Saturday, November 28, 2015

ABH-glycan microarray characterizes ABO subtype antibodies: fine specificity of immune tolerance after ABO-incompatible transplantation

Organ transplantation from ABO blood group-incompatible (ABOi) donors requires accurate detection, effective removal and subsequent surveillance of anti-donor antibodies. Because ABH antigen subtypes are expressed differently in various cells and organs, measurement of antibodies specific for the antigen subtypes in the graft is essential. Erythrocyte agglutination, the century-old assay used clinically, does not discriminate subtype-specific ABO antibodies and provides limited information on antibody isotypes. We designed and created an ABO-glycan microarray and demonstrate here the precise assessment of the presence and, importantly, the absence of donor-specific antibodies in an international study of pediatric heart transplant patients. Specific IgM, IgG and IgA isotype antibodies to non-self ABH-subtypes were detected in controls and recipients of ABO-compatible (ABOc) transplants. Conversely, in children who received ABOi transplants, antibodies specific for A-subtype-II and/or B-subtype-II antigens, the only ABH antigen subtypes expressed in heart tissue, were absent, demonstrating the fine specificity of B-cell tolerance to donor/graft blood group antigens. In contrast to the hemagglutination assay, the ABO-glycan microarray allows detailed characterization of donor-specific antibodies necessary for effective transplant management, representing a major step forward in precise ABO antibody detection (read more) Print this post

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