Antigen site distribution among weak A' red cell populations. A study of A3, Ax and Aend variants

The distribution of the A receptors was studied among 'agglutinated' and 'free' populations of A variant RBC (A3, AX, Aend) known to be either partially or weakly agglutinated by human anti-A reagents. Following separation of the red cell populations and disaggregation of the clumps by mild treatment with soluble blood group substances, it was shown after appropriate controls, that among A3 ARBC, the 'agglutinated' RBC have at least five times as 'free' RBC, these latter however being strongly A positive. The differences between the A antigenic content of the AX RBC were less pronounced. The most striking result was obtained with the Aend RBC, where two populations are clearly demonstrated; the first, including 5-10 per cent of the RBC, strongly agglutinates with anti-A and contains erythrocytes of high antigenic content (140,000 A receptors per cell). The second, including the majority of RBC could not be differentiated from the control O RBC. A wide heterogeneity of antibody binding capacity of the various populations of A3, AX and Aend red cells, was also demonstrated following ultrastructural examination by immunoelectron microscopy with peroxidase-conjugated antibodies. Such study reveals furthermore an heterogeneity of labelling from one cell to another in the same population of red blood cells. Comparison of 'week A' RBC and O RBC enzymatically converted into A RBC, demonstrates a similar pattern of reactivity between these cells, and supports the general relationship between antigen site density and red cell agglutination. It is concluded that the typical pattern of agglutinability of A3 and AX RBC arises both from their heterogeneous antigenic content and from the occurrence of an antigenic threshold below which red cells become non-agglutinable. The typical mixed-field agglutination pattern of Aend RBC merely reflects the occurrence of a probably true dual population of RBC. Finally, the mechanisms of inheritance of such well-known Mendelian characters, enabling the production of highly heterogeneous blood cell populations in the same individual, remains to be elucidated.