Abstract
Neutrophil alloantigens are involved in a variety of clinical conditions including immune neutropenias, transfusion-related acute lung injury (TRALI), refractoriness to granulocyte transfusions and febrile transfusion reactions. In the last decade, considerable progress has been made in the characterization of the implicated antigens. Currently, seven antigens are assigned to five human neutrophil antigen (HNA) systems. The HNA-1a, HNA-1b and HNA-1c antigens have been identified as polymorphic forms of the neutrophil Fcgamma receptor IIIb (CD16b), encoded by three alleles. Recently, the primary structure of the HNA-2a antigen was elucidated and the HNA-2a-bearing glycoprotein was identified as a member of the Ly-6/uPAR superfamily, which has been clustered as CD177. The HNA-3a antigen is located on a 70-95 kDa glycoprotein; however, its molecular basis is still unknown. Finally, the HNA-4a and HNA-5a antigens were found to be caused by single nucleotide mutations in the alphaM (CD11b) and alphaL (CD11a) subunits of the leucocyte adhesion molecules (beta2 integrins). Molecular and biochemical characterization of neutrophil antigenshave expanded our diagnostic tools by the introduction of genotyping techniques and immunoassays for antibody identification. Further studies in the field of neutrophil immunology will facilitate the prevention and management of transfusion reactions and immune diseases caused by neutrophil antibodies.
Highlights
Human neutrophil alloantigens systemsELYSE MORITZ, ÂNGELA M.M.I. NORCIA, JOSÉ D.B. CARDONE, SACHIE T. KUWANO, AKEMI K. CHIBA, MIHOKO YAMAMOTO and JOSÉ O. BORDIN Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo Rua Botucatu, 740, 04023-902 São Paulo, SP, Brasil Manuscript received on September 1, 2008; accepted for publication on April 27, 2009; presented by LUIZ R. TRAVASSOS
Neutrophil alloantigens are involved in a variety of clinical conditions including immune neutropenias, transfusionrelated acute lung injury (TRALI), refractoriness to granulocyte transfusions and febrile transfusion reactions
Neutrophil antibodies have been shown to play a key role in the patophysiology of several clinical conditions, including neonatal alloimmune neutropenia (NAN), autoimmune neutropenia of childhood, febrile non-hemolytic transfusion reactions (FNHTR), transfusion-related acute lung injury (TRALI), immune neutropenia after bone-marrow transplantation, transfusion-related alloimmune neutropenia (TRAIN), drug-induced neutropenia, and refractoriness to granulocyte transfusion
Summary
ELYSE MORITZ, ÂNGELA M.M.I. NORCIA, JOSÉ D.B. CARDONE, SACHIE T. KUWANO, AKEMI K. CHIBA, MIHOKO YAMAMOTO and JOSÉ O. BORDIN Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo Rua Botucatu, 740, 04023-902 São Paulo, SP, Brasil Manuscript received on September 1, 2008; accepted for publication on April 27, 2009; presented by LUIZ R. TRAVASSOS
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