Original article

Blood Transfusion - 5 2019 (September-October)

Transfused platelets enhance alloimmune responses to transfused KEL-expressing red blood cells in a murine model

Authors

Key words: red blood cells, platelets, antibodies
Publication Date: 2018-11-07

Abstract

Background. Factors influencing the development of alloantibodies against blood group antigens on transfused red blood cells are poorly defined. We hypothesised that transfused platelets may act as a danger signal to recipients and affect humoral immune responses to transfused red blood cells.
Materials and methods. Platelet-rich plasma prepared from wild-type C57BL/6 or CD40L knock-out donors was transfused into wild-type or CD40L knock-out recipients. Leucoreduced red blood cells from transgenic donors expressing high levels of the human KEL glycoprotein in an erythrocyte-specific manner (KELhi donors) were transfused after the platelets, and anti-KEL responses were measured longitudinally. In some experiments, recipients were treated with poly (I:C), monoclonal CD40L-blocking antibody, or CD4-depleting antibody prior to transfusion.
Results. Transfusion of wild-type C57BL/6 platelets or treatment with poly (I:C) prior to KELhi red blood cell transfusion led to an anti-KEL alloimmune response in wild-type recipients. Transfusion of platelets from wild-type but not CD40L knock-out donors prior to KELhi red blood cell transfusion led to an IgG anti-KEL alloimmune response in CD40L knock-out recipients; unexpectedly, transfusion of platelets from CD40L knock-out donors prior to KELhi red blood cell transfusion led to a robust anti-KEL alloimmune response in wild-type recipients. Recipient treatment with MR1 CD40L-blocking antibody or CD4-depleting antibody prevented KEL alloimmunisation altogether.
Discussion. Transfused platelets serve as an adjuvant in this T-dependent murine model of anti-KEL red blood cell alloimmunisation, with CD40/CD40L interactions being involved to some degree but with additional mechanisms also playing a role. These findings raise questions about the role that transfused or endogenous platelets may play in other innate/adaptive immune responses.

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Authors

David J. Madrid - Yale University School of Medicine, Department of Pediatrics, New Haven, CT, Unites States of America

Manjula Santhanakrishnan - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America

Jingchun Liu - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America

David R. Gibb - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America

Dong Liu - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America

Prabitha Natarajan - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America

Daniel Beitler - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of Americ

Zhimin Shi - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America; Nanfang Hospital of Southern Medical University, Department of Blood Transfusion, Guangzhou, Guangdong, China

Chunyan Mo - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America; Institute of Clinical Transfusion, Guangzhou Blood Centre, Guangzhou, China

Christopher A. Tormey - Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America; VA Connecticut Healthcare System, Pathology and Laboratory Medicine Service, West Haven, CT, Unites States of America

Seema R. Patel - Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, GA, Unites States of America

Sean R. Stowell - Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Atlanta, GA, Unites States of America

Jeanne E. Hendrickson - Yale University School of Medicine, Department of Pediatrics, New Haven, CT, Unites States of America; Yale University School of Medicine, Department of Laboratory Medicine, New Haven, CT, Unites States of America

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