Kodecytes: modifying the surface of red blood cells

Abstract

There are few routine techniques available to modify the antigenic surface of red blood cells (RBC). Primarily, modification techniques involve antigen destruction with enzymes or denaturing chemicals. In contrast, very few antigen additive technologies exist. One antigen additive technology involves the passive insertion of Function‐Spacer‐Lipid constructs (Kode Technology) into the cell membrane. Kode constructs can label any cell (creating kodecytes) with controlled levels of almost any small molecule, including blood group carbohydrate and peptide antigens. They have been used to modify RBCs with a variety of ABH, Lewis and related antigens to study the specificity of monoclonal and polyclonal antibodies. Although kodecytes with carbohydrate epitopes have been extensively evaluated, those with peptide antigens also exist and some can be prepared with cross‐reactive bacterially related peptide antigens, to create IgG‐reactive kodecytes. These so‐called ASKGkodecytes can mimic all serological IgG reactions and are particularly suited for teaching and training. Recently kodecytes have also been used to quantify ABH antibody levels without the requirement for plasma dilution, and in this review the probable mechanism of action is explained. In general, kodecytes allow for the controlled antigen modification of RBCs and have the ability to make almost unlimited quantities of antigen rare or unusual RBCs from common resources. Not only are kodecytes useful research tools to study RBCs in vitro and in vivo but they also have the potential to create standardized diagnostics, quality control systems, advanced serological teaching panels and novel research tools.