Immunohistochemical Demonstration of Blood Group Antigen Expression in Intestinal Endothelium Links Blood Type and Necrotizing Enterocolitis
|Charissa L Manuat1, Sherri J Yong3, Phillip J DeChristopher2, Christina A Kwong2, Loretto A Glynn4, Omar Habeeb5, Tricia L Thomson1 and Jonathan K Muraskas1*|
|1Division of Neonatology, Department of Pediatrics, Loyola University Health System, Maywood, IL, USA|
|2Department of Pathology, Loyola University Health System, Maywood, IL, USA|
|3Department of Pathology, OSF Saint Francis Medical Center, Peoria, IL, USA|
|4Department of Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago at Cadence Health, Winfield, IL, USA|
|5Department of Pathology, Hutt Valley District Health Board, Wellington, NZ|
|*Corresponding Author :||Jonathan K Muraskas
2160 S First Avenue Maywood
IL 60153, USA
E-mail: [email protected]
|Received: January 04, 2016 Accepted: February 03, 2016 Published: February 08, 2016|
|Citation: Manuat CL, Yong SJ, De Christopher PJ, Kwong CA, Glynn LA, et al. (2016) Immunohistochemical Demonstration of Blood Group Antigen Expression in Intestinal Endothelium Links Blood Type and Necrotizing Enterocolitis. J Neonatal Biol 5:211. doi:10.4172/2167-0897.1000211|
|Copyright: © 2016 Manuat CL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Objectives: To determine the presence of A and B blood group antigens on vascular endothelial cells of intestinal tissue and compare tissue resected for necrotizing enterocolitis (NEC) with tissues resected for non-NEC pathologies (spontaneous intestinal perforation (SIP), intussusception, Hirschsprung disease, intestinal atresia, etc.) in an effort to implicate blood group antigen expression on bowel endothelium as a mechanism of bowel injury in NEC via a humoral immune-mediated inflammatory response.
Methods :Intestinal tissue from 21 patients with NEC and 23 non-NEC patients (5 of which were SIP) was stained with monoclonal antibodies against blood group antigens A and B. Vascular endothelial lined spaces were examined for expression of these blood group antigens and graded as 0 (no staining) to 3 (marked staining).
Results: Control group birth gestational age (GA) ranged from 26 to 40 weeks (Mdn=36.4-37.0). Both NEC and SIP groups had birth GA ranging from 24 to 37 weeks (Mdn=29.3 and Mdn=27.6, respectively). Overall, A and B blood group antigens were appropriately expressed on the endothelium of all intestinal tissue regardless of the presence of NEC. The A antigen appeared to stain more intensely than the B antigen in most tissue, except for the NEC sample from an AB blood type patient in which A and B antigens stained equally intense (grade 3). Multivariate regression analysis confirms the significantly inverse relationship between gestational age and NEC, but a significant relationship could not be established between blood group or IHC scoring of the blood group antigen expression and NEC. 1.4 Conclusions: Blood group antigens, A more than B or AB together, may increase the risk of a neonate to develop NEC in the presence of passively or actively transferred isoagglutinins.