Summary. Fcc receptor (FccR)-mediated destruction of immunoglobulin-coated red blood cells (RBCs) is the underlying mechanism of haemolytic disease of the newborn. Human leucocyte antigen (HLA) antibodies in vitro are able to block monocyte FccRs and prevent phagocytosis. The intention was to demonstrate this effect in vivo upon a volunteer. Plasma containing a non-cytotoxic HLA-DR alloantibody was infused into the subject. The FccR blockade was achieved and persisted for about 2AE5 d, but, unexpectedly, a mild transfusion-related acute lung injury (TRALI) was also caused. Monocytes disappeared completely from the peripheral blood within the first hour after infusion and a mild pulmonary oedema was observed within 3-4 h. The subject recovered within 2 d.
A previously unrecognized second antigen, HNA-1d, is present on FcγRIIIb encoded by FCGR3B*02. This antigen is characterized by the sequence Ala78---Asn82. It appears that only individuals carrying the HNA-1c phenotype can form anti-HNA-1d alloantibodies. The HNA-1 system now consists of four antigens encoded by three alleles.
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