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Final Copy 2020 11 26 Drizo This electronic thesis or dissertation has been downloaded from Explore Bristol Research, http://research-information.bristol.ac.uk Author: Drizou, Despoina Title: Characterising Red Cell-Derived Vesicles in Sickle Cell Disease and Investigating Potential to Induce Tolerance to Human Red Cell Antigens General rights Access to the thesis is subject to the Creative Commons Attribution - NonCommercial-No Derivatives 4.0 International Public License. A copy of this may be found at https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode This license sets out your rights and the restrictions that apply to your access to the thesis so it is important you read this before proceeding. Take down policy Some pages of this thesis may have been removed for copyright restrictions prior to having it been deposited in Explore Bristol Research. However, if you have discovered material within the thesis that you consider to be unlawful e.g. breaches of copyright (either yours or that of a third party) or any other law, including but not limited to those relating to patent, trademark, confidentiality, data protection, obscenity, defamation, libel, then please contact [email protected] and include the following information in your message: •Your contact details •Bibliographic details for the item, including a URL •An outline nature of the complaint Your claim will be investigated and, where appropriate, the item in question will be removed from public view as soon as possible. Characterising Red Cell-Derived Vesicles in Sickle Cell Disease and Investigating Potential to Induce Tolerance to Human Red Cell Antigens Despoina Drizou A dissertation submitted to the University of Bristol in accordance with the requirements for award of the degree of Doctor of Philosophy in the Faculty of Biomedical Sciences School of Cellular and Molecular Medicine August 2020 Word count: 47,960 0 Abstract Patients with sickle cell disease (SCD) receive regular blood transfusions, which can lead to alloimmunisation due to exposure to different red blood cell (RBC) antigens. The spleen is frequently damaged in these patients, resulting in higher numbers of red cell-derived particles (RCDP) and autophagic vesicles (AV). Most RCDP, produced through membrane budding, are right-side out and expose the external domains of RBC proteins, whereas AV are inside-out, exposing cytoplasmic domains. Since SCD patients have higher numbers of RCDP and AV, we aimed to characterise these particles and compare with healthy donor plasma and with storage vesicles (SV) from outdated blood. We also investigated the use of these particles to induce tolerance to RBC antigens, in a murine model. RCDP and AV from SCD and healthy plasma were isolated using immunomagnetic separation. Results using imaging flow cytometry (IS) showed that RBC markers like glycophorins A and C, band 3, glucose transporter1 and phosphatidylserine, were detected in all particles, confirming they originated from RBC. RCDP were more prevalent and generally larger than AV but both particle types were more abundant in SCD than healthy plasma. IS was more sensitive for small particle detection than flow cytometry. The latter detected large ghost membranes. All particle types were detected by transmission electron microscopy (TEM) and immunogold staining against extracellular or cytoplasmic GPA domains further confirmed their RBC origin. TEM, IS and dynamic light scattering showed that RCDP were larger than AV. A model system was developed to investigate tolerance induction in vivo and indicated that both SV and ghosts could be used to prime host animals. In conclusion, small RCDP and AV from SCD and healthy plasma have been characterised for first time, using IS. It may be possible to use particles from blood cells induce tolerance to RBC antigens and thereby reduce alloimmunisation. Abstract word count: 299 1 Dedication and Acknowledgements I have always wanted to pursue a PhD after finishing my undergraduate studies. However, it took several years to find (or to be found by!) the best project I could ever imagine. On top of that, I had the greatest opportunity to work alongside with not only lovely people but also top experts in the field of transfusion and red blood cell biology. I would like to deeply thank my supervisor Dr Allison Blair for all her support, guidance, kindness, invaluable help and for making this 4-year journey easier for me. I am also grateful to my second supervisor, Professor Dave Anstee, for trusting me with his great idea of inducing tolerance in young patients with sickle cell disease, with the aim of improving the quality of their adult life. This thought kept me focused on my work throughout the last and most challenging years. The Ethos and Values of both my supervisors, so different to what I had encountered thus far in the pharmaceutical industry, inspired me to do science to make a difference. It's good to know there are still researchers that are human first and scientists second. Special thanks go to Dr Tosti Mankelow for his instrumental advice, patience and for always being available for me. Many thanks to Dr Rachel Smith for all her help, especially during my first steps in this PhD. This project could not have taken place without the kind contribution of Drs. Tom Latham, Sara Trompeter and their patients; I could not thank them enough. Sincere thanks should also go to Mr Shane Grimsley and Dr Nicole Thorton, as well as all the staff in the Red Cell Reference Lab in IBGRL, Filton. Without their valuable help I would not have managed to perform serology. Special thanks to Professor Lindsay Nicholson for his precious advice to the immunological part of the project. I would also like to thank all the people in the IBGRL in Filton for their help and support, as well as people in C72 office at Bristol University. Many thanks to my Progression Panel members, Professor Jan Frayne and Dr David Morgan for all their advice and guidance. Special thanks to our group members, Dr Ben Ede and particularly Dr Vivian Diamanti for their suggestions on my work. Vivian's gorgeous smile and positive energy have been an energetic boost the past few years. I will be always grateful to Professor Athanasios Koutinas, who saw my passion for research and advised me to do a PhD. I cannot thank enough my parents and my sister Dimitra for everything they have done for me so far. Last but not least, many thanks to my partner Zisimos for his patience, amazing cooking skills and for helping me to deal with stress and anxiety through the sleepless PhD nights. 2 Author’s declaration I declare that the work in this dissertation was carried out in accordance with the requirements of the University's Regulations and Code of Practice for Research Degree Programmes and that it has not been submitted for any other academic award. Except where indicated by specific reference in the text, the work is the candidate's own work. Work done in collaboration with, or with the assistance of, others, is indicated as such. Any views expressed in the dissertation are those of the author. SIGNED: Despoina Drizou DATE: 31/08/2020 3 Table of Contents Dedication and Acknowledgements ………..……………….…………………….……………….………2 Author’s Declaration …………………………..…………………………………...……………….….……3 1.1 HAEMOPOIESIS ......................................................................................................................... 14 1.1.1 Production of haemopoietic stem cells .......................................................................... 14 1.1.2 Haemopoietic Hierarchy ................................................................................................ 15 1.1.3 Transcription factors ...................................................................................................... 16 1.1.4 Haemopoietic stem cell regulation by other cells ........................................................... 16 1.2 THE RED BLOOD CELL ............................................................................................................... 17 1.2.1 Function and characteristics .......................................................................................... 17 1.2.2 Formation and maturation ............................................................................................. 17 1.2.3 Metabolic pathways in red cells ..................................................................................... 18 1.2.4 Red cell components ..................................................................................................... 19 1.2.4.1 Haemoglobin .......................................................................................................... 19 1.2.4.2 Red cell membrane composition ............................................................................. 21 1.2.4.3 Phospholipids ......................................................................................................... 22 1.2.4.4 Red blood cell antigens .......................................................................................... 23 1.2.5 Ex vivo generation of red cells ....................................................................................... 24 1.2.6 Animal models of erythropoiesis .................................................................................... 25 1.2.7 Material exported by red cells ........................................................................................ 26 1.3 CELLULAR MICROPARTICLES ....................................................................................................
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