Abstract
The blood cells of patients with paroxysmal nocturnal hemoglobinuria (PNH) have abnormal interactions with complement. The activity of the alternative pathway C3 convertase on the platelets of 9 out of 19 patients with PNH was elevated. 10 patients had C3 convertase activity within the normal range even though 80-95% of their platelets lacked the complement regulatory protein decay accelerating factor (DAF) that is absent from the affected blood cells in PNH. PNH and normal platelets released factor H when C3 was bound to their surfaces. This may account for the apparent regulation of C3 convertase activity on platelets that lack DAF. The abnormal uptake of the membrane attack complex of complement by PNH III erythrocytes was not seen in PNH platelets. 111Indium-labeled platelet survival times were normal in five of eight patients, which suggests that the lack of the membrane attack complex defect results in normal platelet survival in PNH.
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- Aster R. H., Enright S. E. A platelet and granulocyte membrane defect in paroxysmal nocturnal hemoglobinuria: usefulness for the detection of platelet antibodies. J Clin Invest. 1969 Jul;48(7):1199–1210. doi: 10.1172/JCI106084. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ballow M., Cochrane C. G. Two anticomplementary factors in cobra venom: hemolysis of guinea pig erythrocytes by one of them. J Immunol. 1969 Nov;103(5):944–952. [PubMed] [Google Scholar]
- Dixon R. H., Rosse W. F. Mechanism of complement-mediated activation of human blood platelets in vitro: comparison of normal and paroxysmal nocturnal hemoglobinuria platelets. J Clin Invest. 1977 Feb;59(2):360–368. doi: 10.1172/JCI108648. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Falk R. J., Dalmasso A. P., Kim Y., Tsai C. H., Scheinman J. I., Gewurz H., Michael A. F. Neoantigen of the polymerized ninth component of complement. Characterization of a monoclonal antibody and immunohistochemical localization in renal disease. J Clin Invest. 1983 Aug;72(2):560–573. doi: 10.1172/JCI111004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fraker P. J., Speck J. C., Jr Protein and cell membrane iodinations with a sparingly soluble chloroamide, 1,3,4,6-tetrachloro-3a,6a-diphrenylglycoluril. Biochem Biophys Res Commun. 1978 Feb 28;80(4):849–857. doi: 10.1016/0006-291x(78)91322-0. [DOI] [PubMed] [Google Scholar]
- Götze O., Müller-Eberhard H. J. Lysis of erythrocytes by complement in the absence of antibody. J Exp Med. 1970 Nov;132(5):898–915. doi: 10.1084/jem.132.5.898. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ham T. H., Dingle J. H. STUDIES ON DESTRUCTION OF RED BLOOD CELLS. II. CHRONIC HEMOLYTIC ANEMIA WITH PAROXYSMAL NOCTURNAL HEMOGLOBINURIA: CERTAIN IMMUNOLOGICAL ASPECTS OF THE HEMOLYTIC MECHANISM WITH SPECIAL REFERENCE TO SERUM COMPLEMENT. J Clin Invest. 1939 Nov;18(6):657–672. doi: 10.1172/JCI101081. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harker L. A. Thrombokinetics in idiopathic thrombocytopenic purpura. Br J Haematol. 1970 Jul;19(1):95–104. doi: 10.1111/j.1365-2141.1970.tb01605.x. [DOI] [PubMed] [Google Scholar]
- Heaton W. A., Davis H. H., Welch M. J., Mathias C. J., Joist J. H., Sherman L. A., Siegel B. A. Indium-III: a new radionuclide label for studying human platelet kinetics. Br J Haematol. 1979 Aug;42(4):613–622. doi: 10.1111/j.1365-2141.1979.tb01174.x. [DOI] [PubMed] [Google Scholar]
- Hoffmann E. M. Inhibition of complement by a substance isolated from human erythrocytes. II. Studies on the site and mechanism of action. Immunochemistry. 1969 May;6(3):405–419. doi: 10.1016/0019-2791(69)90297-3. [DOI] [PubMed] [Google Scholar]
- Kenney D. M., Davis A. E., 3rd Association of alternative complement pathway components with human blood platelets: secretion and localization of factor D and beta 1H Globulin. Clin Immunol Immunopathol. 1981 Dec;21(3):351–363. doi: 10.1016/0090-1229(81)90224-5. [DOI] [PubMed] [Google Scholar]
- Lambris J. D., Dobson N. J., Ross G. D. Release of endogenous C3b inactivator from lymphocytes in response to triggering membrane receptors for beta 1H globulin. J Exp Med. 1980 Dec 1;152(6):1625–1644. doi: 10.1084/jem.152.6.1625. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Medof M. E., Kinoshita T., Nussenzweig V. Inhibition of complement activation on the surface of cells after incorporation of decay-accelerating factor (DAF) into their membranes. J Exp Med. 1984 Nov 1;160(5):1558–1578. doi: 10.1084/jem.160.5.1558. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Murphy E. A., Francis M. E. The estimation of blood platelet survival. II. The multiple hit model. Thromb Diath Haemorrh. 1971;25(1):53–80. [PubMed] [Google Scholar]
- Nicholson-Weller A., Burge J., Fearon D. T., Weller P. F., Austen K. F. Isolation of a human erythrocyte membrane glycoprotein with decay-accelerating activity for C3 convertases of the complement system. J Immunol. 1982 Jul;129(1):184–189. [PubMed] [Google Scholar]
- Nicholson-Weller A., March J. P., Rosenfeld S. I., Austen K. F. Affected erythrocytes of patients with paroxysmal nocturnal hemoglobinuria are deficient in the complement regulatory protein, decay accelerating factor. Proc Natl Acad Sci U S A. 1983 Aug;80(16):5066–5070. doi: 10.1073/pnas.80.16.5066. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nicholson-Weller A., Spicer D. B., Austen K. F. Deficiency of the complement regulatory protein, "decay-accelerating factor," on membranes of granulocytes, monocytes, and platelets in paroxysmal nocturnal hemoglobinuria. N Engl J Med. 1985 Apr 25;312(17):1091–1097. doi: 10.1056/NEJM198504253121704. [DOI] [PubMed] [Google Scholar]
- Packman C. H., Rosenfeld S. I., Jenkins D. E., Jr, Thiem P. A., Leddy J. P. Complement lysis of human erythrocytes. Differeing susceptibility of two types of paroxysmal nocturnal hemoglobinuria cells to C5b-9. J Clin Invest. 1979 Aug;64(2):428–433. doi: 10.1172/JCI109479. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pangburn M. K., Schreiber R. D., Müller-Eberhard H. J. Deficiency of an erythrocyte membrane protein with complement regulatory activity in paroxysmal nocturnal hemoglobinuria. Proc Natl Acad Sci U S A. 1983 Sep;80(17):5430–5434. doi: 10.1073/pnas.80.17.5430. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pangburn M. K., Schreiber R. D., Trombold J. S., Müller-Eberhard H. J. Paroxysmal nocturnal hemoglobinuria: deficiency in factor H-like functions of the abnormal erythrocytes. J Exp Med. 1983 Jun 1;157(6):1971–1980. doi: 10.1084/jem.157.6.1971. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Parker C. J., Baker P. J., Rosse W. F. Increased enzymatic activity of the alternative pathway convertase when bound to the erythrocytes of paroxysmal nocturnal hemoglobinuria. J Clin Invest. 1982 Feb;69(2):337–346. doi: 10.1172/JCI110457. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Parker C. J., Wiedmer T., Sims P. J., Rosse W. F. Characterization of the complement sensitivity of paroxysmal nocturnal hemoglobinuria erythrocytes. J Clin Invest. 1985 Jun;75(6):2074–2084. doi: 10.1172/JCI111927. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Peytremann R., Rhodes R. S., Hartmann R. C. Thrombosis in paroxysmal nocturnal hemoglobinuria (PNH) with particular reference to progressive, diffuse hepatic venous thrombosis. Ser Haematol. 1972;5(3):115–136. [PubMed] [Google Scholar]
- Polley M. J., Nachman R. L. Human complement in thrombin-mediated platelet function: uptake of the C5b-9 complex. J Exp Med. 1979 Sep 19;150(3):633–645. doi: 10.1084/jem.150.3.633. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Polley M. J., Nachman R. The human complement system in thrombin-mediated platelet function. J Exp Med. 1978 Jun 1;147(6):1713–1726. doi: 10.1084/jem.147.6.1713. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rosse W. F., Dacie J. V. Immune lysis of normal human and paroxysmal nocturnal hemoglobinuria (PNH) red blood cells. I. The sensitivity of PNH red cells to lysis by complement and specific antibody. J Clin Invest. 1966 May;45(5):736–748. doi: 10.1172/JCI105388. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rosse W. F., Parker C. J. Paroxysmal nocturnal haemoglobinuria. Clin Haematol. 1985 Feb;14(1):105–125. [PubMed] [Google Scholar]
- Rouault T. A., Rosse W. F., Bell S., Shelburne J. Differences in the terminal steps of complement lysis of normal and paroxysmal nocturnal hemoglobinuria red cells. Blood. 1978 Feb;51(2):325–330. [PubMed] [Google Scholar]
- Schmaier A. H., Smith P. M., Colman R. W. Platelet C1- inhibitor. A secreted alpha-granule protein. J Clin Invest. 1985 Jan;75(1):242–250. doi: 10.1172/JCI111680. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schreiber R. D., Götze O., Müller-Eberhard H. J. Nephritic factor: its structure and function and its relationship to initiating factor of the alternative pathway. Scand J Immunol. 1976;5(6-7):705–713. doi: 10.1111/j.1365-3083.1976.tb03020.x. [DOI] [PubMed] [Google Scholar]
- Sims P. J., Wiedmer T. Repolarization of the membrane potential of blood platelets after complement damage: evidence for a Ca++ -dependent exocytotic elimination of C5b-9 pores. Blood. 1986 Aug;68(2):556–561. [PubMed] [Google Scholar]
- Tack B. D., Prahl J. W. Third component of human complement: purification from plasma and physicochemical characterization. Biochemistry. 1976 Oct 5;15(20):4513–4521. doi: 10.1021/bi00665a028. [DOI] [PubMed] [Google Scholar]
- Thakur M. L., Welch M. J., Joist J. H., Coleman R. E. Indium-LLL labeled platelets: studies on preparation and evaluation of in vitro and in vivo functions. Thromb Res. 1976 Oct;9(4):345–357. doi: 10.1016/0049-3848(76)90135-3. [DOI] [PubMed] [Google Scholar]
- Towbin H., Staehelin T., Gordon J. Electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose sheets: procedure and some applications. Proc Natl Acad Sci U S A. 1979 Sep;76(9):4350–4354. doi: 10.1073/pnas.76.9.4350. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zimmerman T. S., Kolb W. P. Human platelet-initiated formation and uptake of the C5-9 complex of human complement. J Clin Invest. 1976 Jan;57(1):203–211. doi: 10.1172/JCI108261. [DOI] [PMC free article] [PubMed] [Google Scholar]