Dithiothreitol treatment of red blood cells.

Dithiothreitol (DTT), a reducing reagent, has multiple applications in blood bank testing. DTT disrupts the bridging of the disulfide bonds between amino acid residues necessary for structural conformation of some proteins and the bonds holding an IgM molecule in the pentameric formation. DTT treatment of red blood cells (RBCs) can denature or modify certain blood group antigens-in particular, those in the Kell, Lutheran, YT, JMH, LW, Cromer, Indian, Dombrock, and Knops systems-and prevent recognition by the corresponding antibodies. It also destroys RBC CD38, allowing DTT-treated RBCs to be used to avoid testing interference by therapeutic anti-CD38 preparations. DTT treatment can be used to disperse spontaneous agglutination of RBCs caused by heavy IgM autoantibody coating that invalidates ABO/Rh cell grouping and direct antiglobulin tests.