title: Irregular antibodies in no hemolytic autoimmune diseases are able to induce erythrophagocytosis.
abstract: Irregular antibodies are produced by alloimmunization because of pregnancies or blood transfusions. They are called "irregular" due to target erythrocyte antigens from "rare blood systems," those different from the ABO system. Irregular antibodies have been widely investigated in immunohematology since their presence in blood donors may lead to difficulties in blood typing and in blood cross-matching, or to induce hemolytic transfusion reactions. Nevertheless, their incidence and participation in the physiopathology of autoimmune diseases have not been thoroughly studied. In this work, we analyzed the presence and pro-hemolytic capabilities of irregular antibodies in patients with different autoimmune diseases lacking signs of hemolytic anemia, in comparison with healthy multiparous women. Five of 141 autoimmune patients (3.5 %) and two of 77 multiparous women (2.6 %) were positive. Although frequency was relatively low and similar in both populations, the targeted antigens were Kell (k, Kpb, Jsb) and Luth (Lub) in multiparous women, and the same plus Duffy (Fya), Kidd (Jka) and MNS (M, s) in autoimmune patients. Irregular antibodies from autoimmune patients did not induce complement-mediated hemolysis (intravascular), but they were able to induce macrophages-mediated phagocytosis (extravascular hemolysis) in vitro. It is the first approach exploring the presence of irregular antibodies associated with the loss of immune tolerance and demonstrating their hemolytic potential in autoimmune patients without hemolytic manifestations. The presence of irregular antibodies targeted to Duffy (Fya), Kidd (Jka) and MNS (M, s) antigens only in autoimmune patients suggests a loss of immune tolerance to these erythrocyte antigens.
authors: Chemical Sciences Faculty, Autonomous University "Benito Juárez" of Oaxaca, Av. Universidad s/n, ex-hacienda de cinco señores, Oaxaca City, Oaxaca, Mexico.
authors: Paola Ester
authors: PE
authors: López-Díaz
authors: Blood Bank and Laboratory, Number 1 Regional Hospital, Social Security Mexican Institute, Oaxaca City, Oaxaca, Mexico.
authors: María Del Rocío
authors: MDR
authors: Ruiz-Olivera
authors: Chemical Sciences Faculty, Autonomous University "Benito Juárez" of Oaxaca, Av. Universidad s/n, ex-hacienda de cinco señores, Oaxaca City, Oaxaca, Mexico.
authors: Luis Alberto
authors: LA
authors: Hernández-Osorio
authors: Chemical Sciences Faculty, Autonomous University "Benito Juárez" of Oaxaca, Av. Universidad s/n, ex-hacienda de cinco señores, Oaxaca City, Oaxaca, Mexico.
authors: Jaime
authors: J
authors: Vargas-Arzola
authors: Medicine and Surgery Faculty, Autonomous University "Benito Juárez" of Oaxaca, Oaxaca City, Oaxaca, Mexico.
authors: Xareni
authors: X
authors: Valle-Jiménez
authors: Medicine and Surgery Faculty, Autonomous University "Benito Juárez" of Oaxaca, Oaxaca City, Oaxaca, Mexico.
authors: Sergio Roberto
authors: SR
authors: Aguilar-Ruiz
authors: Chemical Sciences Faculty, Autonomous University "Benito Juárez" of Oaxaca, Av. Universidad s/n, ex-hacienda de cinco señores, Oaxaca City, Oaxaca, Mexico. qbhonorio@hotmail.com.
authors: Honorio
authors: H
authors: Torres-Aguilar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000941:Antigens / Q000276:immunology; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D001327:Autoimmune Diseases / Q000097:blood* / Q000276:immunology*; D003165:Complement System Proteins; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D006461:Hemolysis; D006801:Humans; D008875:Middle Aged; D010587:Phagocytosis
chemical_list: D000941:Antigens; D001323:Autoantibodies; D003165:Complement System Proteins
keywords: Anti-erythrocyte autoantibodies; Autoimmune diseases; Extravascular hemolysis; Hemolytic anemia