A molecule has been identified that can elicit a deadly immune response after blood transfusion, as reported in this week’s Nature Medicine.
Transfusion-related acute lung injury (TRALI) is a frequent cause of death after blood transfusion. TRALI is often caused by antibodies found in blood components that are directed against a protein, HNA-3a. The identity of these antibodies has so far remained unknown.
Andreas Greinacher and colleagues now show that HNA-3a is coded by the choline transporter-like protein-2 gene, and that genetic variants in this molecule change the reactivity of the protein with HNA-3a-specific antibodies.
The molecular identification of this antigen should facilitate the development of tests for blood donor screening to lower the risk of TRALI.