{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:09:56Z","timestamp":1789787396315,"version":"4.0.1"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Anti-D prevents hemolytic disease of the fetus and newborn, and this mechanism has been referred to as Ab-mediated immune suppression (AMIS). Anti-D, as well as other polyclonal AMIS-inducing Abs, most often induce both epitope masking and erythrocyte clearance mechanisms. We have previously observed that some Abs that successfully induce AMIS effects could be split into those that mediate epitope masking versus those that induce erythrocyte clearance, allowing the ability to analyze these mechanisms separately. In addition, AMIS-inducing activity has recently been shown to induce Ag modulation (Ag loss from the erythrocyte surface). To assess these mechanisms, we immunized mice with transgenic murine RBCs expressing a single Ag protein comprising a recombinant Ag composed of hen egg lysozyme, OVA sequences comprising aa 251\u2013349, and the human Duffy transmembrane protein (HOD-Ag) with serial doses of polyclonal anti-OVA IgG as the AMIS-inducing Ab. The anti-OVA Ab induced AMIS in the absence of apparent epitope masking. AMIS occurred only when the erythrocytes appeared saturated with IgG. This Ab was capable of inducing HOD-RBC clearance, as well as loss of the OVA epitope at doses of Ab that caused AMIS effects. HOD-RBCs also lost reactivity with Abs specific for the hen egg lysozyme and Duffy portions of the Ag consistent with the initiation of Ag modulation and\/or trogocytosis mechanisms. These data support the concept that an AMIS-inducing Ab that does not cause epitope masking can induce AMIS effects in a manner consistent with RBC clearance and\/or Ag modulation.<\/jats:p>","DOI":"10.4049\/jimmunol.1700874","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T18:50:28Z","timestamp":1516647028000},"page":"1295-1305","source":"Crossref","is-referenced-by-count":21,"title":["Erythrocyte Saturation with IgG Is Required for Inducing Antibody-Mediated Immune Suppression and Impacts Both Erythrocyte Clearance and Antigen-Modulation Mechanisms"],"prefix":"10.1093","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2350-1855","authenticated-orcid":false,"given":"Yoelys","family":"Cruz-Leal","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and the Keenan Research Centre for Biomedical Science in the Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital , Toronto, Ontario M5B 1W8,","place":["Canada"]},{"name":"Centre for Innovation, Canadian Blood Services , Ottawa, Ontario K1G 4J5,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Marjoram","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and the Keenan Research Centre for Biomedical Science in the Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital , Toronto, Ontario M5B 1W8,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan H","family":"Lazarus","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and the Keenan Research Centre for Biomedical Science in the Li Ka Shing Knowledge Institute of St. Michael\u2019s Hospital , Toronto, Ontario M5B 1W8,","place":["Canada"]},{"name":"Centre for Innovation, Canadian Blood Services , Ottawa, Ontario K1G 4J5,","place":["Canada"]},{"name":"Department of Medicine, University of Toronto , Toronto, Ontario M5G 2C4,","place":["Canada"]},{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto , Toronto, Ontario M5S 1A8,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,2,15]]},"reference":[{"key":"2025030610020016600_r1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/0002-9378(76)90015-6","article-title":"Effectiveness of prophylactic Rh immunosuppression after transfusion with D-positive blood","volume":"124","author":"Bowman","year":"1976","journal-title":"Am. 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Inability of F(ab\u2032) 2 antibody to terminate established immune responses and its ability to interfere with IgG antibody-mediated immunosuppression","volume":"24","author":"Chan","year":"1973","journal-title":"Immunology"},{"key":"2025030610020016600_r4","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/S1471-4906(00)01801-9","article-title":"Mechanism of anti-D-mediated immune suppression\u2014a paradox awaiting resolution?","volume":"22","author":"Kumpel","year":"2001","journal-title":"Trends Immunol."},{"key":"2025030610020016600_r5","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1097\/MOH.0b013e328358f86c","article-title":"Towards a prophylactic treatment of HPA-related foetal and neonatal alloimmune thrombocytopenia","volume":"19","author":"Kjeldsen-Kragh","year":"2012","journal-title":"Curr. Opin. 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