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C Mueller-Eckhardt

Publications and source records attributed to C Mueller-Eckhardt.

At least 37 records · Page 2Linked to original sources

New polymorphism on platelet glycoprotein IIIa gene recognized by endonuclease Msp I: implications for PlA typing by allele-specific restriction analysis.

BACKGROUND: Five human platelet alloantigen systems have been shown to result from single base pair substitutions in encoding regions of platelet glycoprotein genes IIIa, Ib, IIb, and Ia. For each of the diallelic systems, at least one restriction enzyme is known to cut only one of the two haplotypes. In the PlA system, restriction endonucleases Nci I and Msp I both recognize the PlA2 allele. STUDY DESIGN AND METHODS: A causal observation of an unexpected Msp I restriction pattern of a PlA2/PlA2 individual was made. Samples from 261 blood donors were then typed for antigens of the PlA system by restriction fragment length polymorphism analysis using the Nci I and Msp I restriction enzymes. RESULTS: Applying both enzymes, concordant restriction patterns were found in 258 of 261 blood donors. Three donors had a base pair mutation on the PlA2 allele, which creates an additional restriction site for Msp I 20 base pairs downstream from the PlA polymorphic site. Nucleotide sequence analysis revealed a CT217-->CG217G base exchange resulting in a Leu40-->Arg40 polymorphism of glycoprotein IIIa. CONCLUSION: Presuming that the mutation is not a singular phenomenon and also occurs with the PlA1 haplotype, it could lead to false interpretations of restriction analysis with Msp I. To exclude that possibility, Nci I is preferred for restriction fragment length polymorphism typing in the PlA system.

Antigens, Human Platelet↗

Alloimmune neonatal neutropenia resulting from immunization to a high-frequency antigen on the granulocyte Fc gamma receptor III.

BACKGROUND: Alloimmune neonatal neutropenia is mainly caused by NA- or NB1-specific alloantibodies. An antibody in the serum of a Turkish mother who had given birth to an infant with alloimmune neonatal neutropenia showed no NA or NB specificity and was therefore investigated further. STUDY DESIGN AND METHODS: The number of antibody-binding sites was calculated by determination of elutable IgG from granulocytes using a quantitative sandwich enzyme-linked immunosorbent assay. Complement activation was tested by immunofluorescence (C3d) and cytotoxicity tests. The antigen was identified using the antigen-capture assay, monoclonal antibody-specific immobilization of granulocyte antigens, and a modified immunoprecipitation method based upon biotinylation of proteins and visualization by luminescence (luminoimmunoprecipitation). Family study and determination of antigen frequency were done by immunofluorescence and agglutination tests. RESULTS: A noncytotoxic, granulocyte-specific alloantibody that recognized the Fc gamma receptor III, independent of the NA phenotype, was detected, and 242,000 binding sites per cell were calculated. Of granulocytes from 150 randomly selected German blood donors, the alloantibody bound to all. The maternal cells were typed NA1/NA2- and NB1-positive. CONCLUSION: These data reveal the presence of a previously unrecognized, high-frequency epitope on the granulocyte Fc gamma receptor III. Luminoimmunoprecipitation proved to be a simple, nonradioactive technique that was useful in identifying the molecule involved.

Antigens↗

Typing of the granulocyte-specific NA antigens by restriction fragment length polymorphism analysis.

An RNA-based method has been developed to genotype donors for the granulocyte-specific alloantigens NA1 and NA2. mRNA was isolated from granulocytes, reversely transcribed into cDNA and amplified using an Fc-gamma-receptor III-1 sequence-specific primer in the polymerase chain reaction (PCR). PCR products were analysed by restriction fragment length polymorphism (RFLP) using the restriction endonuclease Taq I, which provided a distinct restriction fragment pattern corresponding to the NA alleles. 17 donors were typed by PCR-RFLP and the results were in close accordance with those obtained by serological phenotyping by granulocyte immunofluorescence and the antigen capture assay MAIGA.

Antigens, Surface↗

Maternal intravenous immunoglobulin treatment does not prevent intracranial haemorrhage in fetal alloimmune thrombocytopenia.

In fetal alloimmune thrombocytopenia (FAIT) the fetus is threatened by intracranial haemorrhage (ICH); therefore early diagnostic and therapeutic intervention is required. We followed the clinical course of a 30-year-old woman during her fifth pregnancy after she had given birth to a child with alloimmune thrombocytopenia due to anti-Zwa. The fetus was monitored by 13 fetal blood samplings (FBS) always followed by transfusion of either maternal or compatible donor platelets. Intravenous immunoglobulin (ivIg) treatment of the mother was begun at 20 weeks of gestation when the fetal platelet count was 36 x 10(9)/l. The fetal platelets were typed Zwa positive by DNA analysis. Despite 11 weeks of maternal ivIg treatment fetal platelet counts progressively declined to 6 x 10(9)/l and ICH occurred. Subsequently, the fetus was successfully managed by intrauterine platelet transfusions at shorter intervals (3-5 days) and elective Cesarean section was carried out at 35 weeks of gestation. We conclude that maternal ivIg treatment does not prevent ICH in FAIT. The treatment of choice for severely affected cases is serial FBS combined with transfusion of compatible platelets.

Antigens, Human Platelet↗

Localization of the Br polymorphism on a 144 bp exon of the GPIa gene and its application in platelet DNA typing.

Alloimmunization against the human platelet alloantigen system Br (HPA-5) is the second most common cause of neonatal alloimmune thrombocytopenia (NAIT) in Caucasian populations. We have recently shown that a single base polymorphism at position 1648 on platelet mRNA coding for GPIa results in an aminoacid substitution at position 505 on the mature GPIa which is associated with the two serological defined Br phenotypes. Since DNA-typing of platelet alloantigens offers possibilities for useful clinical applications, we designed genomic DNA-based restriction fragment length polymorphism (RFLP) typing for Br alloantigens. To establish this technique we analyzed the genomic organization of GPIa adjacent to the polymorphic base. Using the polymerase chain reaction (PCR) of blood cell DNA we have identified two introns (approximately 1.7 and 1.9 kb) flanking a 144 bp coding sequence of the GPIa gene encompassing the polymorphic base 1648. Based on the intron sequence, a PCR primer was constructed to amplify a 274 bp fragment which was used for allele-specific RFLP to determine the Br genotypes. The results of RFLP analysis using MnlI endonuclease obtained from 15 donors (2 Bra/a, 2 Bra/b and 11 Brb/b) correlate perfectly with serological typing by monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay.

Base Sequence↗

Heparin-associated thrombocytopenia: the effects of various intravenous IgG preparations on antibody mediated platelet activation--a possible new indication for high dose i.v. IgG.

The immunologic type of heparin-associated thrombocytopenia (HAT) is caused by antibodies which activate platelets via the Fc-receptor in the presence of polysulfated oligosaccharides. The antigen is formed by a releasable platelet protein (in many cases PF4) complexed to heparin. Since the role of GP IIb/IIIa in platelet activation by HAT antibodies is controversial, we investigated platelet activation by antibodies related to HAT. We used normal platelets and platelets from a patient with Glanzmann's thrombasthenia (GT) lacking GP IIb/IIIa. Heparin and sera from patients with HAT stimulated GT platelets in the same manner as determined by 14C-serotonin release and the changes in phosphorylation of p20 and p47. Platelet activation could be inhibited by an anti FcRII monoclonal antibody (IV. 3, Fab-fragments), and by Fc-fragments, but not by F(ab')2-fragments of human IgG. The effect of four different, commercially available preparations of intact i.v. IgG on the platelet activation by six HAT sera was investigated by 14C-serotonin release. The inhibitory effect was strongly dependent upon the manufacturing process. At a concentration of 20 mg/ml only IgG that had been subjected to low pH and traces of pepsin sufficiently inhibited platelet activation. IgG treated with polyethylenglycol or sulfitolysis was less effective, whereas beta-propiolactone-treated IgG almost completely lost the ability to inhibit platelet activation by antibodies related to HAT. We conclude that inhibition of GP IIb/IIIa-fibrinogen interaction is insufficient for preventing platelet activation in HAT.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Heparin-associated thrombocytopenia: isolation of the antibody and characterization of a multimolecular PF4-heparin complex as the major antigen.

Sera of 34 patients with heparin-associated thrombocytopenia (HAT), giving a positive result in the serotonin release assay (SRA), were assessed in a platelet factor 4 (PF4)/heparin ELISA. Three sera revealing indeterminate results in the SRA and 10 control sera were also investigated. Both tests correlated closely (Kappa 0.742; p = 2.67 x 10(-7)), but one positive serum in the SRA was negative in the pF4/heparin ELISA. We have isolated the HAT antibodies by absorbtion and elution of HAT sera using endothelial cells (HUVEC). Eluates gave similar results as the sera in the PF4/heparin ELISA (Kappa 0.837, p = 9.26 x 10(-9)), and they also correlated very closely with the SRA (Kappa 0.888; p = 8.89 x 10(-10)). This demonstrates that HAT antibodies bind to the same epitope on platelets and on endothelial cells. High heparin concentrations released PF4 in a dose dependent manner from microtiter plates if PF4/heparin, but not if PF4 alone, was covalently linked. Concomitant to the release of PF4, binding of HAT antibodies to PF4/heparin decreased, as indicated by the median optical density (OD) values of OD 0.88 in the presence of buffer compared to OD 0.181 in the presence of 100 IU/ml heparin. The latter values were similar to those obtained when plates were coated with PF4 alone (median OD 0.203). Binding of three eluates was not inhibited by high heparin concentrations and they reacted also with PF4 alone. We conclude that multimolecular PF4/heparin complexes represent the major antigen in HAT. These multimolecular complexes might present several epitopes and form immune complexes after HAT antibody binding which activate platelets via the FcRII. In a few cases, PF4 alone can be recognized by the antibody. However, there is also evidence that other molecules might be involved in some patients.

Antibodies↗

[Fc receptor-dependent platelet activation results independently of glycoprotein complex IIb/IIIa].

Platelets of a patient with Glanzmann's thrombasthenia revealed the same activation pattern when stimulated with antibodies of patients with heparin-associated thrombocytopenia (HAT) or immune complexes. This was investigated by the 14C-serotonin release test and by changes in phosphorylation of p20 and p47. Platelet activation by HAT antibodies was completely inhibited by a moab against the platelet FcRII (IV. 3) and by Fc fragments of human IgG but not by F(ab)2 fragments. We conclude that platelet activation via the FcRII occurs independently of the glycoprotein complex IIb/IIIa. Therapeutical approaches targeting GP IIb/IIIa-fibrinogen interaction seem to be not appropriate in HAT.

Blood Platelets↗

[Suppression of FcRII by intravenously administerd IgG is dependent of preparation procedures of immunoglobulins].

The effect of different i.v. IgG preparations on FcRII-dependent platelet activation by antibodies from patients with heparin-associated thrombocytopenia (HAT) was investigated. Only one preparation (treated with pH 4 and traces of pepsin) sufficiently inhibited FcRII-dependent platelet activation (20 mg/ml). We conclude that administration of high-dose i.v. IgG is efficient for acute treatment of HAT, dependent on the manufacturing process.

Heparin↗

[Comparison of serologic typing and DNA typing of platelet alloantigens].

Platelet alloantigens of the Zw, Ko, Bak und Br systems were determined by restriction fragment length polymorphism (RFLP) analysis of appropriate PCR products in 98 unselected patients. Results were compared with serological typing by monoclonal antibody immobilization of platelet antigens (MAIPA) and platelet agglutination.

Agglutination Tests↗

[Molecular biologic clarification of Br alloantigens in human platelets and its application in DNA typing].

Alloimmunization against the platelet alloantigen Br (HPA-5) is the second most common cause of neonatal alloimmune thrombocytopenia (NAIT) in Caucasian populations. We have recently shown that a single-base polymorphism at position 1648 on platelet mRNA coding for GPIa results in an amino acid substitution at position 505 on the mature glycoprotein Ia which is associated with the two serologically defined Br phenotypes. To establish DNA-based genotyping for the Br system we elucidated the genomic organization of the GPIa gene adjacent to the polymorphic base. Using PCR of blood cell DNA we have identified a 144 bp exon encoding the Br polymorphic base. A PCR primer based on the 3' intron sequence of this exon in combination with an exon-primer was used to amplify a 274 bp fragment of the GPIa gene. Restriction analysis using the endonuclease Mnl I leads to a Br-specific restriction fragment length polymorphism (RFLP) which perfectly correlates with serological phenotyping.

Antigens, Human Platelet↗

[A single base substitution is responsible for the origin of "private" platelet Sra antigens affects molecular weight polymorphism of glycoproteins IIIa].

Some of the genetic polymorphisms of the platelet membrane glycoproteins (GP) IIIa are known to be responsible for alloantibody formation (Zw, Yuk). These antibodies may be involved in neonatal alloimmune thrombocytopenia, posttransfusion purpura, and sometimes in the state of refractoriness to platelet transfusion. Recently we described the first 'private' alloantigen on platelets residing on the 66-kDa membrane-bound fragment of GP IIIa. Further molecular genetic studies showed that the Sr polymorphism is associated with a C to T substitution at base 2004 in the GP IIIa gene resulting in an Arg/Cys amino acid dimorphism at position 636. Transfection of COS cells with recombinant forms of GP IIIa cDNA demonstrated that this amino acid dimorphism is responsible for the formation of the Sra epitope. Furthermore, the Sra variant of GP IIIa showed a slightly increased molecular weight which is presumably caused by different glycosylation.

Antigens, Human Platelet↗

[RNA typing of granulocyte NA antigens by means of PCR-RFLP analysis].

An RNA-based method was developed for genotyping of the granulocyte-specific alloantigens NA1 and NA2, mRNA was isolated from neutrophils and reversely transcribed into cDNA. To avoid coamplification of Fc-gamma receptor III-2 in the polymerase chain reaction (PCR), a Fc-gamma receptor III-1 sequence-specific primer was employed. Restriction analysis using Taq I led to NA-specific restriction fragment length polymorphism (RFLP) of PCR-amplified cDNA. The results of the PCR-RFLP typing were in good concordance with serological phenotyping by granulocyte immunofluorescence test and the antigen capture assay MAIGA.

Granulocytes↗

[Immunoassays for determination of glycoprotein specificity, serum quantitation and determination of binding sites of granulocyte antibodies].

For the characterization of granulocyte antibodies an antigen capture assay and a method based upon quantitative determination of eluted IgG were developed. These assays allowed the quantitation of granulocyte antibodies in sera, the determination of their binding sites and their glycoprotein specificity, and the identification of NA-specific antibodies in sera containing mixtures of granulocyte antibodies.

Antibodies, Monoclonal↗

[Two modifications of MAIPA assays for the demonstration of platelet antibodies].

The monoclonal antibody immobilization of platelet antigens assay (MAIPA), published in 1987, is now used by many laboratories for detection of platelet antibodies. False-positive results were observed with sera containing anti-mouse IgG and in cases where MAIPA was employed to characterize platelet-specific antibodies of the IgM class. Modifications of MAIPA which completely eliminate these artifacts are described.

Animals↗

[Anti Ko(a) as a cause of neonatal alloimmune thrombocytopenia].

Neonatal alloimmune thrombocytopenia (NAIT) is caused by maternal immunization against a paternal antigen on fetal platelets. The antigens mostly involved are Zwa (PlA1) and Br(a). The Ko alloantigen system which is localized on the N-terminal region of glycoprotein Ib usually causes antibody formation in polytransfused patients but is only rarely implicated in NAIT. Ko(a) antibodies raised in the mother of a thrombocytopenic newborn were shown to be detectable by platelet agglutination and MAIPA assay if the antigen-bearing N-terminal glycocalicin is protected from proteolytic degradation.

Antigens, Human Platelet↗