Hunting for the elusive target antigen in gestational alloimmune liver disease (GALD).

The prevailing concept is that gestational alloimmune liver disease (GALD) is caused by maternal antibodies targeting a currently unknown antigen on the liver of the fetus. This leads to deposition of complement on the fetal hepatocytes and death of the fetal hepatocytes and extensive liver injury....

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Main Authors: Klaus Rieneck, Karen Koefoed Rasmussen, Erwin M Schoof, Frederik Banch Clausen, Henrietta Holze, Thomas Bergholt, Marianne Hørby Jørgensen, Vibeke Brix Christensen, Runar Almaas, Peter Lüttge Jordal, Marie Locard-Paulet, Kasper Runager, Leif Kofoed Nielsen, Balthasar Clemens Schlotmann, Joachim Lütken Weischenfeldt, Lars Juhl Jensen, Morten Hanefeld Dziegiel
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0286432
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author Klaus Rieneck
Karen Koefoed Rasmussen
Erwin M Schoof
Frederik Banch Clausen
Henrietta Holze
Thomas Bergholt
Marianne Hørby Jørgensen
Vibeke Brix Christensen
Runar Almaas
Peter Lüttge Jordal
Marie Locard-Paulet
Kasper Runager
Leif Kofoed Nielsen
Balthasar Clemens Schlotmann
Joachim Lütken Weischenfeldt
Lars Juhl Jensen
Morten Hanefeld Dziegiel
author_facet Klaus Rieneck
Karen Koefoed Rasmussen
Erwin M Schoof
Frederik Banch Clausen
Henrietta Holze
Thomas Bergholt
Marianne Hørby Jørgensen
Vibeke Brix Christensen
Runar Almaas
Peter Lüttge Jordal
Marie Locard-Paulet
Kasper Runager
Leif Kofoed Nielsen
Balthasar Clemens Schlotmann
Joachim Lütken Weischenfeldt
Lars Juhl Jensen
Morten Hanefeld Dziegiel
author_sort Klaus Rieneck
collection DOAJ
description The prevailing concept is that gestational alloimmune liver disease (GALD) is caused by maternal antibodies targeting a currently unknown antigen on the liver of the fetus. This leads to deposition of complement on the fetal hepatocytes and death of the fetal hepatocytes and extensive liver injury. In many cases, the newborn dies. In subsequent pregnancies early treatment of the woman with intravenous immunoglobulin can be instituted, and the prognosis for the fetus will be excellent. Without treatment the prognosis can be severe. Crucial improvements of diagnosis require identification of the target antigen. For this identification, this work was based on two hypotheses: 1. The GALD antigen is exclusively expressed in the fetal liver during normal fetal life in all pregnancies; 2. The GALD antigen is an alloantigen expressed in the fetal liver with the woman being homozygous for the minor allele and the father being, most frequently, homozygous for the major allele. We used three different experimental approaches to identify the liver target antigen of maternal antibodies from women who had given birth to a baby with the clinical GALD diagnosis: 1. Immunoprecipitation of antigens from either a human liver cell line or human fetal livers by immunoprecipitation with maternal antibodies followed by mass spectrometry analysis of captured antigens; 2. Construction of a cDNA expression library from human fetal liver mRNA and screening about 1.3 million recombinants in Escherichia coli using antibodies from mothers of babies diagnosed with GALD; 3. Exome/genome sequencing of DNA from 26 presumably unrelated women who had previously given birth to a child with GALD with husband controls and supplementary HLA typing. In conclusion, using the three experimental approaches we did not identify the GALD target antigen and the exome/genome sequencing results did not support the hypothesis that the GALD antigen is an alloantigen, but the results do not yield basis for excluding that the antigen is exclusively expressed during fetal life., which is the hypothesis we favor.
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series PLoS ONE
spelling doaj-art-6c90ac40f7e14cda8962eef73d907e212024-11-28T05:31:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011810e028643210.1371/journal.pone.0286432Hunting for the elusive target antigen in gestational alloimmune liver disease (GALD).Klaus RieneckKaren Koefoed RasmussenErwin M SchoofFrederik Banch ClausenHenrietta HolzeThomas BergholtMarianne Hørby JørgensenVibeke Brix ChristensenRunar AlmaasPeter Lüttge JordalMarie Locard-PauletKasper RunagerLeif Kofoed NielsenBalthasar Clemens SchlotmannJoachim Lütken WeischenfeldtLars Juhl JensenMorten Hanefeld DziegielThe prevailing concept is that gestational alloimmune liver disease (GALD) is caused by maternal antibodies targeting a currently unknown antigen on the liver of the fetus. This leads to deposition of complement on the fetal hepatocytes and death of the fetal hepatocytes and extensive liver injury. In many cases, the newborn dies. In subsequent pregnancies early treatment of the woman with intravenous immunoglobulin can be instituted, and the prognosis for the fetus will be excellent. Without treatment the prognosis can be severe. Crucial improvements of diagnosis require identification of the target antigen. For this identification, this work was based on two hypotheses: 1. The GALD antigen is exclusively expressed in the fetal liver during normal fetal life in all pregnancies; 2. The GALD antigen is an alloantigen expressed in the fetal liver with the woman being homozygous for the minor allele and the father being, most frequently, homozygous for the major allele. We used three different experimental approaches to identify the liver target antigen of maternal antibodies from women who had given birth to a baby with the clinical GALD diagnosis: 1. Immunoprecipitation of antigens from either a human liver cell line or human fetal livers by immunoprecipitation with maternal antibodies followed by mass spectrometry analysis of captured antigens; 2. Construction of a cDNA expression library from human fetal liver mRNA and screening about 1.3 million recombinants in Escherichia coli using antibodies from mothers of babies diagnosed with GALD; 3. Exome/genome sequencing of DNA from 26 presumably unrelated women who had previously given birth to a child with GALD with husband controls and supplementary HLA typing. In conclusion, using the three experimental approaches we did not identify the GALD target antigen and the exome/genome sequencing results did not support the hypothesis that the GALD antigen is an alloantigen, but the results do not yield basis for excluding that the antigen is exclusively expressed during fetal life., which is the hypothesis we favor.https://doi.org/10.1371/journal.pone.0286432
spellingShingle Klaus Rieneck
Karen Koefoed Rasmussen
Erwin M Schoof
Frederik Banch Clausen
Henrietta Holze
Thomas Bergholt
Marianne Hørby Jørgensen
Vibeke Brix Christensen
Runar Almaas
Peter Lüttge Jordal
Marie Locard-Paulet
Kasper Runager
Leif Kofoed Nielsen
Balthasar Clemens Schlotmann
Joachim Lütken Weischenfeldt
Lars Juhl Jensen
Morten Hanefeld Dziegiel
Hunting for the elusive target antigen in gestational alloimmune liver disease (GALD).
PLoS ONE
title Hunting for the elusive target antigen in gestational alloimmune liver disease (GALD).
title_full Hunting for the elusive target antigen in gestational alloimmune liver disease (GALD).
title_fullStr Hunting for the elusive target antigen in gestational alloimmune liver disease (GALD).
title_full_unstemmed Hunting for the elusive target antigen in gestational alloimmune liver disease (GALD).
title_short Hunting for the elusive target antigen in gestational alloimmune liver disease (GALD).
title_sort hunting for the elusive target antigen in gestational alloimmune liver disease gald
url https://doi.org/10.1371/journal.pone.0286432
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