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P D Issitt

Publications and source records attributed to P D Issitt.

At least 91 records · Page 5Linked to original sources

A "normal" individual with a positive direct antiglobulin test: case complicated by pregnancy and unusual autoantibody specificity.

A "normal" individual with a positive, direct antiglobulin test is described. In common with many other "normal" persons in whom a similar finding has been made, there was no evidence of an increased rate of in vivo red blood cell destruction in this patient. The patient successfully completed a pregnancy during the time that detailed serologic studies on her autoantibodies were being performed. Although the maternal autoantibodies were demonstrable in both an eluate made from the red blood cells of her newborn infant, and in the cord serum, there was no reason to believe that the antibodies caused red blood cell destruction in the infant. The case was of further interest because of the specificities of some of the autoantibodies. Although the mother and child were both C-negative, eluates from their red blood cells contained what ostensibly appeared to be anti-C. Studies that showed that the antibody could be totally adsorbed with C-negative, as well as C-positive red blood cells, proved that this was another example of an autoantibody mimicking an alloantibody. Although this autoantibody appeared initially to have anti-C specificity it was eventually shown to be more closely related to anti-Hr or anti-Rh34, than to anti-C.

Adult↗

An investigation of the relationship between the V(hrv), VS, and hrH antigens.

The data from this investigation show that the anti-VS sera studied cannot be separated into anti-hrv (anti-V) and anti-hrH specificities. The antibody specificity is singular and is directed against an antigenic determinant present on VS positive red blood cells. That some anti-VS sera appear to have a separable specificity may be due to the incomplete absorption of those antisera. It was shown that V-, VS+ red blood cells adsorb more anti-VS than do those that are V+, VS+. Several absorption of anti-VS serum with V+, VS+ red blood cells may remove enough of the antibody that the absorbed serum will no longer (visibly) react with V+, VS+ red blood cells, though the same absorbed serum will react with V-, VS+ red blood cells. That this is not a separable specificity can be demonstrated by subsequent absorption to exhaustion of the same serum with V+, VS+ red blood cells. Testing of the original Hernandez serum comfirmed that it defines the antigenic specificity, hrH. The relationship of hrH to VS may be similar to the relationship of the Rh0 (D) antigen to the antigens of the Rh0 (D) mosaic.

Absorption↗

Demonstration of anti-Wrb in a second serum containing anti-Ena.

Many persons who are of a "deletion" or "null" phenotype with regard to a particular blood group system, form a complex specificity antibody or mixture of antibodies, when immunized. Recently, we demonstrated that M.E.P., the En(a-), Wr(a- b-) proposita in a family described by Darnborough has at least, anti-Ena and anti-Wrb in her serum. We suggested that the same two antibodies might be present in the serum of G.W., the En(a-), Wr(a- b-) propositus in the family reported by Furuhjelm et al. We have now been able to confirm that G.W.'s serum does contain antiEna and anti-Wrb and that the antibodies can be separated by adsorption. Because, at this time, it is not known if En(a-), Wr(a- b-) people lack other common antigens from their red blood cells, the possibility remains that the anti-Ena, separated from the anti-Wrb, might be a mixture of antibodies. These findings are important in that they show that reported typings for Ena were actually performed with mixtures of at least anti-Ena and anti-Wrb. Anti-Ena, lacking antiWrb, can be made only by adsorption of a serum containing the two antibodies, onto En(a+), Wr(a+b-) red blood cells, with recovery of the anti-Ena by elution.

Antibody Specificity↗

Difficulty in LW typing as revealed by a family study.

A family is described in which two members of the second generation are of the phenotype LW3. In the course of the investigation the mother of the LW3 propositus was at first believed to be phenotypically LW3 as well. Eventually, it was shown that she is, in fact, phenotypically LW2 but that her R-1 (no D), LWlw, genotype had resulted in less LW being present on her red blood cells than is expected in LW2 persons. This reduced level of LW could not be detected with one example of anti-LW made by an LW3 individual.

Accidents, Occupational↗

Weak B antigen in a family.

A family is described in which six members were of a week subgroup of B. Presence of the subgroup in each individual was first indicated by lack of anti-B in that person's serum. Additional tests showed that the B subgroup red blood cells would adsorb anti-B and yield that antibody on elution, and that the saliva of two B subgroup persons tested contained B and H substances. The blood of one of the family members with the weak B antigen was inadvertently transfused to a group O recipient but caused no ill effects.

ABO Blood-Group System↗

Notes on the Ena and U antigens of Ena(En.OP) heterozygotes, and the U antigen of En(a--) individuals.

Using two anti-Ena antibodies, from which anti-Wrb had been removed, and anti-U antibodies, the authors have failed to demonstrate any difference in the amounts of Ena and U antigens on the red blood cells of individuals with one and two functioning Ena(En.OP) genes. Two En(a--) samples, one from an individual who is En/En (En.op/En.op) and the other En/Mk (En.op/Mk), could not be distinguished from U-positive samples from individuals with two functioning U (U.OP) genes in dosage studies with anti-U.

Antibodies↗

Antibodies that define NANA-independent MN-system antigens.

The hemagglutinating properties of a large proportion of anti-M and anti-N reagents, and sera containing antibodies to MN-related antigens, have been shown to be unaffected by treatment of red blood cells with neuraminidase. These antibodies, which define NANA-independent MN-system structures, provide further evidence that MN blood group specificity may also be determined by moieties other than N-acetylneuraminic acid.

Antigen-Antibody Reactions↗

Allo-anti-C in a patient who had previously made an autoantibody mimicking anti-C.

A patient, previously studied by us, who had produced a benign autoantibody with a specificity that mimicked anti-C, has now produced allo-anti-C that is not of the mimicking type. She is no longer producing any serologically demonstrable autoantibody. It is highly probable that conversion from auto to alloantibody production in this patient was prompted by the introduction of additional foreign immunogen on fetal red blood cells during her third pregnancy.

Autoantibodies↗

Anti-Rh39--a "new" specificity Rh system antibody.

Two examples of an autoantibody that defines a hitherto unrecognized Rh system antigen are described. Both were produced by C-negative individuals and ostensibly resembled anti-C in specificity. However, adsorption studies showed that the antigen that the autoantibodies define is present on all red blood cells with a "normal" Rh phenotype and on D--/D-- and Dc--/Dc--samples. The antigen detected is not present on Rhnull red blood cells. Serologic studies have shown that the new antibody, that has been named anti-Rh39, has a different specificity from those that define the antigens C, Ce(rhi), G, Hro, Hr, CG, LW, Rh:29, Rh:34 and U. A possible relationship between auto-anti-Rh39 and allo-anti-C, in terms of the immune response, is discussed.

Adsorption↗

Anticomplement and the indirect antiglobulin test.

We used 140 IgG complement-fixing blood group alloantibodies of 17 different specificities in tests to determine whether anticomplement antibodies are still necessary in antiglobulin reagents to be used in indirect antiglobulin tests. Anti-Rh and other IgG noncomplement fixing antibodies were excluded from the study. A polyspecific antiglobulin reagent that contained anti-IgG and anticomplement antibodies, and an anti-IgG reagent containing the same level of anti-IgG as the polyspecific one, were compared. Titrations with some of the antibodies were repeated with only the polyspecific reagent. With each antibody, studies were done with complement activation blocked, and compared with results in which it was allowed to proceed. We found that 42.9% of the antibodies were detected at a higher dilution, and 64.3% of them were detected with a higher titer score, when the poly-specific antiglobulin serum containing anticomplement antibodies was used. We conclude that anticomplement antibodies are indeed still essential for the correct performance of indirect antiglobulin tests.

Antibody Specificity↗

Absence of autoanti-Jk3 as a component of anti-dl.

Thirty-five examples of anti-dl, autoantibodies initially reacting with all red blood cells against which they were tested, were examined prior to, and following adsorption with Jk(a-b-) red blood cells. None of them was found to contain autoanti-Jk3. One example of autoanti-Jka was identified in an adsorbed eluate. The antibody had been produced by a pregnant Caucasian, in whom laboratory and clinical evaluation showed that the auto-antibody was benign in vivo.

Adsorption↗

An auto-anti-Ena, inhibitable by MN sialoglycoprotein.

An auto-anti-Ena, which reacts with trypsin, but not with ficin-treated red blood cells, and which can be totally inhibited with sialoglycoprotein (SGP) isolates from red blood cells, is described. From comparative studies on this antibody and on the four known examples of allo-anti-Ena, it is clear that the term "anti-Ena" describes a heterogeneous group of related but not identical specificities. The specificities contained within the auto-anti-Ena described are different from those within any of the sera containing allo-anti-Ena. Several of the specificities that have been included under the blanket term, anti-Ena, complex with the MN SGP of normal red blood cells, but recognize different portions of that polypeptide.

Autoantibodies↗

Production of allo-anti-Ena by an individual whose red blood cells carry some Ena antigen.

We recently described an individual whose red blood cells appear to carry a hybrid MNSs sialoglycoprotein (SGP). The MN-derived portion of that SGP carries at least two determinants defined by some examples of antibodies that have been called anti-Ena. However, the red blood cells lack a different determinant that is defined by other examples of anti-Ena. This individual has now formed an anti-Ena antibody that reacts with the portion of Ena that her red blood cells lack, but not with the Ena determinants that have been shown to be carried on MN SGP. It is not yet clear whether the portion of Ena that her red blood cells lack and that her antibody defines is MN SGP-borne. The findings in this case provide further support for our conclusions that the terms "Ena" and "anti-Ena," as previously used, describe heterogeneous groups of antigens and antibodies.

Adsorption↗

Anti-Tm is anti-N polypeptide.

Anti-Tm defines an antigen in the MN blood group system, and 382 Tm + samples were found in tests on 900 random Caucasian, and 500 random Negro bloods. Of the 382 Tm + samples, 373 were also N +, but a further 625 N+ samples were nonreactive with anti-Tm. We have now shown that when the original anti-Tm serum is adsorbed free of anti-T, and is tested against neuraminidase-treated red blood cells, it has anti-N specificity. Further, while anti-Tm cannot be inhibited by sialoglycoprotein (SGP) preparations from untreated N+ red blood cells, it is inhibited by SGP fractions prepared from N+ red blood cells that have been pretreated with neuraminidase. It seems that anti-Tm is directed against a part of the polypeptide backbone of the N SGP.

Adsorption↗