Immune recognition of exposed xenoantigens on the surface of PEGylated bovine red blood cells

Due to potential problems that can occur during blood transfusion and increasing blood shortages, our group engineered methoxypolyethylene glycol conjugated bovine red blood cells (mPEG-bRBCs) as a potential universal oxygen therapeutic. This current work investigates the immunological properties of mPEG-bRBCs incubated with human plasma (hP) and correlates these properties to exposed Gala(1,3)Gal xenoantigens. After mPEG-bRBCs were incubated with hP, the amount of bound IgG and IgM was assessed via flow cytometry. Flow cytometry also assessed the amount of GS-IB4 bound to exposed Gala(1,3)Gal xenoantigens. The results of this study demonstrate that most hP samples strongly promote agglutination of mPEG-bRBCs regardless of the extent of mPEG surface coverage or donor blood type. IgG and IgM from hP bound strongly to mPEG-bRBCs. In general, the Gala(1,3)Gal xenoantigen remains exposed at all levels of PEG surface coverage. PEGylation did block some of the xenoantigens as the amount of exposed Gala (1,3)Gal decreased with increased mPEG surface coverage. However, this was not sufficient to prevent a strong agglutination reaction. Taken together, the results of this study indicate that the current strategy for PEGylating bRBCs is unsatisfactory for the development of immunologically silent oxygen therapeutics.