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Molecular Biology of the Rh Antigens

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Molecular Biology of the Rh Antigens From www.bloodjournal.org by guest on October 31, 2014. For personal use only. 1991 78: 551-563 Molecular biology of the Rh antigens P Agre and JP Cartron Updated information and services can be found at: http://www.bloodjournal.org/content/78/3/551.full.html Articles on similar topics can be found in the following Blood collections Information about reproducing this article in parts or in its entirety may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#repub_requests Information about ordering reprints may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#reprints Information about subscriptions and ASH membership may be found online at: http://www.bloodjournal.org/site/subscriptions/index.xhtml Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published weekly by the American Society of Hematology, 2021 L St, NW, Suite 900, Washington DC 20036. Copyright 2011 by The American Society of Hematology; all rights reserved. From www.bloodjournal.org by guest on October 31, 2014. For personal use only. REVIEW ARTICLE Molecular Biology of the Rh Antigens By Peter Agre and Jean-Pierre Cartron HISTORICAL BACKGROUND ‘251-labeledon the extracellular surface of intact RBCs. HE RH BLOOD group antigens are of large clinical Although the glycophorins and the band 3 anion trans- T importance because of their involvement in hemolytic porter were also labeled, membranes from Rh positive disease of the newborn, transfusion medicine, and autoim- RBCs (obtained from individuals with presumed genotype mune hemolytic The historic discovery of the Rh DID or D/d) were noted by autoradiography to have a D antigen was made just over 50 years ago by Levine and diffuse but strongly labeled band of approximately 28 to 33 Stet~on.~Soon after delivery, the mother of a stillborn Kd. A similar but much fainter band was seen in mem- infant had received a blood transfusion donated by her branes from typical Rh negative RBCs (Fig 1). Anti-D husband, and she experienced an immediate and severe antibodies were added to the membranes before detergent transfusion reaction. The investigators detected an anti- solubilization, and the ‘xI-labeled band was specifically body in her serum that agglutinated red blood cells (RBCs) immunoprecipitated with antibodies specific for D from Rh from 80% of randomly selected type 0 donors. The D positive RBCs. Likewise, anti-c and anti-E, respectively, antibody specificity was identical to antibodies raised in immunoprecipitated similar but less heavily radiolabeled rabbits injected with RBCs from Rhesus monkeys, hence bands from Rh c and Rh E positive RBCs.” These new “anti-Rhesus” or “anti-Rh.”’ Ironically, “Rh” is in fact a bands together are now referred to as the “Rh poly- misnomer, because the surface antigens detected by the peptides.” human and rabbit antibodies were not identical, and the The Rh polypeptides were shown to be highly unusual latter antigen was subsequently named “LW” in honor of RBC membrane proteins.” The Rh polypeptides were Landsteiner and Wiener: found to have electrophoretic mobilities varying from 28 to Early investigators soon observed that Rh was very 32 Kd relative to molecular weight standards in sodium complex, with multiple antigenic variants. A controversy dodecyl sulfate-polyacrylamide gel electrophoresis (SDS- arose concerning whether Rh is a single protein containing PAGE), presumably due to increased binding of SDS, multiple antigenic epitopes (referred to as Rho,rh’, hr’)’ or which is known to occur to very hydrophobic protein^.'^ whether there exist multiple closely linked alleles each Also, despite the presence of an exofacial tyrosine that can coding for an independent protein specific for a different be surface ‘251-labeled,the Rh polypeptides on intact RBC Rh antigen (Cic, Did, or E/e).8 The latter system does not membranes resisted proteolytic degradation. Endogenous explain all of the complexities of Rh, but is easier to phosphorylation was not detected either.” communicate and is more compatible with current molecu- Most surprisingly, the Rh polypeptides contained no lar studies (see below). D is the major Rh antigen detected detectable carbohydrate when examined with methods for on the surface of RBCs obtained from individuals with the labeling terminal sugars.” The isolated Rh polypeptides presumed genotypes DID or Did, commonly referred to as also failed to adsorb to lentil lectin affinity columns and “Rh positive.” The antithetical antigen d is not immunolog- were not degraded by glycosidases nor by alkaline hydroly- ically detectable and is not expressed, hence “Rh negative.” sis, which normally removes 0-linked oligosaccharides. The Whether from Rh positive or negative individuals, virtually apparent lack of carbohydrate was indeed an extraordinary all normal RBCs bear the antithetical antigens C and/or c in finding, because all known blood group antigens and addition to E andlor e. Exceedingly rare individuals lack all virtually all mammalian transmembrane proteins are glyco- of these antigens and are referred to as Rh,,,,.’ Rh,,,, RBCs proteins. express multiple RBC membrane abnormalities, suggesting Apparent membrane skeleton linkage. Recent advances that the Rh antigens are of physiologic importance (see in RBC membrane biochemistry have established that the below). The molecular basis of the Rh antigens has proven to be a very difficult problem in membrane biology, and unfortu- From the Departments of Medicine and Cell Biology, Johns Hopkins nately many early research efforts proved to be false leads. University School of Medicine, Baltimore, MD, and INSERM Unite Rh antigenic reactivity is lost after membranes are solubi- U76, Institut National de Transfusion Sanguine, Paris. lized or transferred onto immunoblot membranes, and Submitted Januaiy IO, 1991; accepted April 4, 1991. Supported in part by NATO Collaborative Research 0556188, most biochemical methods therefore actually kill the anti- National Institutes of Health ROI HL33991, Institut National de la genic reactivities that identify and define the Rh antigens. Sante et de la Recherche Medicale, and the Caisse Nationale There has been little agreement about the molecular d’AssurancesMaladies des Travaillers Salaries. P.A. is an Established identity of the Rh antigens until recently. Investigator of the American Heart Association. Written in honor of Prof C. Lockard Conley, Emeritus Director of THE RH POLYPEPTIDES the Johns Hopkins Hematology Division and Prof Charles Salmon, Emeritus Director of the Institut National de Transjiuion Sanguine. Discovery. Two reports published in the winter of 1982 Address reprint requests to Peter Agre, MD, Johns Hopkins Univer- drastically changed the direction of Rh research. Moore et sity School ofMedicine, 725 N Wolfe St, Baltimore, MD 21205. al’” Edinburgh and Gahmberg” in Helsinki independently 0 I991 by The American Society of Hematology. observed a previously unrecognized protein that could be 0006-4971I91 17803-0035$3.OOiO Blood, Vol78, No 3 (August 1). 1991: pp 551-563 551 From www.bloodjournal.org by guest on October 31, 2014. For personal use only. 552 AGRE AND CARTRON DD Dd dd DD Dd dd tivcly." This distancc is approximatcly the lcngth of an cxtcndcd spcctrin tctramcr.'" Othcr studics dcmonstratcd a latticc-likc distribution on thc mcmhranc surfacc with fcncstrations of approximatcly IO nm." Linkagc of thc Rh polypcptidc to thc mcmhranc skclcton would hc a logical cxplanation for thcsc findings, although mcmbranc skclcton linkagc has not bccn dircctly cstah- lishcd. Undcr ccrtain conditions thc Rh polypcptidcs wcrc found to prccipitatc with thc mcmbranc skcIcton.3'.2'Thc mcmhranc skclcton was also shown to prcscrvc Rh anti- genic activity whcn mcmhrancs wcrc soluhilizcd in nonionic Glyco- dctcrgcnts.?' Morcovcr, ccrtain glycoprotcins missing from phorins Rh,,,, RBCs also hchavc as if linkcd to thc mcmhranc skclcton (scc hclow). A fraction of thc Rh polypcptidc is obviously soluhlc in 1% (volhrol) Triton X-IW. hccausc initial rcports dcscribcd immunoprccipitation of Rh poly- pcptidc from Triton-solubilizcd mcmbrancs."'.'' conditions in which thc spcctrin-actin mcmbranc skclcton is insolu- Rh blc." Thc incrcascd solubility of Rh polypcptidc whcn complcxcd with anti-D is most likcly confcrrcd by thc watcr-solublc Ig rathcr than a sccondary cffcct on the mcmbranc skclcton. Ncvcrthclcss, whcn asscsscd quantita- tivcly. 70% to 80% of thc Rh polypcptidcs wcrc still asstxiatcd with the insoluhlc mcmbranc skclcton after incubation in up to 5% (volhrol) Triton X-IO at 0°C for 15 minutcs. whcrcas glycophorin A. a nonskclcton-linkcd protcin, was largcly soluble."'.:' membranes anti-D immppt. Whilc a rclativcly weak interaction bctwccn thc Rh polypcptidcs and thc mcmhranc skclcton may cxist. this Fig 1. Autoradiograph of radiolabehd Rh polypeptides on mom- hchavior may simply rcflcct thc rclativc insolubility of thc hnaof intact RBCs [left panel) or immunoprecipitatedwlth anti-D Rh polypcptidc in Triton X-100. bccausc subscqucnt invcs- (right panel). Intact RBCs from individuals with presumed Rh geno- tigators dcmonstratcd that physical shaking of intact RBC types cD€/cD€ (DO),CDdcde (Dd), and cdelcde (dd lanes) were 'Waboied using lodogen (Pime, Rockford. IL). Note the strong mcmbrancs in 5% (wthol) Triton X-IO() produccs an wtiace Iakling of Rh powptides on OD RBCs, intermediate label- altogcthcr diffcrcnt rcsult, with lcss than 30% of thc Rh ing on Dd RBCs, and weak labeling on dd RBCs. The anti-D immunopre- polypcptidc rcmaining
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