Brief report

Vol. 22 No. 2 (2024): Blood Transfusion 2-2024 (March-April)

Use of a recombinant deacetylase to convert A1 red blood cells to the acquired B phenotype for quality control purposes

Authors

Key words: ABO blood group, erythrocyte, acquired B phenotype, deacetylase, blood group serology
Publication Date: 2023-09-20

Abstract

Background - Correct blood group typing is the cornerstone of transfusion medicine. In patients whose gastrointestinal wall is compromised, bacterial enzymes can cause deacetylation of blood group A, converting N-acetylgalactosamine to galactosamine, which resembles the B-defining galactose. This acquired B (acqB) phenomenon, first described 1959, can lead to blood grouping errors. Herein, we explore the possibility of producing acqB red blood cells (RBCs) by enzymatic conversion, for quality control purposes.
Materials and methods - A1 RBCs along with group B and O control RBCs were subjected to enzymatic digestion by bacterially derived deacetylase, FpGalNAcDeAc. RBCs were tested with monoclonal anti-A, anti-B, acquired-B-reactive anti-B (ES4 clone), and a panel of donor plasmas. Standard serological techniques were used. RBCs were subsequently frozen by a glycerolisation method, stored at −80 oC, and thawed for testing to evaluate stability.
Results - Specific deacetylation of A antigen was achieved at both enzyme concentrations. Enzymatically modified A1 RBCs reacted 1-3+ with clone ES4 but not with other anti-B reagents. Group B and O RBC controls reacted as expected. Crossmatch testing revealed 1-3+ reactions in 17/26 group A plasma with modified RBCs but not with untreated controls. Furthermore, 2/3 group AB plasmas reacted strongly with the modified RBCs. The acqB phenotype was maintained upon freezing/thawing.
Discussion - Using a recombinant deacetylase, we demonstrated the feasibility of creating acqB RBCs from donor A1 RBCs, thus providing a reagent for quality assurance of monoclonal anti-B. These RBCs can be frozen once treated, providing a reliable source of this unusual but clinically important phenotype.

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Authors

Jennifer Ricci Hagman - Division of Hematology and Transfusion Medicine, Department for Laboratory Medicine, Biomedical Center C14, Lund University, Lund, Sweden; Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Region Skåne, Lund, Sweden https://orcid.org/0000-0002-5584-9875

Peter Rahfeld - Avivo Biomedical Inc., Vancouver, BC, Canada; Department of Chemistry, University of British Columbia, Vancouver, BC, Canada https://orcid.org/0000-0002-1038-9174

Stephen G. Withers - Department of Chemistry, University of British Columbia, Vancouver, BC, Canada https://orcid.org/0000-0002-6722-5701

Jayachandran N. Kizhakkedathu - Department of Pathology and Laboratory Medicine, Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada https://orcid.org/0000-0001-7688-7574

Martin L. Olsson - Division of Hematology and Transfusion Medicine, Department for Laboratory Medicine, Biomedical Center C14, Lund University, Lund, Sweden; Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Region Skåne, Lund, Sweden https://orcid.org/0000-0003-1647-9610

Jill R. Storry - Division of Hematology and Transfusion Medicine, Department for Laboratory Medicine, Biomedical Center C14, Lund University, Lund, Sweden; Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Region Skåne, Lund, Sweden https://orcid.org/0000-0003-2940-2604

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