Lack of the multidrug transporter MRP4/ABCC4 defines the PEL-negative blood group and impairs platelet aggregation

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Azouzi, Slim | Mikdar, Mahmoud | Hermand, Patricia | Gautier, Emilie-Fleur | Salnot, Virginie | Willemetz, Alexandra | Nicolas, Gaël | Vrignaud, Cedric | Raneri, Alexandre | Mayeux, Patrick | Bole-Feysot, Christine | Nitschké, Patrick | Cartron, Jean-Pierre | Colin, Yves | Hermine, Olivier | Jedlitschky, Gabriele | Cloutier, Marc | Constanzo-Yanez, Jessica | Ethier, Carole | Robitaille, Nancy | St-Louis, Maryse | Le van Kim, Caroline | Peyrard, Thierry

Edité par CCSD ; American Society of Hematology -

International audience. The rare PEL-negative phenotype is one of the last blood groups with an unknown genetic basis. By combining whole-exome sequencing and comparative global proteomic investigations, we found a large deletion in the ABCC4/MRP4 gene encoding an ATP-binding cassette (ABC) transporter in PEL-negative individuals. The loss of PEL expression on ABCC4-CRISPR-Cas9 K562 cells and its overexpression in ABCC4-transfected cells provided evidence that ABCC4 is the gene underlying the PEL blood group antigen. Although ABCC4 is an important cyclic nucleotide exporter, red blood cells from ABCC4null/PEL-negative individuals exhibited a normal guanosine 3',5'-cyclic monophosphate level, suggesting a compensatory mechanism by other erythroid ABC transporters. Interestingly, PEL-negative individuals showed an impaired platelet aggregation, confirming a role for ABCC4 in platelet function. Finally, we showed that loss-of-function mutations in the ABCC4 gene, associated with leukemia outcome, altered the expression of the PEL antigen. In addition to ABCC4 genotyping, PEL phenotyping could open a new way toward drug dose adjustment for leukemia treatment.

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