Mechanisms of immune haemolysis: cell-dependent destruction of autologous red blood cells in penicillin-induced haemolytic anaemia.
The mechanisms of red blood cell destruction in 2 patients with penicillin-induced immune haemolytic anaemia were investigated. Anti-penicillin antibodies of the IgG subclass were found in the patients' sera and in the eluates of their direct antiglobulin positive red blood cells. Using a rapid 51Cr in vitro assay it was shown that fresh peripheral blood mononuclear phagocytes and granulocytes but not lymphocytes from both patients lysed and phagocytosed autologous red blood cells previously treated in vivo or in vitro by penicillin and autologous anti-penicillin antibody. Antibody-dependent cell-mediated cytotoxicity (ADCC) as well as antibody-dependent phagocytosis (ADPh) were proportional to serum concentration and to the number of attacking cells. Anti-penicillin antibody from 1 patient activated the complement system in vitro but failed to induce lysis of penicillin-treated red blood cells in the presence of complement. These results suggest that ADCC as well as ADPh participate in the destruction of red blood cells in penicillin-induced haemolysis in vivo.
D000328:Adult; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D000920:Antibody-Dependent Cell Cytotoxicity; D003298:Coombs Test; D004306:Dose-Response Relationship, Immunologic; D004912:Erythrocytes / Q000187:drug effects / Q000276:immunology / Q000502:physiology; D005260:Female; D006461:Hemolysis; D006801:Humans; D007106:Immune Sera / Q000494:pharmacology; D008297:Male; D009000:Monocytes / Q000276:immunology / Q000502:physiology; D010400:Penicillin G / Q000009:adverse effects* / Q000276:immunology; D010587:Phagocytosis
D007106:Immune Sera; D010400:Penicillin G