR among individuals with blood group A (RR, 0.98; 95% confidence interval [CI], 0.85, 1.13), B (RR, 0.96; 95% CI, 0.76, 1.20), AB (RR, 1.00; 95% CI, 0.76, 1.30), and non-O (RR, 0.94; 95% CI, 0.79, 1.11) as compared to those with blood group O. Meta-analysis showed that the incidences of OHSS were similar in women with blood group A (RR, 1.05; 95% CI, 0.66, 1.66), B (RR, 1.04; 95% CI, 0.46, 2.35), AB (RR, 0.51; 95% CI, 0.10, 2.56), non-O (RR, 1.02; 95% CI, 0.65, 1.57) with blood group O. As to the clinical outcomes, meta-analysis showed no difference in LBR among individuals with blood group A (RR, 1.27; 95% CI, 0.74, 2.17), B (RR, 1.47; 95% CI, 0.95, 2.29), AB (RR, 1.48; 95% CI, 0.76, 2.90), non-O (RR, 1.28; 95% CI, 0.83, 1.98) when compared to those with blood group O. Similarly, the results also found that there were no difference in CPR and MR between women with blood A (CPR: RR, 1.12), B (CPR: RR, 1.08), AB (CPR: RR, 1.05), non-O (CPR: RR, 1.05; MR: RR, 0.94) and blood group O.

CONCLUSIONS

ABO blood groups may not be associated with DOR, OHSS, LBR, CPR, and MR of ART. Infertility and ART outcomes are influenced by multiple factors. Blood groups should not be taken into account excessively during diagnosis and treatment of infertile women.

ABO blood groups and risk of covid-19

INTRODUCTION

Coronavirus pandemic has been the subject of a large number of publications, some of which have shown an increased risk of contracting Covid-19 in carriers of blood group A.

AIMS

In this study we looked at the profile of blood group phenotype of a series of Tunisian patients with covid-19 admitted to Abderrahman Mami hospital in Ariana .

METHODS

Our study included 51 Tunisian patients with SARS-CoV-2 infection admitted to Abderrahmane Mami hospital between late march 2020 and early May 2020. The distribution of blood groups in Covid-19 patients was compared with that of a control group of 1506 patients with no Covid-19 infection as well as with the distribution of blood groups in a population of 63375 voluntary blood donors.

RESULTS

Our series, although limited in size, showed a higher prevalence of blood group A among Covid-19 patients, statistically significant compared to ABO blood group distribution among Tunisian blood donors and among a control group of patients without Covid -19.

CONCLUSION

these results are in line with data from the literature, particularly on larger series in China.

ABO hemolytic disease of newborn : Does newborn's blood group a risk factor?

BACKGROUND

Due to the marked decline of maternal-fetal rhesus incompatibility, ABO alloimmunization has become the leading cause of the newborn hemolytic disease. It is estimated that 15-25 % of all pregnancies are concerned by ABO incompatibility.

AIM

Neonatal blood group B seems to be more predisposing to acute hemolysis and severe hyperbilirubinemia. We propose to find if the newborn's blood group B represents a risk factor for severe hemolysis and/or severe hyperbilirubinemia.

METHODS

We conducted a comparative study in the pediatrics department "B" of the Children Hospital of Tunis. We collected retrospectively the medical files of the newborn hospitalized for ABO alloimmunization (January 2011 - March 2014), then we compared two groups, OA group with OA alloimmunization and OB group with OB alloimmunization. A significant threshold was fixed to 0.05.

RESULTS

We collected 98 cases of newborn ABO hemolytic disease. Both groups, OA and OB, were similar for the onset of jaundice, age of hospitalization, initial hemoglobin and indirect bilirubin levels. There were no statistically significant difference in the severity of hyperbilirubinemia and the use of exchange transfusion for the two groups. However, transfusion was statistically more frequent in the OB group compared to OA group (81.6‰ vs 10.2‰, p = 0,039, OR=2.9, 95% IC (1.1 - 7.8)).

CONCLUSION

OB alloimmunization seems to induce more active hemolysis than OA one, with no difference for severe hyperbilirubinemia in both groups.

Comparative analysis of ABO-incompatible kidney transplantation with ABO-compatible transplantation: A single-center experience from Eastern India

This study aimed to compare the outcomes of ABO-incompatible kidney transplantation (ABOiKT) with ABO-compatible kidney transplantation (ABOcKT) in a singlecenter study. A total of 30 consecutive ABOiKT recipients (ABOiKTR) from April 2014 to June 2015 were included in this study. All the patients received rituximab 200 mg/body for B-cell depletion. Plasmapheresis was done for anti-ABO antibody removal. The target anti-ABO titer was kept at <1:8. The outcomes of this group of patients were compared with that of thirty ABOcKT recipients. Both the groups received similar induction therapy with antithymocyte globulin and methylprednisolone. After a follow-up period of one year, the outcomes of both the groups were compared in terms of patient survival, graft survival, graft function, incidence of rejections, infective complications, and duration of posttransplant hospital stay. The patient survival in both the groups of patients was 96.67%. The death-censored graft survival was 96.67% in both the groups. The average serum creatinine level, estimated glomerular filtration rate, incidence of rejections, infective episodes, and posttransplant hospital stay were comparable in both the groups. The outcomes of ABOiKT were comparable with ABOcKT and as such, this modality can expand the living donor pool substantially.

ABO Blood Group and Prevalence of Osteoporosis and Osteopenia in the Elderly Population: An Amirkola Health and Ageing Project (AHAP)-Based Study

Osteoporosis is known as a degenerative disease of the skeletal system and its main complication is fracture, which influences quality of life in the elderly. There are 4 major blood groups in humans based on the presence of A and B antigens. According to the investigations, there are reported relations between blood types and some diseases. In this study, the association between the ABO blood group and the prevalence of osteoporosis and osteopenia in an elderly population was investigated. Medical records of 990 elderly people were investigated in a cross-sectional study and the association between their blood group and the incidence of osteoporosis and osteopenia was analyzed using SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). The results showed that ABO blood groups had no association with the prevalence of osteoporosis in both elderly men and women. The association between age and osteoporosis was significant and the association between this disorder and gender was significant too. The results also indicate that there is no association between RH⁺ and RH^- blood types and osteoporosis and osteopenia in both men and women. Based on this finding, it would be reasonable to conduct extensive studies.

Finno-Ugrians, Blood Types, and Suicide: Comment on Voracek, Fisher, and Marusic

In a sample of 20 European nations, the distribution of blood types provided a better explanation for the association of longitude with suicide rates than did the percentage of Finno-Ugrian ethnic group.

ABO blood group and von Willebrand factor: biological implications

ABO blood group antigens are complex carbohydrate molecules expressed on the surface of red blood cells and a variety of human cells and tissues. It is well known that ABO blood type exerts a profound influence on hemostasis, being a major determinant of von Willebrand factor (VWF), and consequently factor VIII, plasma levels. In this review, we will focus on the molecular mechanisms underlying the interaction between ABO blood group and VWF in normal and pathological conditions.

Fucosyltransferase 2 (FUT2) non-secretor status and blood group B are associated with elevated serum lipase activity in asymptomatic subjects, and an increased risk for chronic pancreatitis: a genetic association study

OBJECTIVE

Serum lipase activities above the threefold upper reference limit indicate acute pancreatitis. We investigated whether high lipase activity-within the reference range and in the absence of pancreatitis-are associated with genetic single nucleotide polymorphisms (SNP), and whether these identified SNPs are also associated with clinical pancreatitis.

METHODS

Genome-wide association studies (GWAS) on phenotypes 'serum lipase activity' and 'high serum lipase activity' were conducted including 3966 German volunteers from the population-based Study-of-Health-in-Pomerania (SHIP). Lead SNPs associated on a genome-wide significance level were replicated in two cohorts, 1444 blood donors and 1042 pancreatitis patients.

RESULTS

Initial discovery GWAS detected SNPs within or near genes encoding the ABO blood group specifying transferases A/B (ABO), Fucosyltransferase-2 (FUT2), and Chymotrypsinogen-B2 (CTRB2), to be significantly associated with lipase activity levels in asymptomatic subjects. Replication analyses in blood donors confirmed the association of FUT-2 non-secretor status (OR=1.49; p=0.012) and ABO blood-type-B (OR=2.48; p=7.29×10(-8)) with high lipase activity levels. In pancreatitis patients, significant associations were found for FUT-2 non-secretor status (OR=1.53; p=8.56×10(-4)) and ABO-B (OR=1.69, p=1.0×10(-4)) with chronic pancreatitis, but not with acute pancreatitis. Conversely, carriers of blood group O were less frequently affected by chronic pancreatitis (OR=0.62; p=1.22×10(-05)) and less likely to have high lipase activity levels (OR=0.59; p=8.14×10(-05)).

CONCLUSIONS

These are the first results indicating that ABO blood type-B as well as FUT2 non-secretor status are common population-wide risk factors for developing chronic pancreatitis. They also imply that, even within the reference range, elevated lipase activities may indicate subclinical pancreatic injury in asymptomatic subjects.

Association of type-O blood with neuroendocrine tumors in multiple endocrine neoplasia type 1

CONTEXT

The ABO blood type system describes the expression of human blood group antigens found on both erythrocytes and normal tissue throughout the body. We recently reported an association between O blood type and the manifestation of pancreatic neuroendocrine tumors in a cohort of patients with Von Hippel-Lindau syndrome.

OBJECTIVE

The aim of the study was to determine whether there is an association of ABO blood type with the development of neuroendocrine tumors in patients with multiple endocrine neoplasia, type 1 (MEN-1).

DESIGN

A retrospective analysis of 105 patients with MEN-1 was performed. Demographic, clinical, and biochemical data were analyzed by ABO blood type. Fisher's exact test was used to determine association between ABO blood type and manifestation of neuroendocrine tumor.

RESULTS

Demographic and clinical characteristics were similar amongst blood type cohorts. We found an association between O blood type and the manifestation of a primary neuroendocrine tumor of the gastrointestinal tract, lung, pancreas, and thymus in patients with MEN-1 (P = 0.01). Sixteen of 17 (94%) metastatic tumors had type-O blood, compared to 32 of 43 (74%) with a benign tumor who had non-O blood type.

CONCLUSIONS

Our findings suggest an association between O blood type and the manifestation of a primary neuroendocrine tumor in patients with MEN-1. Prospective clinical studies are warranted to see whether patient blood type status may be a useful addition to current screening and surveillance practices.

[Relationship between the effects of a high-fat meal and blood group in determination of alkaline phosphatase activity]

We previously reported that two isoforms of intestinal alkaline phosphatase (IAP) are present in the serum, a high-molecular-weight isoform(HIAP) and a normal-molecular-weight isoform (NIAP), and that both are present at high levels in blood group B or O secretors. In the present paper, we investigated the relationship between effects of high-fat meal and blood groups on ALP activity. Subjects fasted for 14 hours after dinner the previous evening and ate a high-fat meal the following morning. Two types of meals were prepared; a low-calorie meal (470 kcal), and a high-calorie meal (950 kcal). Subjects ate the 2 types of meal on different days. Blood was collected 3 times; once preprandially, and at 3 and 6 h postprandially. Among B or O secretors (n = 24), the mean +/- SD for increase in ALP activity after the high-fat meal was 26.4 +/- 10.2 U/L and 23.3 +/- 9.0 U/L at 3 and 6 h postprandially, respectively, following the low-calorie meal, and 47.9 +/- 19.9 U/L and 55.1 +/- 21.9 U/L at 3 and 6 h postprandially, respectively, after the high-calorie meal. Thus, ALP activity increased 2-fold after the high-calorie meal. Similarly, among subjects with other blood groups (n = 28), the increase in ALP activity was 5.7 +/- 3.7 U/L and 4.2 +/- 3.1 U/L at 3 and 6 h postprandially, respectively, with the low-calorie meal and 8.5 +/- 5.2 U/L and 10.6 +/- 6.0 U/L at 3 and 6 h postprandially, respectively, with the high-calorie meal. Thus, significant differences were seen between the blood groups (p < 0.001). The increases in ALP activity after the high-fat meal were nearly identical to the increases in NIAP activity. These results suggest that a high-fat meal is more likely to affect ALP activity in blood group B or O secretors, and that this effect peaks between 3 and 6 h after the high-fat meal. Taken together, the present results indicate that, as a rule, blood samples for determining ALP activity should be collected in the early morning with the patient in a fasted state.

ABO(H) blood groups and vascular disease: a systematic review and meta-analysis

BACKGROUND

Associations between vascular disease and ABO(H) blood groups have a long history, but no consensus exists regarding its magnitude and significance, or whether it relates to all disorders equally. An accurate calculation of risk would allow direct assessment of whether the effects of non-O status on thrombosis risk are of the magnitude predicted by its effect on von Willebrand factor/FVIII levels.

METHODS AND RESULTS

We conducted a systematic review and meta-analysis of studies reporting associations with non-O blood groups. This gave pooled odds ratios of 1.25 [95% confidence interval (CI) 1.14-1.36] for myocardial infarction (MI), 1.03 (95% CI 0.89-1.19) for angina, 1.45 (95% CI 1.35-1.56) for peripheral vascular disease, 1.14 (95% CI 1.01-1.27) for cerebral ischemia of arterial origin, and 1.79 (95% CI 1.56 to 2.05) for venous thromboembolism (VTE). However, restriction to prospective MI studies only did not confirm the association (OR 1.01; 95% CI 0.84-1.23), although these studies may have failed to capture early-onset disease. For VTE, using a combined group of OO/A(2)A(2)/A(2)O as index, the combination of A(1)A(1)/A(1)B/BB gave an OR of 2.44 (95% CI 1.79-3.33) and A(1)O/ BO/A(2)B an OR of 2.11 (95% CI 1.66-2.68).

CONCLUSIONS

This study confirms the historical impression of linkage between some vascular disorders and non-O blood group status. Although the odds ratios are similar to those predicted by the effect of ABO(H) on von Willebrand factor levels, further work is required to assess risk prospectively and to refine the effect of reducing O(H) antigen expression on thrombosis. However, as non-O and particularly A(1)A(1), A(1)B, BB constitute a significant proportion of the population attributable fraction of VTE, there may be a role for more widespread adoption of ABO(H) typing in testing strategies.

Norovirus recognizes histo-blood group antigens on gastrointestinal cells of clams, mussels, and oysters: a possible mechanism of bioaccumulation

Outbreaks of norovirus (NoV) gastroenteritis are often associated with the consumption of contaminated bivalves such as oysters, clams, and mussels. Crassostrea virginica oysters trap the Norwalk virus through the intestinal type A-like histo-blood group antigen (HBGA), a possible mechanism of bioaccumulation responsible for NoV outbreaks. In this study, we tested binding and inhibition of binding in three species of oysters and one species each of clams and mussels with NoVs, representing four HBGA receptor-binding patterns. Our results indicated that all three oyster species expressed type A- and type O-like HBGA in their gastrointestinal tissue. Similar type A-like antigens also were found in mussels and clams, but only some of them express the O-like antigens. Both genogroups I and II recombinant norovirus-like particles (rNoVLPs) bound to gastrointestinal homogenates from oysters, mussels, and clams, and the binding was inhibited by preincubation of the rNoVLP with HBGA-specific monoclonal antibodies or with types A or O HBGA-positive human saliva. Co-localization of rNoVLPs and HBGA on gastrointestinal epithelial cells of oysters, mussels, and clams was also observed by immunofluorescent microscopy. Finally, the binding of rNoVLP to oyster gastrointestinal homogenates was inhibited by incubation with HBGA analogs. This study significantly expands our understanding that multiple HBGAs are expressed in oyster, mussel, and clam gastrointestinal tissues, which could be the major mechanism of bioaccumulation of NoVs by these bivalves. Our results also suggest that this bioaccumulation could be reversed by incubation with HBGA analogs, a possible important new strategy for depuration.

ABO blood group phenotypes influence parity specific immunity to Plasmodium falciparum malaria in Malawian women

Background

Blood group O has been significantly associated with increased placental malaria infection in primiparae and reduced risk of infection in multiparae in the Gambia, an area with markedly seasonal malaria transmission. This study analyses the association between ABO blood group phenotypes in relation to placental malaria pathology and birth outcomes in southern Malawi, an area with perennial malaria transmission.

Methods

A cross-sectional study of 647 mother/child pairs delivering in Montfort Hospital, Chikwawa District between February-June 2004 and January-July 2005 was undertaken. Maternal peripheral and cord blood samples were obtained at delivery. Placental tissue was obtained and malaria histology classified as active, past or no malaria infection. Birth anthropometry was recorded. ABO blood group was measured by agglutination.

Results

In primiparae, blood group O was significantly associated with increased risk of active placental infection (OR 2.18, 95% CI 1.15–4.6, p = 0.02) and an increased foetal-placental weight ratio compared to non-O phenotypes (5.68 versus 5.45, p = 0.03) In multiparae blood group O was significantly associated with less frequent active placental infection (OR 0.59, 95% CI 0.36–0.98, p = 0.04), and a higher newborn ponderal index compared to non-O phenotypes (2.65 versus 2.55, p = 0.007). In multivariate regression parity was independently associated with increased risk of placental malaria (active andpast infection) in primiparae with blood group O (p = 0.034) and reduced risk in multiparae with the same phenotype (p = 0.015).

Conclusion

Parity related susceptibility to placental malaria is associated with the mothers ABO phenotype. This interaction influences foetal and placental growth and could be an important modifying factor for pregnancy outcomes. The biological explanation could relate to sialic acid dependent placental membrane differences which vary with ABO blood group.

Effects of human milk on adhesion of Streptococcus mutans to saliva-coated hydroxyapatite in vitro

Adhesion of bacteria to pellicle-coated tooth surfaces is the first step in biofilm formation on teeth. The aim of this study was to explore whether human milk prevents or promotes adhesion of cariogenic Streptococcus mutans to saliva-coated hydroxyapatite (HA) using an in vitro model system. S. mutans binding to HA coated with human parotid saliva (s-HA) or human milk was studied, in addition to binding inhibition to s-HA by human milk. S. mutans did not bind to HA coated with milk. S. mutans binding to s-HA was inhibited by milk from 15 (71 %) of 21 women, whereas milk from the remaining 6 mothers enhanced binding of S. mutans to s-HA. Inhibition of S. mutans binding correlated with bacterial binding to s-HA (r = 0.76). Human milk does not mediate adhesion of S. mutans to HA in vitro, but affects adhesion in an individually varying fashion. Phenotypic variations in milk and saliva glycosylation may explain the inhibitory capacity and possibly affect susceptibility to colonization by S. mutans in childhood.

Plasmodium falciparum malaria and ABO blood group: is there any relationship?

There is increasing evidence that Plasmodium falciparum malaria is influenced by ABO blood group but the extent of association between both is yet to be well defined. Studies that investigated association between P. falciparum malaria and ABO blood group were identified using MEDLINE search and were systematically reviewed. There were apparent discrepancies and contradictions in the studies as some reported significant association between both while others observed no significant association. This outcome may reflect the complex interaction between P. falciparum malaria and the host immune responses. However, findings from all studies reviewed suggested that individuals of blood group O are relatively resistant to severe disease caused by P. falciparum infection. It was established that parasitized erythrocytes form rosettes more readily with red blood cells (RBCs) of A, B, or AB groups than with blood group O and this parasite-triggered RBC rosette formation is associated with the severity of clinical disease and with the development of cerebral malaria. Differences in rosetting ability were based on the P. falciparum strain-specific preference of rosetting with non-O blood groups and not only a phenomenon of laboratory-propagated strains, but also exist in wild clinical isolates from all major malarious areas of the world.

von Willebrand factor propeptide in malaria: evidence of acute endothelial cell activation

The pathogenicity of Plasmodium falciparum is thought to relate to the unique ability of infected erythrocytes to adhere to and subsequently activate the vascular endothelium. To study the state of endothelial activation during falciparum malaria, we measured plasma levels of both von Willebrand factor (VWF) and its propeptide, indices of chronic and acute endothelial cell perturbation, respectively. Results were correlated with clinical and biochemical markers of disease severity, including plasma lactate. Our data show that acute endothelial cell activation is a hallmark of malaria in children, indicated by a significant rise in VWF and VWF propeptide. The highest VWF and propeptide levels were seen in cerebral and non-cerebral severe malaria, and associations found between VWF propeptide level and lactate (P < 0.001). Mean VWF propeptide levels (nmol/l) were in cerebral malaria 33.4, non-cerebral severe malaria 26.3, mild malaria 22.1, non-malaria febrile illness 10.2, and controls 10.1. Differences between patient and control groups were highly significant (P < 0.005). Follow-up of 26 cerebral malaria cases showed that levels of VWF propeptide, but not VWF fell by 24 h, following the clinical course of disease and recovery. These novel findings potentially implicate acute, regulated exocytosis of endothelial cell Weibel-Palade bodies in the pathogenesis of Plasmodium falciparum malaria.

Impact of ABO blood groups on tirofiban mediated inhibition of platelet function

Previous investigations revealed that ABO blood groups are associated with divergent concentrations of several coagulation factors. Concentrations of von Willebrand factor (vWF) and factor VIII are lower in individuals with blood group O as compared to subjects with blood group A, B or AB which might result in a reduced inhibition of platelet aggregation. The aim of the present in-vitro-investigation was to elucidate the impact of ABO blood group dependent vWF concentrations on tirofiban mediated inhibition of GPIIb/IIIa function. Platelet function was measured with the platelet function analyzer PFA-100 at baseline and at increasing concentrations of tirofiban and stratified for blood group O vs. A. If measured with the collagen/epinephrine cartridge, blood group O was associated with a prolonged mean baseline closure time in comparison with blood group A (175.8 +/- 64.9 s vs. 121.4 +/- 33.4 s, p = 0.037) which was paralleled by reduced concentrations of vWF and factor VIII. In contrast, no differences in closure time (227.6 +/- 76.1 s vs. 223.9 +/- 81.9 s, p = 0.96) could be found in the presence of tirofiban (0.1 microg/ml). Thus, tirofiban mediated GP IIb/IIIa receptor antagonism as determined with the PFA-100 seems to be independent on plasma concentration of vWF.

Norovirus and histo-blood group antigens: demonstration of a wide spectrum of strain specificities and classification of two major binding groups among multiple binding patterns

Noroviruses, an important cause of acute gastroenteritis, have been found to recognize human histo-blood group antigens (HBGAs) as receptors. Four strain-specific binding patterns to HBGAs have been described in our previous report. In this study, we have extended the binding patterns to seven based on 14 noroviruses examined. The oligosaccharide-based assays revealed additional epitopes that were not detected by the saliva-based assays. The seven patterns have been classified into two groups according to their interactions with three major epitopes (A/B, H, and Lewis) of human HBGAs: the A/B-binding group and the Lewis-binding group. Strains in the A/B binding group recognize the A and/or B and H antigens, but not the Lewis antigens, while strains in the Lewis-binding group react only to the Lewis and/or H antigens. This classification also resulted in a model of the norovirus/HBGA interaction. Phylogenetic analyses showed that strains with identical or closely related binding patterns tend to be clustered, but strains in both binding group can be found in both genogroups I and II. Our results suggest that noroviruses have a wide spectrum of host range and that human HBGAs play an important role in norovirus evolution. The high polymorphism of the human HBGA system, the involvement of multiple epitopes, and the typical protein/carbohydrate interaction between norovirus VLPs and HBGAs provide an explanation for the virus-ligand binding diversities.

Variation in European suicide rates is better accounted for by latitude and longitude than by national percentage of Finno-Ugrians and Type O blood: a rebuttal of Lester and Kondrichin (2004)

The variation in contemporary suicide rates for men and women across 20 European nations is, in terms of shared variance, better accounted for by latitude and longitude than by national percentage of Finno-Ugrians and Type O blood, thus supporting the conclusion of Voracek, et al. in 2003 and refuting the supposition of Lester and Kondrichin of 2004. Discussion focuses on possible bases of this finding and on research problems pertaining to relations between suicide and blood type.

ABO blood groups and risk of venous thromboembolism during pregnancy and the puerperium. A population-based, nested case-control study

OBJECTIVES

To examine possible associations of ABO blood types with the risk of venous thromboembolism (VTE) in pregnancy and the puerperium.

PATIENTS AND METHODS

We conducted a nested case-control study within a cohort of 71,729 women who gave birth to 126,783 children in the North Jutland County, Denmark, from 1980 to 2001. We identified 129 cases with VTE in pregnancy (n = 61) or the puerperium (n = 68), and 258 controls with no VTE. We collected information on ABO blood groups and possible maternal confounding factors and estimated the relative risk [odds ratio (OR)].

RESULTS

Women with an A or AB blood group had elevated risk estimates of VTE in pregnancy or the puerperium compared with women with a O blood group [adjusted ORs 2.4, 95% confidence interval (CI) 1.3, 4.3, and 2.0, 95% CI 0.7, 5.8, respectively]. No increased risk estimate was found for group B (adjusted OR 1.2, 95% CI 0.5, 3.0). The increased risk estimates of VTE for blood groups A and AB appeared present in both pregnancy (adjusted ORs of 3.9, 95% CI 1.5, 9.7, and 2.2, 95% CI 0.4, 12.5) and in the puerperium (adjusted ORs of 2.4, 95% CI 1.0, 4.9 and 2.7, 95% CI 0.8, 9.3). Furthermore, blood groups A and AB appeared to be associated with increased risk estimates for both DVT and pulmonary embolism.

CONCLUSION

Keeping the modest statistical precision of our study in mind, blood groups A and AB may be associated with increased risk estimates for VTE in pregnancy and the puerperium.

Association of histo-blood group antigens and susceptibility to norovirus infections

BACKGROUND

Noroviruses (NoVs) are the leading cause of viral gastroenteritis in humans of all ages. Challenge studies that used the NoV prototype strain Norwalk virus (NV) have shown that some individuals are not susceptible to infection, suggesting the absence of a receptor. Recent studies have identified histo-blood group antigens (HBGAs) as possible receptors. Being a nonsecretor and presence of HBGA type B were associated with protection against infection with NV, a genogroup (GG) I NoV.

METHODS

In the present retrospective study, we investigated the association between presence of HBGAs and the risk of infection with another NoV belonging to GGI (Hu/NV/I/Birmingham/93/UK). The study was done as part of an investigation of a waterborne outbreak in a group of schoolchildren and of a cohort of healthy adults. The ABH histo-blood group phenotype was determined by use of saliva or serum samples from these individuals.

RESULTS

Presence of HBGA type B was significantly correlated with a lack of susceptibility to infection with GGI NoV and with an absence of antibodies. No correlation was found with GGII NoV. Although the infection rate in nonsecretors was lower, this difference was not statistically significant, and several children lacking HBGAs in saliva were found to be infected.

CONCLUSIONS

Individuals with the HBGA type B may be protected against infection with GGI (but not GGII) NoVs. The association between susceptibility to NoV infection and being a secretor may be restricted to GGI NoV.

Blood type B might imply longevity

The aim of the present study was to investigate the association between blood groups and life expectancy. We compared frequencies of ABO blood group in 269 centenarians (persons over 100 years) living in Tokyo and those in regionally matched controls (n=7153). Frequencies of blood types A, O, B, and AB in centenarians were 34.2, 28.3, 29.4, and 8.2%, respectively, while those in controls were 38.6, 30.1, 21.9, and 9.4%, respectively. Blood type B was observed more frequently in centenarians than in controls (chi(2)=8.41, P=0.04). This tendency also was true in comparison between centenarians and 118 elderly old individuals of the 7153. Approximate one-third of the centenarians were free from serious diseases such as malignancy. However, blood types were not associated with such medical records. Our findings suggest that blood type B might be associated with exceptional longevity. Responsible mechanisms need to be investigated.

Nosocomial outbreak of norovirus gastroenteritis and investigation of ABO histo-blood group type in infected staff and patients

The blood groups were analysed of staff and patients (N=45) infected during two nosocomial outbreaks of norovirus gastroenteritis at a German University hospital. Persons with O phenotype were significantly less affected than was expected from the normal distribution of blood group types in Southwest Germany (OR 2.45; 95% CI 1.22-4.95; P=0.01).

A guide to blood groups, transfusion and coagulation

Recent medical advances have resulted in more patients surviving increasingly complex surgery. This series of articles aims to refresh our knowledge of blood-its composition, the origins and roles of blood's components and how coagulation occurs. New technologies that have developed to reduce inappropriate transfusion of blood and blood products will be explored. We will be updated on national projects to reduce inappropriate transfusion.

Involvement of H type 1 carbohydrate antigen in cell adhesion to vascular endothelial cells of human endometrial cancer

A number of previously published studies have suggested that blood-group-related carbohydrate antigens, expressed on cancer cell membranes, may be related to the cytobiological characteristics (invasiveness, metastasizing potential, etc.) of cancer. In our previous study, we divided SNG-II, a human endometrial cancer cell line, into SNG-S and SNG-W and compared their properties. In that study, we found that H type 1 carbohydrate antigen, which is scarcely expressed on SNG-S but strongly expressed on SNG-W, may play a significant role in the adhesion of SNG-W to vascular endothelial cells. In the present study, we clarified in some detail, the relationship between H type 1 carbohydrate antigen and endothelial cell adhesion, and also compared the propensity for hematogenous metastasis of these two cell lines in vivo. The following results were obtained: 1. The adhesion of SNG-W to human umbilical vein endothelial cells (1), was inhibited in a concentration-dependent manner by the addition of one H type 1 monoclonal antibody. 2. In the flow cytometric analysis using single carbohydrate-conjugated fluorescent beads, it was shown that H type 1 carbohydrate-attached beads adhered to HUVECs. On the other hand, beads conjugated with Lewis, Lewis, or H type 2 carbohydrate antigen did not adhere to HUVECs. 3. In an in vivo study using a nude mouse model of lung metastasis, SNG-W was found to show a significantly greater propensity for blood-borne metastasis than SNG-S. These results suggest that the H1 carbohydrate antigen expressed on the cancer cell membrane serves as an adhesion factor for vascular endothelial cells, and that endometrial cancer expressing high levels of this antigen has a high propensity for blood-borne metastasis, suggesting that the expression of this antigen on the cancer cells may serve as an indicator of poor prognosis.

[ABO blood-group system: past and present]

The ABO blood group system was discovered one hundred years ago; the respective ABH antigens were found in the protein and lipid membrane components of various cells (most importantly, erythrocytes) and soluble blood group substances. The genetics of the ABO system was also elucidated. This old knowledge is still useful, bringing new applications. Although we do not really know the complete biological role of blood group systems, including that of the major ABO system, data, which is still being accumulated, ensure scientists and physicians of its importance in research and the diagnosis and therapy of diseases. For example, susceptibility to some diseases has been shown to be connected with the blood group of the patient, or the phenotype changes of the ABH determinants may indicate the presence of defined form of cancer. The data presented in this article clearly suggest the validity of the ABO blood group system in medical and biological sciences.

Norwalk virus-like particle hemagglutination by binding to h histo-blood group antigens

Noroviruses are a major cause of epidemic acute nonbacterial gastroenteritis worldwide. Here we report our discovery that recombinant Norwalk virus virus-like particles (rNV VLPs) agglutinate red blood cells (RBCs). Since histo-blood group antigens are expressed on gut mucosa as well as RBCs, we used rNV VLP hemagglutination (HA) as a model system for studying NV attachment to cells in order to help identify a potential NV receptor(s). rNV VLP HA is dependent on low temperature (4 degrees C) and acidic pH. Of the 13 species of RBCs tested, rNV VLPs hemagglutinated only chimpanzee and human RBCs. The rNV VLPs hemagglutinated all human type O (11 of 11), A (9 of 9), and AB (4 of 4) RBCs; however, few human type B RBC samples (4 of 14) were hemagglutinated. HA with periodate- and neuraminidase-treated RBCs indicated that rNV VLP binding was carbohydrate dependent and did not require sialic acid. The rNV VLPs did not hemagglutinate Bombay RBCs (zero of seven) that lack H type 2 antigen, and an anti-H type 2 antibody inhibited rNV VLP HA of human type O RBCs. These data indicated that the H type 2 antigen functions as the rNV VLP HA receptor on human type O RBCs. The rNV VLP HA was also inhibited by rNV VLP-specific monoclonal antibody 8812, an antibody that inhibits VLP binding to Caco-2 cells. Convalescent-phase sera from NV-infected individuals showed increased rNV VLP HA inhibition titers compared to prechallenge sera. In carbohydrate binding assays, the rNV VLPs bound to synthetic Lewis d (Le(d)), Le(b), H type 2, and Le(y) antigens, and these antigens also inhibited rNV VLP HA of human type O RBCs. Overall, our results indicate that carbohydrate antigens in the gut are a previously unrecognized factor in NV pathogenesis.

Effect of ABO blood group on the collagen-binding assay for von Willebrand factor

von Willebrand disease (VWD) is the most common congenital bleeding disorder and is caused by a quantitative or qualitative abnormality of von Willebrand factor (VWF). Ristocetin cofactor (RCoF) assay is used to evaluate VWF activity, but it does not assess collagen-binding activity. Normal values of RCoF and VWF antigen vary with ABO blood group type. The collagen-binding assay (CBA) measures VWF activity; however, its relationship with ABO blood group has not been completely explored. We performed CBA on plasma samples from 131 healthy volunteers to determine if CBA values correlated with blood type. Individuals with blood group O had a mean CBA value of 94 +/- 28%, which was significantly different from the mean of 117 +/- 33% in persons with non-O blood groups (P = 0.0001). Thus, CBA values appear to correlate with ABO blood type in a manner similar to RCoF.

ABO blood group antigens in oral mucosa. What is new?

Histo-blood group ABH (O) antigens are major alloantigens in humans. These antigens are widely distributed in human tissues and undergo changes in expression during cellular differentiation and malignant development. The ABH antigens have been characterized as terminal disaccharide determinants which represent secondary gene products. They are synthesized in a stepwise fashion from a precursor by the action of different glycosyltransferases. In non-keratinized oral mucosa, a sequential elongation of the carbohydrates is associated with differentiation of epithelial cells, resulting in expression of precursors on basal cells and A/B antigens on spinous cells. Reduction or complete deletion of A/B antigen expression in oral carcinomas has been reported, a phenotypic change that is correlated with invasive and metastatic potential of the tumours and with the mortality rates of the patients. Disappearance of the antigens is ascribed to the absence of A or B transferase gene expression. Several studies have shown that loss of A and B antigen expression is associated with increased cell motility, invasion in matrigel, and tumourigenecity in syngenic animals. In vivo studies of human oral wound healing show similarly decreased expression of A/B antigens on migrating epithelial cells. Some studies suggest that the relationship between expression of blood group antigens and cell motility can be explained by different degrees of glycosylation of integrins. Changes in ABO expression in tumours have, in some cases, been due to the A/B gene promoter, although little is known about the regulation of A, and B expression, in normal tissue.

Molecular diversity in the biosynthesis of GI tract glycoconjugates. A blood-group-related chart of microorganism receptors

This paper examines the potential of carbohydrate blood-group antigens present on mucosal surfaces in acting as receptors for microorganisms. Mucosal surfaces express significant amounts of carbohydrate blood-group antigens under the control of the Secretor, Lewis and ABO systems. The exact glycoconjugate profile an individual presents to the lumen is complex, and can only be correctly determined by a combination of serology and genotyping. We have isolated and structurally resolved the glycolipids expressed in the small intestine of group O individuals having various common or rare phenotypes. Using this information, we have been able to construct a biosynthetic pathway and propose that the type, size and glycotopes expressed, are controlled to a major extent by blood-group-related glycosyltransferases. Many of these glycotopes are potential receptors for microorganisms; some resemble tumour antigens, while others resemble the lipopolysaccharides of some pathogens. Although the origins of the blood-group glycosyltransferases remain uncertain, it is evident that they significantly diversify the mucosal glycotopes exposed to microbes; and therein may be found a potential explanation for their existence.

Hemostatic Changes in Patients Receiving Hydroxyethyl Starch: The Influence of ABO Blood Group

Hydroxyethyl starches (HES) interfere with coagulation because of their molecular structure and the amount infused during surgery. Coagulation defects include platelet dysfunction and a decrease of the VIII/von Willebrand factor complex (VIII/vWF). We examined the effects of 6% HES 200/0.6 on hemostasis by using an in vitro platelet function analyzer, the usual coagulation tests, the VIII/vWF complex assessment, and TEG analysis in patients undergoing abdominal surgery. The influence of the blood group was investigated. HES infusion induced primary hemostasis alterations, assessed by a prolonged platelet function analyzer closure time in the presence of epinephrine and adenosine diphosphate, which was not correlated with the platelet count. The decrease in VIII/vWF complex was proportional to the volume of infused HES (20 and 30 mL/kg) and was more pronounced in patients of the O blood group. The preoperative hypercoagulability status assessed by TEG analysis was reversed 24 h after HES infusion. In conclusion, 6% HES 200/0.6 induced immediate hemostasis alterations. Patients of the O blood group were likely to develop a von Willebrand-like syndrome after HES infusion. We conclude that intraoperative use of 6% HES 200/0.6 should be restricted in patients of the O blood group undergoing surgical procedures with high risk for bleeding.

Comparison of the expression of ABH/Lewis-related antigens in polypoid and non-polypoid growth types of colorectal carcinoma

BACKGROUND AND AIMS

Colorectal tumors can be classified based on their growth pattern into the polypoid growth-type (PG-type) and non-polypoid growth-type (NPG-type). To ascertain whether there is any relationship between the expression of particular blood group-related antigens (A, B, H, Lewis (Le)a, sialyl Le(a), Le(x), sialyl Le(x)) in a colorectal tumor, and a tumor having polypoid or non-polypoid growth, we examined 78 PG-type and NPG-type colorectal cancers.

METHODS

Fourteen PG-type and 64 NPG-type colorectal carcinomas were subjected to immunohistochemical analyses by using monoclonal antibodies against A, B, H, Le(a), sialyl Le(a), Le(x) and sialyl Le(x).

RESULTS

The patients with NPG-type carcinomas had a significantly younger age of onset, significantly smaller maximal tumor diameter, significantly higher rate of lymph node metastasis and significantly worse prognosis than those with PG-type carcinomas. Among the 32 tumors of patients with blood type A or AB, isoantigen A was expressed in a significantly larger percentage of NPG-type carcinomas than PG-type carcinomas (95.8 vs 62.5%, respectively; P=0.014). Among all 78 tumors, sialyl Le(x) antigen was expressed in a significantly larger percentage of NPG-type than PG-type carcinomas (90.6 vs 64.3%, respectively; P=0.010). Multivariate analysis using the logistic regression model revealed that isoantigen A and sialyl Le(x) expression were independent predictive risk factors for the development of NPG-type colorectal carcinoma.

CONCLUSIONS

These data suggest that the expression of isoantigen A and sialyl Le(x) in a colorectal carcinoma partially determines whether the tumor will have polypoid or non-polypoid growth.

Influence of ABO blood groups on primary hemostasis

BACKGROUND

Recently, the in vitro bleeding time test (IVBT) was proved to be a very sensitive screening method for the detection of vWD, showing rather good correlation between the closure time and the level of vWF. The vWF levels have been found to be significantly lower in healthy humans who are group O than in those who belong to the other ABO blood groups (non-group O). The aim of this study was to detect whether these differences in vWF levels in normal persons correspond to differences in nonvascular primary hemostasis when investigated by the IVBT.

MATERIAL AND METHODS

Healthy blood donors (n = 162) without evidence of hemostatic disorders, without ingestion of drugs for at least 2 weeks, and with normal in vivo bleeding time endpoints, normal factor VIII clotting activity levels, normal structure of vWF multimers, and normal ristocetin-induced platelet aggregation were examined by IVBT. IVBT was performed with two automated systems (Thrombostat 4000, VDG [TST]; and a platelet function analyzer (PFA-100, Dade Behring [PFA]). CaCl2 and ADP were used as aggregants for the two TST tests (TST-CaCl2 and TST-ADP), and ADP- or epinephrine (Epi)-coated membranes were used with the two PFA tests (PFA-ADP and PFA-Epi).

RESULTS

Closure time in the IVBT significantly correlated with the blood groups, but in reverse order (as did blood volume; data not shown): TST-ADP (mean +/- SD): group O, 89 +/- 14.6 seconds versus non-group O, 82 +/- 13 seconds (p<0.01); TST-CaCl(2): group O, 154 +/- 28.9 seconds versus non-group O, 140 +/- 31.3 seconds (p<0.01); PFA-ADP: group O, 91 +/- 13.4 seconds versus non-group O, 86 +/- 11.9 seconds (p<0.05); PFA-Epi: group O, 112 +/- 15.4 seconds versus non-group O, 104 +/- 16.7 seconds (p<0.05). Donors with vWF < or =77.5 % had longer closure time than those with vWF >77.5 % (p<0.05).

CONCLUSION

Significant ABO-group-specific differences in nonvascular primary hemostasis could be found by IVBT. The differences are small, however, and lie within the normal range. Whether these differences have any biologic relevance can only be speculated.

The semiconserved head structure of Plasmodium falciparum erythrocyte membrane protein 1 mediates binding to multiple independent host receptors

Erythrocytes infected with mature forms of Plasmodium falciparum do not circulate but are withdrawn from the peripheral circulation; they are bound to the endothelial lining and to uninfected erythrocytes in the microvasculature. Blockage of the blood flow, hampered oxygen delivery, and severe malaria may follow if binding is excessive. The NH(2)-terminal head structure (Duffy binding-like domain 1 [DBL1alpha]-cysteine-rich interdomain region [CIDR1alpha]) of a single species of P. falciparum erythrocyte membrane protein 1 (PfEMP1) is here shown to mediate adherence to multiple host receptors including platelet-endothelial cell adhesion molecule 1 (PECAM-1)/CD31, the blood group A antigen, normal nonimmune immunoglobulin M, three virulence-associated receptor proteins, a heparan sulfate-like glucosaminoglycan, and CD36. DBL2delta was found to mediate additional binding to PECAM-1/CD31. The exceptional binding activity of the PfEMP1 head structure and its relatively conserved nature argues that it holds an important role in erythrocyte sequestration and therefore in the virulence of the malaria parasite.

Ley/H: an endothelial-selective, cytokine-inducible, angiogenic mediator

Endothelial cells (ECs) are key participants in angiogenic processes that characterize tumor growth, wound repair, and inflammatory diseases, such as human rheumatoid arthritis (RA). We and others have shown that EC molecules, such as soluble E-selectin, mediate angiogenesis. Here we describe an EC molecule, Lewisy-6/H-5-2 glycoconjugate (Ley/H), that shares some structural features with the soluble E-selectin ligand, sialyl Lewisx (sialyl Lex). One of the main previously recognized functions of Lewisy is as a blood group glycoconjugate. Here we show that Ley/H is rapidly cytokine inducible, up-regulated in RA synovial tissue, where it is cell-bound, and up-regulated in the soluble form in angiogenic RA compared with nonangiogenic osteoarthritic joint fluid. Soluble Ley/H also has a novel function, for it is a potent angiogenic mediator in both in vitro and in vivo bioassays. These results suggest a novel paradigm of soluble blood group Ags as mediators of angiogenic responses and suggest new targets for therapy of diseases, such as RA, that are characterized by persistent neovascularization.

Type 1 von Willebrand disease - a clinical retrospective study of the diagnosis, the influence of the ABO blood group and the role of the bleeding history

This clinical retrospective study investigated the difficulties in diagnosing type 1 von Willebrand disease (VWD). A total of 246 patients previously diagnosed with type 1 VWD were reclassified into 'possible' type 1 VWD (patients with low levels of VWF adjusted for the blood group and either a significant bleeding history or family history) and 'definite' type 1 VWD, requiring low levels of von Willebrand factor (VWF), a bleeding history and inheritance. On reclassification, only 144/246 (59%) patients had low VWF levels adjusted for blood group, 88/246 (36%) patients met all the criteria for 'definite' type 1 VWD and 51/246 (21%) patients were 'possible' type 1 VWD. A significant proportion of patients, 102/246 (42%), remained an indeterminate group with blood type O, VWF levels between 35 and 50 U/dl and personal and/or family bleeding history. This subgroup might require reclassification as 'not VWD'. However, a similar bleeding tendency was found in two matched groups of patients of blood groups O and non-O and VWF levels between 35 and 50 U/dl. These results suggest that the use of ABO adjusted ranges for VWF levels might not be essential for diagnosis, because bleeding symptoms may depend on the VWF level regardless of the ABO type. Of the diagnostic criteria, the bleeding history was of prime importance in the clinical decision to diagnose and treat type 1 VWD. These observations could help in the reconsideration of how the criteria for diagnosing type 1 VWD could be adjusted in order to maximize their clinical relevance.

Renal transplantation across the ABO barrier using A2 kidneys

BACKGROUND

The waiting list for cadaveric kidney transplantation has continued to grow, and with the relative scarcity of cadaver donors, the median waiting time for patients in the United States increased to 824 days in 1994. The median waiting times for patients with blood groups B or O were 1329 and 1007 days, respectively. Allocation of blood group A2 kidneys (20% of group A) to blood group O and B patients expands their potential donor pool and shortens their waiting time for a kidney transplantation.

METHODS

Between May 1991 and June 1998, we transplanted 15 A2 kidneys into 6 blood group O and 9 blood group B patients. Anti-A isoagglutinins were measured before transplantation, and patients with anti-A1 titers > or = 1:8 underwent plasmapheresis (PP).

RESULTS

One patient with high titer anti-A antibodies, who did not receive PP, lost her allograft because of hyperacute rejection. Allograft function was excellent in the remaining 14 patients, with a mean serum creatinine level of 1.7 (+/-0.89) mg/dl at 1 month and 1.3 (+/-0.34) mg/dl at 1 year. The actuarial 1-year graft survival rate was 93.3+/-6.4% and the patient survival rate was 100%.

CONCLUSION

We conclude that the allocation of blood group A2 kidneys for blood group O and B recipients is a practical way to expand the donor pool for these transplant candidates. PP may be important for reducing the levels of anti-A1 and anti-A2 antibodies and for reducing the risk of hyperacute rejection. Splenectomy seems to be unnecessary.

Coagulation parameters of ABO group-specific cryosupernatant

Patients with thrombotic thrombocytopenic purpura that is refractory to conventional fresh frozen plasma (FFP) exchange therapy are sometimes switched to cryosupernatant as the replacement fluid, although its hemostatic properties are not well defined. We performed several key coagulation assays on three pools of four units from each of three ABO groups of cryosupernatant and FFP. Fibrinogen, factor VIII activity, and von Willebrand factor antigen (vWF:Ag) levels were all significantly lower in cryosupernatant compared with FFP, although at levels usually not considered clinically significant. We confirmed that group O FFP contained significantly less factor VIII activity and vWF:Ag compared with groups AB and B. In contrast to FFP, group AB cryosupernatant contained lower levels of fibrinogen, factor V activity, factor VIII activity, and vWF:Ag than groups O or B. Group AB cryosupernatant, with the lowest levels of vWF:Ag and universal ABO compatibility, may be the product of choice for refractory thrombotic thrombocytopenic purpura.

The effect of ABO and Rh blood type on the response to intravenous immune globulin (IVIG) in children with immune thrombocytopenic purpura (ITP)

PURPOSE

Immune thrombocytopenic purpura (ITP) is a common childhood illness characterized by thrombocytopenia secondary to shortened platelet survival. Medical therapy includes corticosteroids, intravenous immune globulin (IVIG), and IV Rho (D) immunoglobulin (anti-D). Individuals with Rh-negative blood generally do not respond to treatment with anti-D, but little information is currently available regarding the potential relationship between blood type and response to IVIG. This study was designed to characterize the relationship between ABO and Rh blood type and the response to IVIG in children and adolescents with newly diagnosed ITP.

PATIENTS AND METHODS

A retrospective chart review was performed for 52 children and adolescents with newly diagnosed ITP initially treated with IVIG by the Division of Pediatric Hematology-Oncology at Robert Wood Johnson University Hospital in New Brunswick, New Jersey.

RESULTS

There were no significant differences in response rate or clinical outcome by ABO blood group or Rh type in children with ITP who received IVIG monotherapy as their initial treatment.

CONCLUSIONS

ABO blood group and Rh type do not appear to be prognostic factors when IVIG monotherapy is the initial treatment for childhood ITP.

Histo-blood group A/B versus H status of human carcinoma cells as correlated with haptotactic cell motility: approach with A and B gene transfection

In a search for the molecular basis of ABH status of tumors as correlated with malignancy, we studied various malignancy-related phenotypes of high H/Le(y)-expressing tumor cell lines in comparison with phenotypes of the same lines transfected with histo-blood group A or B genes. A and B gene transfectants, prepared independently from different H-active parental cells, showed A or B activity and abolition of H activity. All A and B gene transfectants, regardless of source, were characterized by significantly reduced Matrigel-dependent haptotactic motility. The level of haptotaxis of all transfectants was similar to that of parental cells in the presence of antibodies against human integrin subunits alpha3, alpha6, or beta1. These subunits showed high expression of A or B epitope in the A and B gene transfectants. Enhancement versus reduction of malignancy, associated with deletion versus induction of A/B epitopes, may be due in part to enhanced haptotaxis sustained by alpha3, alpha6, and beta1 integrin receptors, the activities of which are regulated by H or A/B glycosylation. These phenotypic changes provide a rationale for the deletion of A and B epitopes as one criterion defining human tumor malignancy.

Role of ABO and Lewis blood group antigens in donor-recipient compatibility of corneal transplantation rejection

PURPOSE

There are conflicting results regarding the role of human leukocyte antigen (HLA) matching and ABO compatibility in corneal graft rejection for low- and high-risk patients. Lewis blood group antigens could be an important histocompatibility system. Beneficial effects of Lewis antigens matching have been reported in renal transplantation, but its effect is still unknown in corneal allografting.

METHODS

Between 1987 and 1993, ABO, Lewis and HLA phenotypes were determined in 697 consecutive grafts of corneal transplantations. The effect of Lewis matching on corneal endothelial rejection was evaluated over a 3-year period. Data analysis was done by plotting survival curves with the Kaplan-Meier method for survivorship data and performing statistical analysis with the log-rank test (Mantel-Haenszel test) for curve comparison.

RESULTS

In vascularized recipients, the ABO, Lewis, and HLA systems did not influence the graft outcome. However, for the unvascularized recipients, the endothelial 3-year rejection rate was significantly lower for both Lewis compatible patients (84% vs. 68%; log rank = 0.03) and HLA compatible patients (86% vs 72%; log rank = 0.001), but not for the ABO-matched patients (82% vs. 79%; log rank = 0.56).

CONCLUSIONS

The authors' study suggests that Lewis antigens and HLA matching could positively influence corneal graft survival for the unvascularized recipients, but it did not seem to have any effect in vascularized recipients.

[The significance of blood group-related antigen A in a pancreatic cell line (PGHAM-1) in hamsters. With special reference to cell proliferation]

The relationship between blood group-related antigen A and cell proliferation was studied in a pancreatic carcinoma cell line (PGHAM-1) induced by N-nitrosobis (2-oxopropyl) amine (BOP) in hamsters. In vitro, the cell proliferation of PGHAM-1 was inhibited in a culture medium with an added monoclonal antibody (MoAb) against blood group-related antigen A depending on its concentration. In in vivo experiments, immunohistochemical double staining was performed using MoAb against blood group-related antigen A and bromodeoxyuridine (BrdU) in pancreatic carcinomas by intrapancreatic transplantation of PGHAM-1. Antigen A was expressed in the cell membrane and cytoplasm of PGHAM-1 cells. The BrdU labeling index (LI) in lesions with strong expression of MoAb A (> or = 50%) was 27.4 +/- 5.00, whereas the BrdU LI in lesions with weak expression of MoAb A (< or = 10%) was 11.9 +/- 2.10. The mean LIs in strongly expressed lesions of MoAb A were higher than those in weakly expressed lesions of MoAb A (p < 0.01). These results indicated that antigen A might be associated with cell proliferation in pancreatic carcinomas induced in hamsters.

Characterization of the specificities of human blood group H gene-specified alpha 1,2-L-fucosyltransferase toward sulfated/sialylated/fucosylated acceptors: evidence for an inverse relationship between alpha 1,2-L-fucosylation of Gal and alpha 1,6-L-fucosylation of asparagine-linked GlcNAc

The assembly of complex structures bearing the H determinant was examined by characterizing the specificities of a cloned blood group H gene-specified alpha 1,2-L-fucosyltransferase (FT) toward a variety of sulfated, sialylated, or fucosylated Gal beta 1,3/4GlcNAc beta- or Gal beta 1,3GalNAc alpha-based acceptor structures. (a) As compared to the basic type 2, Gal beta 1,4GlcNAc beta-(K(m) = 1.67 mM), the basic type 1 was 137% active (K(m) = 0.83 mM). (b) On C-6 sulfation of Gal, type 1 became 142.1% active and type 2 became 223.0% active (K(m) = 0.45 mM). (c) On C-6 sulfation of GlcNAc, type 2 showed 33.7% activity. (d) On C-3 or C-4 fucosylation of GlcNAc, both types 1 and 2 lost activity. (e) Type 1 showed 70.8% and 5.8% activity, respectively, on C-6 and C-4 O-methylation of GlcNAc. (f) Type 1 retained 18.8% activity on alpha 2,6-sialylation of GlcNAc. (g) Terminal type 1 or 2 of extended chain had lower activity. (h) With Gal in place of GlcNAc in type 1, the activity became 43.2%. (i) Compounds with terminal alpha 1,3-linked Gal were inactive. (j) Gal beta 1,3GalNAc alpha- (the T-hapten) was approximately 0.4-fold as active as Gal beta 1,4GlcNAc beta-. (k) C-6 sulfation of Gal on the T-hapten did not affect the acceptor activity. (l) C-6 sulfation of GalNAc decreased the activity to 70%, whereas on C-6 sulfation of both Gal and GalNAc the T-hapten lost the acceptor ability. (m) C-6 sialylation of GalNAc also led to inactivity. (n) beta 1,6 branching from GalNAc of the T-hapten by a GlcNAc residue or by units such as Gal beta 1, 4GlcNAc-, Gal beta 1,4(Fuc alpha 1,3)GlcNAc-, or 3-sulfoGal beta 1,4GlcNAc- resulted in 111.9%, 282.8%, 48.3%, and 75.3% activities, respectively. (o) The enhancement of enzyme affinity by a sulfo group on C-6 of Gal was demonstrated by an increase (approximately 5-fold) in the K(m) for Gal beta 1,4GlcNAc beta 1,6(Gal beta 1,3)GalNAc alpha-O-Bn in presence of 6-sulfoGal beta 1,- 4GlcNAc beta-O-Me (3.0 mM). (p) Among the two sites in Gal beta 1, 4GlcNAc beta 1,6(Gal beta 1,3) GalNAc alpha-O-Bn, the enzyme had a higher affinity ( > 3-fold) for the Gal linked to GlcNAc. (q) With respect to Gal beta 1,- 3GlcNAc beta-O-Bn (3.0 mM), fetuin triantennary asialo glycopeptide (2.4 mM), bovine IgG diantennary glycopeptide (2.8 mM), asialo Cowper's gland mucin (0.06 mM), and the acrylamide copolymers (0.125 mM each) containing Gal beta 1,3GlcNAc beta-, Gal beta 1,3(6-sulfo)GlcNAc beta-, Gal beta 1,3GalNAc alpha-, Gal beta 1,3Gal beta-, or Gal alpha 1,3Gal beta- units were 153.6%, 43.0%, 6.2%, 52.5%, 94.9%, 14.7%, 23.6%, and 15.6% active, respectively. (r) Fucosylation by alpha 1,2-L-FT of the galactosyl residue which occurs on the antennary structure of the bovine IgG glycopeptide was adversely affected by the presence of an alpha 1,6-L-fucosyl residue located on the distant glucosaminyl residue that is directly attached to the asparagine of the protein backbone. This became evident from the 4-fold activity of alpha 1,2-L-FT toward bovine IgG glycopeptide after approximately 5% removal of alpha 1,6-linked Fuo.

Effects of anticoagulant, serum, and temperature on the natural killer activity of human peripheral blood mononuclear cells stored overnight

The effects of immediate versus delayed cell separation, storage temperature, presence of serum, and type of anticoagulation on the natural killer (NK) cytotoxicity of human mononuclear cells were assessed. The NK cytotoxicity of Ficoll-Hypaque-separated peripheral blood mononuclear cells (PBMC) was tested in a 3-h chromium-51 release assay with K562 cells at various effector/target cell ratios. The NK activities of PBMC from blood anticoagulated with either heparin or EDTA and then immediately separated and assayed were not different (42.9 +/- 2.5% for heparin and 40.3 +/- 4.6% for EDTA). When these separated cells were cultured in medium with 10% fetal calf serum and stored at 4,25, or 37 degrees C for 18 h before the assay, there was a significant increase in cytotoxicity. PBMC from blood stored in heparin or EDTA for 18 h before separation had reduced NK cytotoxicity, particularly if they were kept at 37 degrees C. When separated PBMC were cultured in medium with 10% human AB serum, however, samples held at 25 and 37 degrees C decreased in cytotoxicity but samples held at 4 degrees C maintained the cytotoxicity demonstrated at the baseline level with fresh cells. We recommend that heparinized blood be used for NK assays and that the PBMC be isolated immediately and held overnight at 4 degrees C in medium with 10% AB serum if the assay must be delayed. The NK cytotoxicity under these storage conditions most closely matches the results obtained when the PBMC are isolated and tested on the same day. IF PBMC isolation must also be postponed, it is best to store the blood in heparinized tubes at 25 degrees C to prevent loss of cytotoxic function.