Polymorphism of Adhesion Molecule CD31 and Its Role in Acute Graft-Versus-Host Disease
Esther Behar, Ph.D., Nelson J. Chao, M.D., Debra D. Hiraki, Ph.D., Shalini Krishnaswamy, M.D., Byron W. Brown, Ph.D., James L. Zehnder, M.D., and F. Carl Grumet, M.D.
Background Graft-versus-host disease (GVHD) caused by poorlydefined minor (i.e., other than HLA) histocompatibility antigensremains a serious problem in recipients of bone marrow transplants.We sought to determine whether the CD31 adhesion molecule isa minor alloantigen.
Methods We directly sequenced samples of complementary DNA (cDNA)encoding CD31 molecules from 21 unrelated normal subjects. Sequence-specificprimers were then designed to amplify alleles by the polymerasechain reaction, thereby permitting CD31 typing of genomic DNAfrom additional normal subjects. To assess the relevance ofCD31 matching to bone marrow transplantation, we performed CD31typing of 46 recipients of bone marrow (32 without GVHD and14 with severe [grade III or IV] acute GVHD) and their HLA-identicalsibling donors. The immunoreactivity of CD31 phenotypes withanti-CD31 monoclonal antibodies was compared by flow cytometry.
Results Direct sequencing of cDNA for CD31 from the 21 normalsubjects identified a single polymorphism, CTGGTG (LeuVal),at codon 125; we designated the resulting alleles CD31.L andCD31.V, respectively. The CD31 genotypes of these and 142 otherunrelated subjects were of the expected frequencies. Among thetransplant recipients, 71 percent of those with acute GVHD hadCD31 genotypes that were not identical to the donor's genotype,as compared with 22 percent of the recipients without GVHD (P= 0.004). The binding of anti-CD31 monoclonal antibodies asmeasured by fluorescence-activated cell sorting correlated withthe CD31 types of homozygous cell lines.
Conclusions The adhesion molecule CD31 is polymorphic. Whendonor and recipient genotypes are not identical, the risk ofGVHD increases. Prospective CD31 typing may reduce the riskof acute GVHD.
Source Information
From the Departments of Pathology (E.B., D.D.H., S.K., J.L.Z., F.C.G.), Medicine (N.J.C., J.L.Z.), and Health Research and Policy (B.W.B.), Stanford University, Stanford, Calif.
Address reprint requests to Dr. Grumet at the Stanford University Blood Center, 800 Welch Rd., Palo Alto, CA 94304.
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