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Prophylactic anti‐ D preparations display variable decreases in F c‐fucosylation of anti‐ D
Author(s) -
Kapur Rick,
Della Valle Luciana,
Verhagen Onno J.H.M.,
Hipgrave Ederveen Agnes,
Ligthart Peter,
Haas Masja,
Kumpel Belinda,
Wuhrer Manfred,
Schoot C. Ellen,
Vidarsson Gestur
Publication year - 2015
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12880
Subject(s) - fucosylation , antibody , opsonin , immunoglobulin g , glycosylation , medicine , immunization , chemistry , fucose , immunology , andrology , pharmacology , glycoprotein , biochemistry
Background RhIG is obtained from hyperimmunized healthy anti‐ D donors ( HIDs ) boosted with D + red blood cells ( RBC s). One hypothesis for its mechanism of action is fast clearance of opsonized D + RBCs through F cγ receptor ( FcγR ) III . Levels of immunoglobulin ( Ig ) G F c‐fucosylation influence interactions with FcγRIII , with less F c‐fucosylation strengthening the interaction. Study Design and Methods Anti‐ D IgG 1 F c‐glycosylation patterns in 93 plasma samples from 28 male and 28 female D utch HID s and RhIG were analyzed with mass spectrometry. The F c‐glycosylation profiles of HID s were evaluated with regard to their immunization history. Results HID sera demonstrated clearly lowered anti‐ D F c‐fucosylation compared to normal IgG fucosylation (93%); this was more pronounced for female than for male HID s (47% vs. 65%, p = 0.001). RhIG preparations from seven manufacturers varied greatly in the level of F c‐fucosylation (56%‐91%). The level of fucosylation slightly increased upon repeated immunization, although it remained fairly constant over time. The RhIG from the different manufacturers all demonstrated increased F c‐galactosylation (64%‐82%) compared to total IgG (38%‐51%). Conclusion RhIG preparations vary in F c‐fucosylation and all demonstrate increased galactosylation. Despite not knowing the exact working mechanism, immunoprophylaxis could perhaps be optimized by selection of donors whose anti‐ D have low amounts of F c‐fucose, to increase the clearance activity of anti‐ D preparations, as well as high amounts of galactosylation, for anti‐inflammatory effects. Implementing a biologic assay in the standardization of RhIG preparations might be considered.