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Plasma from a 35-year-old, D– woman was found to have anti-D, -C, and -G at 5 weeks’ gestation and again at 8 weeks’ gestation, when she presented with a nonviable intrauterine pregnancy. The anti-D titer increased with a pattern that suggested it was stimulated by the 8-week pregnancy. Six years before this admission, the patient’s blood type changed from group O, D+ to group O, D– after a bone marrow transplant for aplastic anemia. Three years after transplant, the antibody screen was negative. After the patient was admitted for the nonviable pregnancy, the products of con-ception were found to be D+ by DNA testing for RHD. There were no documented transfusions or pregnancies during the interval in which anti-D appeared. The timing of the alloimmunization was unusual. In a subsequent pregnancy, fetal D typing was performed by molecular methods. Immunohematology 2012;28:55–9.

BACKGROUND: The rare phenotypes Dc- and D-- lack the expression of E/e and CcEe antigens, respectively; their cotransmission in a single family has not been reported. STUDY DESIGN AND METHODS: Six members of a Chinese family with two exhibiting the Dc- phenotype were studied using standard serologic methods. Rh genotypes were analyzed by Southern blot, and RH loci, by exon PCR. Rh transcripts were characterized by gene-specific RT-PCR and sequencing. RESULTS: Although Rh typing detected two members as Dc- homozygotes, RFLP analysis and exon PCR showed them to be Dc- heterozygotes with a partial deletion of RHCE. cDNA sequencing showed the expression in the family of normal RHD and RHCe as well as hybrid transcripts, RHD(1-9)/RHCE(10) and RHCE(1-3)/RHD(4-10). Thus, the Dc- members had the genotype of Dc-/ D-- and expressed both hybrid genes that were inherited from their parents, respectively. DISCUSSION: This is the first demonstration in a family that the Dc- and D-- complexes neither are linked with a normal RHD or RHCE gene. The segregation of these two different hybrid genes with single break points sug-gests their independent genetic origin and provides molecular insights into the dynamic nature of genomic rearrangements leading to RH locus contraction.

The antigens of the Cromer blood group system reside on decay accelerating factor (DAF), a protein belonging to the regulators of complement activation family. The blood group system consists of eight high-incidence antigens and three low-incidence antigens. The molecular basis for the antigens is known and, with the exception of IFC, each antigen is the product of a single nucleotide polymorphism in the DAF gene and has been localized to one of the four short consensus repeat regions on the DAF protein. The red blood cells (RBCs) of people with the Cromer null phenotype, Inab, lack DAF. Antibodies to Cromer antigens are rarely encountered although there is evidence that the antibodies may cause accelerated destruction of transfused RBCs. There is no risk of hemolytic disease of the newborn associated with Cromer system antibodies because the placenta is a rich source of fetally derived DAF, which is thought to adsorb the antibodies. Immunohematology 2002;18:95–103.

BACKGROUND: In a Moroccan family, the partial D phenotype DBT is defined by an RHD-CE-D gene in which exons 5 to 7 of RHD were replaced by those of RHCE. In this study, the molecular basis and inheritance of DBT in a Japanese family are described. STUDY DESIGN AND METHODS: A Japanese proposita exhibiting the DBT phenotype was analyzed by serologic methods and molecular techniques. The RH transcripts of the proposita were sequenced and compared with those of normal donors. The inheritance and structure of the RH genes in the family were determined by Southern blot analysis and exon-specific polymerase chain reaction. RESULTS: The proposita typed weak D and C+c+E+e+Rh:32. Family data indicated a cotransmission of Rh32 with DBT and a linkage of C and e with DBT. Southern blot testing of the proposita's genomic DNA indicated a partial and a total absence of RHD on the respective homologous chromosomes. Sequencing of her cDNA showed expression of Ce, cE, and RHD-CE-D transcripts but not D. The RHD-CE-D hybrid was characterized by a conversion of five RHD exons into RHCE exons (exons 5-9). The 5′ and 3′ breakpoints in the fusion gene were localized to the intron 4/exon 5 region and intron 9. CONCLUSION: The new RHD-CE-D gene defines a separate genetic origin of DBT in the Japanese family. The proximal sequence encoded by RHD exon 4 and RHCE exon 5, together with the distal RHCE sequence, may involve the cotransmission of Rh32 and DBT, which behave as codominant and recessive characters, respectively.

Background: Monoclonal antibody 148 is a murine monoclonal anti- glycophorin B that preferentially reacts with S+ human red cells. Study Design and Methods: Serologic and immunochemical studies were performed using red cells with various phenotypes. Results: These studies reveal that this monoclonal antibody is unusual in that it fails to agglutinate S+ TSEN+ red cells and agglutinates S- St(a+) and S- Dantu+ red cells. Conclusion: These results allow the prediction of the glycophorin composition of GP.Hop (Mi.IV) red cells.

BACKGROUND Sulindac, a nonsteroidal, anti-inflammatory, indene-derived drug, caused life-threatening immune hemolytic anemia in an individual with back pain. CASE REPORT A patient was admitted to the hospital with immune hemolytic anemia and kidney and liver failure after several days ingestion of sulindac. The direct antiglobulin test was positive with polyspecific and monospecific anti-IgG but not with anti-C3. The eluate did not react in routine tests but reacted strongly after the addition of sulindac. The serum contained a sulindac-dependent antibody reacting to a titer of 32. The sulindac-dependent antibody was of both IgG and IgM classes and had no apparent blood group specificity. The antibody agglutinated red cells from humans and chimpanzees but not from chickens, rabbits, or sheep, which implied that a specific component on human and chimpanzee red cells was needed for reactivity. The antibody reacted with red cells treated with trypsin, papain, pronase, dithiothreitol, and sialidase. With aggressive medical care, the patient's condition improved. CONCLUSION These findings appear compatible with the so-called immune complex mechanism for drug-induced immune hemolytic anemia. Physicians are alerted to the severe nature of this syndrome.

Glycophorin C (GPC) and glycophorin D (GPD) are homologous sialoglycoproteins in the human red blood cell membrane. Both are thought to be encoded by the GPC gene (GYPC). We report that the rare blood group antigen, Ana, is expressed on GPD but not on GPC. cDNA was synthesized from total RNA obtained from two unrelated, heterozygous Ana+ blood donors and analyzed by the polymerase chain reaction using primers that spanned sequences encoded by the GYPC gene. The expected 412-bp fragment was generated, and sequencing of the amplified product showed a G-->T substitution at nucleotide 67 of the coding sequence, resulting in the substitution of alanine by serine at amino acid residue 23 of GPC and, presumably, residue 2 of GPD. To explain the expression of Ana on GPD but not on GPC, we postulate that the conformation of the amino acid residues at the N-terminal region of GPD determines the antigenic expression as this conformation would be different from that of the same sequence of amino acids occurring within GPC. Other possible reasons for antigen expression on a shorter protein product but not on the full-length protein product of the same gene are discussed. We extrapolate this reasoning to account for the expression of the common GE2 blood group antigen on GPD but not on GPC.

Mesenteric volvulus is a potentially life-threatening condition. Little information is available for the recommended treatment of viable bowel and virtually no information is available for the suggested elective treatment of a mesenteric volvulus. This communication details a series of enteropexies that were successful in the management of this disorder.

A case of autoimmune hemolytic anemia (AIHA) in a young child is described. The hemolysis was resistant to steroid therapy but responded to splenectomy and intravenous immunoglobulin. The autoantibody was shown to be anti-Sc1 by both serologic and immunoblotting techniques. This seems to be the first report of an autoanti-Sc1 detected by immunoblotting and the first example of AIHA in a child caused by autoanti-Sc1.

Immunoblotting under non-reducing conditions with purified human anti-Gya and anti-Hy locates both antigens to an erythrocyte membrane glycoprotein of apparent Mr 46,750-57,500. The antigens are destroyed on intact red cells by the enzymes pronase, trypsin and chymotrypsin, and by treatment with reducing agents. Immunoblotting with anti-Gya and anti-Hy to membranes prepared from red cells pre-treated with an Endo F preparation caused a mean reduction in apparent Mr of the glycoprotein by 11 kDa at the leading and trailing edges, when compared with control membranes. These results suggest that the glycoprotein has one or more complex N-glycans that are not completely sensitive to Endo F digestion on intact cells. The majority of Gya/Hy-active molecules are not tightly associated with the red cell membrane skeleton. A gross reduction in reactivity with anti-Gya and anti-Hy by immunoblotting was observed in red cell membranes from patients with paroxysmal nocturnal haemoglobinuria, suggesting a possible membrane linkage via glycosylphosphatidylinositol for the glycoprotein that carries the Gya and Hy antigens. Immunoprecipitation of the glycoprotein by anti-Gya showed that the protein migrates faster under reducing conditions (Mr 45,000-54,000). A putative dimer was also evident in the precipitates. The glycoprotein was demonstrated to be distinct from lymphocyte-function-associated antigen-3 (CD58), the LWab-active glycoprotein, the Fya-active glycoprotein, the Oka-active glycoprotein and the BRIC 125 glycoprotein (CD47).

Near-real-time monitoring of active landslides or landslide-prone hillslopes can provide immediate notification of landslide activity, as well as high-quality data sets for understanding the initiation and movement of landslides. Typical components of ground-based, near-real-time landslide monitoring systems include field sensors, data acquisition systems, remote telemetry, and software for base-station data processing and dissemination. For the last several decades, we have used these monitoring tools to investigate different landslide processes. Someof our field applications have determined the groundwater conditions controlling slowmoving landslides, detected 3-D displacements of large rockmasses, and characterized the transient near-surface hydrology triggering shallow landsliding.

An antibody to a high-incidence antigen in the serum from a Pakistani female (SD) was identified as anti-Ena. Her red cells have the En(a–)FIN phenotype and lack glycophorin A. This is the first En(a–) to be described in a Pakistani individual and represents the fourth family to be reported. Immunohematology 1995;11:51–53.

In the current study, we have characterized group I metabotropic glutamate (mGlu) receptor enhancement of 4-aminopyridine (4AP)-evoked [3H]glutamate release from rat cerebrocortical synaptosomes. The broad spectrum mGlu receptor agonist (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid ((1S,3R)-ACPD, 10 microM) increased 4AP-evoked [3H]glutamate release (143.32+/-2.73% control) only in the presence of exogenously applied arachidonic acid; an effect reversed by the inclusion of bovine serum albumin (BSA, fatty acid free). In contrast, the selective group I mGlu receptor agonist (S)-3,5-dihydroxyphenylglycine (DHPG) potentiated (EC50 = 1.60+/-0.25 microM; Emax = 147.61+/-10.96% control) 4AP-evoked [3H]glutamate release, in the absence of arachidonic acid. This potentiation could be abolished by either the selective mGlu1 receptor antagonist (R,S)-1-aminoindan-1,5-dicarboxylic acid (AIDA, 1 mM) or the selective PKC inhibitor (Ro 31-8220, 10 microM) and was BSA-insensitive. The selective mGlu5 receptor agonist (R,S)-2-chloro-5-hydroxyphenylglycine (CHPG, 300 microM) was without effect. DHPG (100 microM) also potentiated both 30 mM and 50 mM K+ -evoked [3H]glutamate release (121.60+/-12.77% and 121.50 +/-4.45% control, respectively). DHPG (100 microM) failed to influence both 4AP-stimulated 45Ca2+ influx and 50 mM K+ -induced changes in synaptosomal membrane potential. Possible group I mGlu receptor suppression of tonic adenosine A1 receptor, group II/III mGlu receptors or GABA(B) receptor activity is unlikely since 4AP-evoked [3H]glutamate release was insensitive to the selective inhibitory receptor antagonists 8-cyclopentyl-1,3-dimethylxanthine, (R,S)-alpha-cyclopropyl-4-phosphonophenylglycine or CGP55845A, respectively. These data suggest an 'mGlu1 receptor-like' receptor potentiates [3H]glutamate release from cerebrocortical synaptosomes in the absence of exogenously applied arachidonic acid. This PKC dependent effect is unlikely to be via modulation of synaptosomal membrane potential or voltage-activated Ca2+ channels and not via a suppression of tonically active inhibitory adenosine A1 receptor, group II/III mGlu receptors or GABA(B) receptors.

Since kainate evokes large non-desensitizing currents at alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, kainate is of limited use in discriminating between AMPA and kainate receptors. Following recent reports that (2S,4R)-4-methylglutamate is a kainate receptor-selective agonist, we have radiolabelled and subsequently characterized the binding of [3H]-(2S,4R)-4-methylglutamate to rabbit whole-brain membranes. [3H]-(2S,4R)-4-methylglutamate binding was rapid, reversible and labelled two sites (KD1 = 3.67+/-0.50 nM/Bmax1 = 0.54+/-0.03 pmol/mg protein and KD2 = 281.66+/-12.33 nM/ Bmax2 = 1.77+/-0.09 pmol/mg protein). [3H]-(2S,4R)-4-methylglutamate binding was displaced by several non-NMDA receptor ligands: domoate > kainate >> L-quisqualate > or = L-glutamate > 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) >> (S)-AMPA = (S)-5-fluorowillardiine > NMDA. Neither the metabotropic glutamate receptor agonists (1S,3R)-ACPD or L-AP4, together with the L-glutamate uptake inhibitor L-trans-2,4-PDC, influenced binding when tested at 100 microM. We conclude that [3H]-(2S,4R)-4-methylglutamate is a useful radioligand for labelling kainate receptors. It possesses high selectivity, and possesses a pharmacology similar to that for rat cloned low-affinity (Glu5 and 6) kainate receptor subunits.

Antibodies in Section 2B of the Third International Workshop on Monoclonal Antibodies were tested against human erythrocytes treated with different enzymes and against erythrocytes with well-defined rare phenotypes by immunoblotting and hemagglutination. In some instances, the epitope recognized by the Mab was precisely determined.

Seventy Mabs against human glycophorins (GP) and band 3 were tested with red blood cells (RBCs) of various non-human primates, from anthropoid apes to monkeys. Differences among Mabs reactivity in tests with non-human primate RBCs reflect the complexity of the immune reactions to human GPs and provide insights into aspects of evolution and a tool to epitope map.

We report an antibody (anti-MINY) that recognises a novel low-incidence MNS-related blood group antigen. Anti-MINY agglutinates all Hil-positive red cells tested (Mi.III, Mi.V, Mi.VI, GP.Kipp, GP.Mor and AG) and Hil-negative TSEN-positive red cells (Mi.IV, JR, JL, Oca. and Rag.). All MINY-positive red cells possess glycophorin A-B hybrid molecules. The MINY antigen occurs at the unique amino acid sequence which results from the junction of glycophorin A58 to glycophorin B27 regardless of whether the glycophorin B gene encodes methionine or threonine at amino acid residue 29 of normal glycophorin B. The MINY antigen has been provisionally assigned the MNS blood group system number 002.034 on behalf of the ISBT Working Party on Terminology for Red Cell Surface Antigens.

The blood group Duch (Dha) antigen is located on glycophorin C (GPC). Total RNA prepared from the reticulocyte fraction of two Dh(a+) individuals were used in the synthesis of first-strand cDNA. The first-strand cDNA served as templates for the amplification of GPC-related DNA by polymerase chain reaction (PCR). The expected PCR product consisted of 412 base pairs. On sequencing the PCR-amplified DNA, a base change (cytosine----thymidine) at nucleotide 40 of the GPC cDNA was detected. Thus, the variant GPC (GPC.Dha) on Dh(a+) red cells has a substitution of leucine by phenylalanine at amino acid residue 14.

Eighteen commercial bovine serum albumin (BSA) preparations were evaluated for their efficacy in hemagglutination enhancement by the capillary tube method. Their physicochemical variables (pH, conductivity, free fatty acids, total protein, and polymer content) were quantified. The results showed that a BSA preparation which consistently performed well in hemagglutination enhancement contained some albumin polymer and had a low free fatty acid content. We also found that the addition of Ficoll (final concentration of 1.24%) could convert BSA preparations producing mediocre hemagglutination enhancement into good enhancers, provided that these preparations did not have high free fatty acid content. Hence, the addition of Ficoll can obviate the requirement for selecting a polymer-enhanced albumin for use in capillary tube tests.

This study considers women's opinions of antenatal care. Arguing that previous research results from two opposing perspectives, that of the provider of the service and that of the user, the authors then locate the present study firmly in the latter category. They report on findings from a study of consumers' opinions of antenatal care as it was delivered in a large city hospital. Three areas form the, topics for discussion; these are practical considerations of clinic visits, doctor-patient interaction, and antenatal classes.

A 38-year-old Russian woman (KZ) has been identified as the fourth proposita with the Inab blood group phenotype. Like the first two propositi, she has a chronic intestinal disorder and, as shown for the third proposita, her Inab phenotype is demonstrably inherited. KZ's serum contained anti-IFC, which reacted with a red blood cell (RBC) membrane component with an Mr of 70,000, which is decay accelerating factor (DAF). Her RBCs lacked all Cromer-related blood group antigens and DAF. Her RBCs were no more susceptible than normal control RBCs to lysis in acid lysis or in rabbit or human antibody-initiated complement lysis tests. Northern blots of total RNA isolated from KZ's Epstein- Barr virus-transformed lymphoblasts showed a marked reduction of DAF mRNA when compared with normal. Polymerase chain reaction (PCR) amplification of cDNA confirmed this reduced level of DAF mRNA. Sequencing of the PCR product showed a 44-nucleotide deletion in the mRNA close to the short consensus repeats IIIa/IIIb intron/exon boundary. This deletion results in a change in the reading frame that places a termination codon six amino acids after the deletion. The putative translation product would lack a glycosyl phosphatidyl- inositol linkage site and, therefore, would not be membrane-bound in the RBC.