Polyreactivity of disease-associated anti-RBC IgG autoantibodies of patients with warm autoimmune haemolytic anaemia and natural anti-RBC IgG autoantibodies of healthy individuals.

Anti-red blood cell (RBC) immunoglobulin G (IgG) autoantibodies are present in patients with warm autoimmune haemolytic anaemia (WAIHA), and, as natural autoantibodies, in healthy individuals. This study investigated whether the feature of polyreactivity discriminates disease-associated from natural anti-RBC IgG autoantibodies. The patterns of reactivity of purified anti-RBC IgG eluted from the RBC of WAIHA patients and from the RBC of healthy individuals were analysed using quantitative immunoblotting on a panel of whole human tissue or bacterial cell extracts as antigen sources. In parallel, the reactivity patterns of IgG purified from plasma were analysed. Anti-RBC IgG of WAIHA patients and of healthy individuals recognized a wide range of self- and nonself-antigens. The reactivity patterns of anti-RBC IgG were homogeneous among patients and controls, did not differ between patients and controls, and were similar to those of IgG purified from plasma in the case of both patients and healthy individuals. The data demonstrate that the anti-RBC IgG autoantibodies of WAIHA patients share extensive similarity with those of healthy individuals. Polyreactivity is a common feature of both disease-associated and natural anti-RBC IgG autoantibodies.