Inhibition of an anti-Pr1d cold agglutinin by citrate present in commercial red cell preservative solutions. Transfusion 1990;30(3):267-70
Date
03/01/1990Pubmed ID
2316003DOI
10.1046/j.1537-2995.1990.30390194352.xScopus ID
2-s2.0-0025194526 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
A patient with known cold autoimmune hemolyticanemia was admitted for surgery. Routine cold agglutinin evaluations, using commercial red cells (RBCs) in modified Alsever's preservative solution, revealed a cold agglutinin titer of 4 to 16. However, using RBCs washed four times with saline, a high-titer (greater than 2000 at 4 degrees C) cold autoagglutinin was demonstrated. The cold agglutinin was shown to be an IgM kappa paraprotein with anti-Pr1d specificity. The addition of Alsever's solution to washed RBCs inhibited the cold agglutinin. Each major component of Alsever's solution (neomycin, chloramphenicol, inosine, dextrose, and citrate) was tested individually; only citrate inhibited the patient's cold agglutinin. Various compounds structurally related to citrate were tested and found to cause various degrees of inhibition. The strongest inhibition correlated with the presence of either three carboxyl groups on molecules devoid of double-bonded carbon atoms or two carboxyl groups in cis configuration. A panel of 54 cold agglutinins, including 7 with anti-Pr specificity, was analyzed. None was significantly inhibited by Alsever's solution, although one with anti-Pr2 specificity was weakly inhibited. In summary, these studies describe an anti-Pr1d cold autoagglutinin that was inhibited by citrate in RBC preservative solutions. The failure to detect such a cold agglutinin can result from not washing RBCs free of citrate before testing.
Author List
Green ED, Curtis BR, Issitt PD, Gutgsell NS, Roelcke D, Farrar RP, Chaplin HAuthor
Brian Curtis PhD Director in the Platelet & Neutrophil Immunology Laboratory department at BloodCenter of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAgglutinins
Blood Group Antigens
Blood Preservation
Citrates
Cryoglobulins
Erythrocytes
Humans
I Blood-Group System
Male
Preservatives, Pharmaceutical
Structure-Activity Relationship
