No abstract

Summary. The inexplicable severity of anti‐Pr autoimmune haemolytic anaemia led us to test the hypothesis that the haemolysis was primarily due to a change in the function of glycophorin A, on which the Pr antigen is located. The lectins Maclura pomifera and wheat germ agglutinin that bind to glycophorin A induced the haemolysis of normal erythrocytes in vitro. Lectin binding led to an increase in erythrocyte membrane permeability to sodium and potassium, the former resulting in an influx of water and subsequent haemolysis. The response was glycophorin A specific as Concanavalin A, which binds to band 3, did not cause haemolysis and peanut agglutinin only did so after removal of erythrocyte sialic acid. The lectin‐induced cation leak was not mediated by activation of cation channels as the inhibitors, tetrodotoxin, amiloride and 4,4′ diisothiocyanate stilbene 2,2′disulphonate, had no effect, suggesting that the haemolysis was due to exacerbation of the inherent cation permeability of the erythrocyte membrane. A human IgAK anti‐Pr autoantibody and a mouse anti‐human glycophorin A antibody increased erythrocyte permeability to sodium. The role of glycophorin A in stabilizing and, upon aggregation, destabilizing the phospholipid bilayer is discussed. Our findings may help explain the severity of anti‐Pr autoimmune haemolytic anaemia and other pathophysiological changes in human erythrocytes.

Soluble GM-CSF receptor α subunit (sGMRα) is a soluble isoform of the GMRα that is believed to arise exclusively through alternative splicing of the GMRα gene product. The sGMRα mRNA is expressed in a variety of tissues, but it is not clear which cells are capable of secreting the protein. We show here that normal human monocytes, but not lymphocytes, constitutively secrete sGMRα. Stimulation of monocytes with GM-CSF, LPS, PMA, or A23187 rapidly up-regulates the secretion of sGMRα in a dose-dependent manner, demonstrating that secretion is also regulated. To determine whether sGMRα arose exclusively through alternative splicing of the GMRα gene product, or whether it could also be generated through ectodomain shedding of GMRα, we engineered a murine pro-B cell line (Ba/F3) to express exclusively the cDNA for cell surface GMRα (Ba/F3.GMRα). The Ba/F3.GMRα cell line, but not the parental Ba/F3 cell line, constitutively shed a sGMRα-like protein that bound specifically to GM-CSF, was equivalent in size to recombinant alternatively spliced sGMRα (60 kDa), and was recognized specifically by a mAb raised against the ectodomain of GMRα. Furthermore, a broad-spectrum metalloprotease inhibitor (BB94) reduced constitutive and PMA-, A23187-, and LPS-induced secretion of sGMRα by monocytes, suggesting that shedding of GMRα by monocytes may be mediated in part through the activity of metalloproteases. Taken together, these observations demonstrate that sGMRα is constitutively secreted by monocytes, that GM-CSF and inflammatory mediators up-regulate sGMRα secretion, and that sGMRα arises not only through alternative splicing but also through ectodomain shedding of cell surface GMRα.

On the basis of the finding of alternatively spliced mRNAs, the -subunit of the receptor for GM-CSF is thought to exist in both a membrane spanning (tmGMR) and a soluble form (solGMR). However, only limited data has been available to support that the solGMR protein product exists in vivo. We hypothesized that hematopoietic cells bearing tmGMR would have the potential to also produce solGMR. To test this hypothesis we examined media conditioned by candidate cells using functional, biochemical, and immunologic means. Three human leukemic cell lines that express tmGMR (HL60, U937, THP1) were shown to secrete GM-CSF binding activity and a solGMR-specific band by Western blot, whereas a tmGMR-negative cell line (K562) did not. By the same analyses, leukapheresis products collected for autologous and allogeneic stem cell transplants and media conditioned by freshly isolated human neutrophils also contained solGMR. The solGMR protein in vivo displayed the same dissociation constant (Kd = 2-5 nmol) as that of recombinant solGMR. A human solGMR ELISA was developed that confirmed the presence of solGMR in supernatant conditioned by the tmGMR-positive leukemic cell lines, hematopoietic progenitor cells, and neutrophils. Furthermore, the ELISA demonstrated a steady state level of solGMR in normal human plasma (36 ± 17 pmol) and provided data suggesting that plasma solGMR levels can be elevated in acute myeloid leukemias.