alexa Immunohistochemical Demonstration of Blood Group Antige
ISSN: 2167-0897

Journal of Neonatal Biology
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Research Article

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
Tel: 708-216-1067
Fax: 708-216-5602
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.


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