Effect of ABO blood group mismatching on corneal epithelial cells: an in vitro study
Jin H Chana, Harminder S Duaa, April Powell-Richardsa, D Rhodri E Jonesb, Ian M Harrisc
a Department of
Ophthalmology, School of Clinical and Laboratory Sciences, University
of Nottingham, UK, b Department of Immunopathology, c Department of Haematology
Correspondence to: Professor HS Dua, Department of Ophthalmology, Eye Ear Nose Throat Centre, B floor, Queens Medical Centre, University Hospital, Nottingham NG7 2UH, UK harminder.dua{at}nottingham.ac.uk
Accepted for publication 12 March 2001
AIM
To determine, in
vitro, the effects of blood group ABO mismatching on corneal epithelial cells.
METHODSCorneal
epithelial cell cultures were established from 32 human cadaver donor
eyes. Epithelial cells (100 µl of 4 × 102 cells per
µl) were incubated for 4 hours with antibodies against blood group
antigens A, B, and AB, with and without complement. Cell lysis was
assayed by a chemiluminescent assay using Cytolite reagent. Live cells,
remaining after incubation, were counted in a scintillation counter.
The blood group of the donors was determined retrospectively, in a
blinded manner.
RESULTSRetrospective
tracing of donor blood groups was possible for 20 donors. In all cases
the blood group corresponded with that suggested by the cell lysis
assay. Significant cell lysis was observed when known A group cells
were incubated with anti-A and anti-AB antibody, B group cells were
incubated with anti-B and AB antibody, and AB group cells were
incubated with anti-AB antibody. Lysis occurred only in the presence
of complement. No lysis of O group cells was observed with any of the
antibodies. In all cases, lysis was observed only with neat (serum)
antibody concentrations.
CONCLUSIONSBlood
group ABO mismatching results in significant lysis of corneal
epithelial cells. The antibody concentration required for lysis equals
that found in serum. Such levels of antibody are unlikely to be
achieved in tears and/or aqueous. This may offer an explanation for the
conflicting reports of the studies on the effect of blood group
matching on corneal grafts. The variability in the outcome may reflect
the levels of antibodies gaining access to the corneal cells and not
the mismatching alone.
© 2001 by British Journal of Ophthalmology
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