High-Throughput CD36 Phenotyping on Human Platelets Based on Sandwich ELISA and Mutant Gene Analysis.

Background: CD36 deficiency is closely associated with fetal/neonatal alloimmune thrombocytopenia, platelet transfusion refractoriness, and other hemorrhage disorders, particularly in Asian and African populations. There is a clinical need for rapid and high-throughput methods of platelet CD36 (pCD36) phenotyping to improve the availability of CD36 typing of donors and assist clinical blood transfusions for patients with anti-CD36 antibodies. Such methods can also support the establishment of databases of pCD36-negative phenotypes. Study Design and Methods: A sandwich enzyme-linked immunosorbent assay (ELISA) for CD36 phenotyping of human platelets was developed using anti-CD36 monoclonal antibodies. The reliability of the assay was evaluated by calculating the intra-assay and inter-assay coefficients of variation (CV). A total of 1,691 anticoagulant whole blood samples from healthy blood donors were randomly selected. PCD36 expression was measured using a sandwich ELISA. PCD36 deficiency was confirmed by flow cytometry (FC). Mutations underlying pCD36 deficiency were identified using polymerase chain reaction sequence-based typing (PCR-SBT). Results: The sandwich ELISA for pCD36 phenotyping had high reliability (intra-assay CV, 2.1-4.8%; inter-assay CV, 2.3-5.2%). The sandwich ELISA was used to screen for CD36 expression on platelets isolated from 1,691 healthy blood donors. Of these, 36 samples were pCD36-negative. FC demonstrated absence of CD36 expression on monocytes in three of the 36 cases. In the present study population, the frequency of CD36 deficiency was 2.13% (36/1,691), of which 0.18% (3/1,691) was type I deficiency and 1.95% (33/1,691) was type II deficiency. In addition, we used PCR-SBT to characterize the gene mutations in exons 3-14 of the CD36 gene in 27 cases of CD36 deficiency and discovered 10 types of mutations in 13 pCD36-negative samples. Conclusion: The present study describes the development and characterization of a highly reliable sandwich ELISA for high-throughput screening for pCD36 expression. This novel method is feasible for clinical applications and provides a useful tool for the establishment of databases of pCD36-negative phenotype donors.

A new approach to detection of incomplete antibodies using hydrogel chromatography medium.

In assays for incomplete antibody detection, several washing steps are required to remove unbound globulins which may cause false negatives. Here, we present an improved approach employing hydrogel chromatography medium (HCM) in the detection of incomplete antibodies. After a rapid single-step centrifugation, incomplete antibodies, attached to red blood cells (RBCs), were separated from the reaction mixture using HCM and sedimentation. This method obviates the need for multiple centrifugation steps found in conventional Tube-Coombs tests. The HCM-Coombs tests may have a wide range of applications for incomplete antibody detection.

Centrifugal microfluidic platform with digital image analysis for parallel red cell antigen typing.

This study presents a portable multichannel microfluidic device for parallel and digital analysis of red cell antigen typing. A zigzag-shaped precise metering channel was designed for the simultaneous aliquoting of samples, which is independent of the volume of the predeposited blood-typing reagents in the reaction chambers. The entire assay protocol can be conducted using a sequential-step spinning protocol, which resembles that of conventional tube tests for blood typing; however, the manual procedure is largely reduced compared to that of conventional systems. After loading the samples, the disc is centrifuged in a defined program with five sequential steps, each of which can be completed in a few seconds. Through step-wise centrifugation, predeposited antibodies react with red blood cells, enabling the parallel identification of multiple red blood cell antigens without cross-contamination in 1 min. This is combined with gentle mixing to rapidly concentrate the agglutinates, making both visual and digital determination of agglutination straightforward. A customized image analysis algorithm for automatically determining the agglutination state was developed to complement this microfluidic system. The acquired image is processed after the test. The blood type is determined using a machine learning algorithm based on a histogram of oriented gradients (HOG) and support vector machines (SVM). This allows digital analysis to mirror the classical laboratory procedure for blood-type determination more accurately. The system was trained using a validated dataset of 150 blood samples, presenting 750 different agglutination patterns. The combination of SVM and HOG achieved 94.10% in the micro-weighted performance evaluation. This integrated microfluidic chip-based platform provides a "sample-in and answer out" demonstration for red blood cell typing, ensuring fast and reliable results because minimum manual steps are involved.

Study on a Natural Silk Cocoon Membrane-Based Versatile and Stable Immunosensing Platform via Directional Immunoaffinity Recognition.

The development of immunosensing assays for in vitro diagnostics has attracted great attention in recent years. Various substrate materials and immobilization methods of biomolecules were exploited for immunosensors, but their bioactivity and longevity have been facing serious challenges. To address this limitation, we investigated a natural silk cocoon membrane as immunosensing substrate material. By using its intrinsic properties, the target biomolecules were immobilized on the membrane through directional immunoaffinity recognition. The silk cocoon membrane-based immunosensor showed great potential for both qualitative and quantitative immunoassays, through naked-eye observation or analyzing the change in red color intensity, respectively. The immunosensor exhibited significant detection capability for anti-D (titer 1:1024) sensitized red blood cells. The colorimetric responses of concentrations ranged from 1 µg/mL to 1 ng/mL, and the detection limit for anti-D was 3.4 ng/mL. The immunosensor also showed excellent stability for the immobilized antibodies when stored at 4 and 25 °C; the bioactivity remained unchanged or slightly declined within 40 weeks. Even at 37 °C, the bioactivity began to decline after 12 weeks. This current work highlights the potential of using the natural silk cocoon membrane as a substrate for a versatile and thermally stable immunosensing platform for application in immunoassays.

Chicken Egg Yolk Antibodies (IgYs) block the binding of multiple SARS-CoV-2 spike protein variants to human ACE2.

The SARS-CoV-2 virus is still spreading worldwide, and there is an urgent need to effectively prevent and control this pandemic. This study evaluated the potential efficacy of Egg Yolk Antibodies (IgY) as a neutralizing agent against the SARS-CoV-2. We investigated the neutralizing effect of anti-spike-S1 IgYs on the SARS-CoV-2 pseudovirus, as well as its inhibitory effect on the binding of the coronavirus spike protein mutants to human ACE2. Our results show that the anti-Spike-S1 IgYs showed significant neutralizing potency against SARS-CoV-2 pseudovirus, various spike protein mutants, and even SARS-CoV in vitro. It might be a feasible tool for the prevention and control of ongoing COVID-19.

Application of lyophilised human platelets for antibody detection in solid phase red cell adherence assay.

Antibodies against human platelets cause a variety of thrombocytopenic disorders, which lead to potentially fatal haemorrhage. Therefore, their prompt detection is mandatory for successful patient treatment. Solid phase red cell adherence (SPRCA) assay allows for platelet antibody detection widely. However, preparation of fresh platelets with HLA-I and human platelet antigens (HPA)1-5,15 genotyped as target cells is inconvenient and fresh platelets have a short shelf life. In this study, the lyophilised human platelets for antibody detection in SPRCA were prepared. Firstly, platelets were resuspended in lyophilisation buffer and freeze-dried. Then the characteristics of lyophilised platelet were analysed. Rehydrated platelets were recovered with a mean rate of 80.91% ± 2.87%, and still retained spherical morphology. Indirect flow cytometry showed that glycoproteins IIb/IIIa, Ia/IIa, Ib/IX, IV, CD109, and HLA class I were present on the surface of the lyophilised platelets at a comparable level to that of fresh platelets. The consistent results obtained with WHO reference reagents containing anti-HPA-1a, anti-HPA-3a, and anti-HPA-5b, as well as clinical samples from the same donors containing anti-HLA antibodies when reacting with lyophilised versus fresh platelets confirmed good antigenicity preservation of platelets after freeze-drying. Further investigation showed that the lyophilised platelets could be stored at 2-8 °C for up to 14 months and the reconstituted suspension was stable for 48 h. Therefore, lyophilised platelets can be a convenient alternative to fresh platelets to use for anti-platelet antibody detection in SPRCA tests.

An Internal Reference Control Duplex Real-Time Polymerase Chain Reaction Assay for Detecting Bacterial Contamination in Blood Products.

Real-time polymerase chain reaction (RT-PCR) enables effective and sensitive screening for infectious risk in the field of blood safety. However, when using RT-PCR to detect bacterial contamination, several intractable points must be considered, one of which is the lack of appropriate quality control. In this study, we developed a simplified RT-PCR assay in which the same primer set and two distinct probes were used to detect both, an internal reference control and the target in a reaction. The copy number of the internal reference control represents the positive detection limit of the assay; therefore, when the threshold-cycle value of the target is less than or equal to that of the internal reference control, the result obtained for the target can be considered to be a true positive. When human gDNA was spiked with Escherichia coli gDNA and the detection limit for the internal reference control was set to five copies, the measured detection limit for E. coli gDNA was two copies. The internal reference control duplex RT-PCR assay showed high efficiency (0.91-1.02), high linearity (R2 > 0.99), and good reproducibility in intra- and inter-assay comparisons. Lastly, when human platelet-rich plasma samples were spiked with E. coli or other bacterial species, all species were detected efficiently, and the results of a two-sample pooled t test showed that the limit of detection for E. coli was 1 cfu/mL. Here, we present a synthetic internal reference control molecule and a new statistical method for improving the reliability of RT-PCR assays when screening for bacterial contamination in blood products.