title: Chemical Basis for Qualitative and Quantitative Differences Between ABO Blood Groups and Subgroups: Implications for Organ Transplantation.
abstract: Blood group ABH(O) carbohydrate antigens are carried by precursor structures denoted type I-IV chains, creating unique antigen epitopes that may differ in expression between circulating erythrocytes and vascular endothelial cells. Characterization of such differences is invaluable in many clinical settings including transplantation. Monoclonal antibodies were generated and epitope specificities were characterized against chemically synthesized type I-IV ABH and related glycans. Antigen expression was detected on endomyocardial biopsies (n = 50) and spleen (n = 11) by immunohistochemical staining and on erythrocytes by flow cytometry. On vascular endothelial cells of heart and spleen, only type II-based ABH antigens were expressed; type III/IV structures were not detected. Type II-based ABH were expressed on erythrocytes of all blood groups. Group A1 and A2 erythrocytes additionally expressed type III/IV precursors, whereas group B and O erythrocytes did not. Intensity of A/B antigen expression differed among group A1 , A2 , A1 B, A2 B and B erythrocytes. On group A2 erythrocytes, type III H structures were largely un-glycosylated with the terminal "A" sugar α-GalNAc. Together, these studies define qualitative and quantitative differences in ABH antigen expression between erythrocytes and vascular tissues. These expression profiles have important implications that must be considered in clinical settings of ABO-incompatible transplantation when interpreting anti-ABO antibodies measured by hemagglutination assays with reagent erythrocytes.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.|Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.|Canadian National Transplant Research Program, Edmonton, Alberta, Canada.|Alberta Transplant Institute, Edmonton, Alberta, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Jeyakanthan
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.|Alberta Transplant Institute, Edmonton, Alberta, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Tao
authors.affiliation: Alberta Glycomics Centre, Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Zou
authors.affiliation: Alberta Glycomics Centre, Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: P J
authors.initials: PJ
authors.lastname: Meloncelli
authors.affiliation: Alberta Glycomics Centre, Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: T L
authors.initials: TL
authors.lastname: Lowary
authors.affiliation: Alberta Diabetes Institute Molecular Biology Core, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Southern Alberta Cancer Research Institute Antibody Services, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Boland
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.|Alberta Transplant Institute, Edmonton, Alberta, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Larsen
authors.affiliation: Pediatric Cardiology, Great Ormond Street Hospital, London, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Burch
authors.affiliation: Pediatric Cardiology, Great Ormond Street Hospital, London, United Kingdom.
authors.forename: N
authors.initials: N
authors.lastname: Shaw
authors.affiliation: Division of Pediatric Cardiology, Columbia University, New York.
authors.forename: K
authors.initials: K
authors.lastname: Beddows
authors.affiliation: Division of Pediatric Cardiology, Columbia University, New York.
authors.forename: L
authors.initials: L
authors.lastname: Addonizio
authors.affiliation: Division of Pediatric Cardiology, Columbia University, New York.
authors.forename: W
authors.initials: W
authors.lastname: Zuckerman
authors.affiliation: Department of Laboratory Medicine and Pathology, Edmonton, Alberta, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Afzali
authors.affiliation: Alberta Transplant Institute, Edmonton, Alberta, Canada.|Division of Medicine, Department of Cardiology, University of Alberta, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: D H
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Canadian National Transplant Research Program, Edmonton, Alberta, Canada.|Alberta Transplant Institute, Edmonton, Alberta, Canada.|Department of Laboratory Medicine and Pathology, Edmonton, Alberta, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Mengel
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.|Canadian National Transplant Research Program, Edmonton, Alberta, Canada.|Alberta Transplant Institute, Edmonton, Alberta, Canada.
authors.forename: A M J
authors.initials: AM
authors.lastname: Shapiro
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.|Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.|Canadian National Transplant Research Program, Edmonton, Alberta, Canada.|Alberta Transplant Institute, Edmonton, Alberta, Canada.|Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: L J
authors.initials: LJ
authors.lastname: West
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D042783:Endothelial Cells / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System
keywords: ABO incompatibility; alloantibody; alloantigen; antigen biology