Emory University School of Medicine
Department of Pathology and Laboratory Medicine

Zerra Lab Publications

The Zerra Lab integrates hematology and immunology to transform the treatment landscape for Sickle Cell disease and Hemophilia A. Our goal is to identify predictive biomarkers and to develop targeted, life-saving therapeutics that allow for earlier intervention and significantly improved clinical outcomes for patients with chronic blood disorders.

Zerra Lab Homepage

Publications

  1. Zerra P, Bergsagel J, Lew G, Keller F, Pauly M. “Maintenance treatment with low dose mercaptopurine in combination with allopurinol in children with acute lymphoblastic leukemia and mercaptopurine-induced pancreatitis”. Pediatric Blood Cancer. 2016 Apr;63(4):712-715.
  2. Zerra PE, Cox C, Baldwin WH, Patel SR, Arthur CM, Lollar P, Meeks SL, Stowell SR. “Marginal zone B cells are critical to factor VIII inhibitor formation in mice with hemophilia A.” 2017 Dec 7;130(23):2559-2568.
  3. Patel SR, Bennett A, Girard-Pierce K, Maier CL, Chonat S, Arthur C, Zerra PE, Mener A, Stowell SR. “Recipient priming to one RBC alloantigen directly enhances subsequent alloimmunization in mice.” Blood Advances. 2018 Jan 23;2(2):105-115.
  4. Mener A, Patel SR, Arthur CM, Chonat S, Wieland A, Santhanakrishnan M, Liu J, Maier CJ, Jajosky RP, Girard-Pierce K, Bennett A, Zerra PE, Smith NH, Hendrickson JE, Stowell SR. “Complement serves as a switch between CD4+ T cell-independent and -dependent RBC antibody responses.” JCI Insight. 2018 Nov 15;3(22).
  5. Patel SR, Gibb DR, Girard-Pierce K, Zhou X, Rodrigues LC, Arthur CM, Bennett AL, Jajosky RP, Fuller M, Maier CL, Zerra PE, Chonat S, Smith NH, Tormey CA, Hendrickson JE, Stowell SR. “Marginal zone B cells induce alloantibody formation following RBC transfusion.” Frontiers in Immunology. 2018 Nov 16;9:2516.
  6. Chonat S, Arthur CM, Zerra PE, Maier CL, Jajosky RP, Yee MEM, Miller MJ, Josephson CD, Roback JD, Fasano R, Stowell SR. “Challenges in preventing and treating hemolytic complications associated with red blood cell transfusion.” Transfusion Clinique et Biologique. 2019 May;26(2):130-134.
  7. Zerra PE, Arthur CM, Chonat S, Maier C, Mener A, Shin S, Allen J, Baldwin H, Cox C, Verkerke H, Jajosky R, Tormey C, Meeks S, Stowell S. “Fc gamma receptors and complement component 3 facilitate anti-fVIII antibody formation.” Frontiers in Immunology. 2020 Jun 9;11:905.
  8. Chonat S, Graciaa S, Shin HS, Newton JG, Quarmyne M, Boudreaux J, Tang A, Zerra PE, Rollins MR, Josephson CD, Brown C, Joiner CH, Fasano RM, Stowell SR. “Eculizumab for complement mediated thrombotic microangiopathy in sickle cell disease.” Haematologica. 2020 Dec 1;105(12):2887-2891.
  9. Raghunandan S, Josephson CD, Verkerke H, Linam WM, Ingram TC, Zerra PE, Arthur CM, Stowell SR, Briones M, Chonat S. "Complement inhibition in severe COVID-19 acute respiratory distress syndrome. Frontiers Pediatrics. 2020 Dec 29;8:616731.
  10. Zerra PE, Patel SR, Jajosky RP, Arthur CM, McCoy JW, Allen JWL, Chonat S, Fasano RM, Roback J, Josephson CD, Hendrickson JE, Stowell SR. “Marginal zone B cells mediate a CD4 T cell dependent extrafollicular antibody response following RBC transfusion in mice.” Blood. 2021 Aug 26;138(8):706-721.
  11. Arthur CM, Allen JWL, Verkerke H, Yoo J, Jajosky RP, Girard-Pierce K, Chonat S, Zerra P, Maier C, Rha J, Fasano R, Josephson CD, Roback JD, Stowell SR. "Antigen density dictates RBC clearance, but not antigen modulation, following incompatible RBC transfusion in mice". Blood Adv. 2021 Jan 26;5(2):527-538.
  12. Ho AD, Verkerke H, Allen JW, Saeedi BJ, Boyer D, Owens J, Shin S, Horwath M, Patel K, Paul A, Wu SC, Chonat S, Zerra P, Lough C, Roback JD, Neish A, Josephson CD, Arthur CM, Stowell SR. "An automated approach to determine antibody endpoint titers for COVID-19 by an enzyme-linked immunosorbent assay". Immunohematology. 2021 Mar;37(1):33-43.
  13. Verkerke H, Saeedi BJ, Boyer D, Allen JW, Owens J, Shin S, Horwath M, Patel K, Paul A, Wu SC, Wang J, Ho A, Maier CL, Zerra PE, Chonat S, Arthur CM, Roback JD, Neish AS, Lough C, Josephson CD, Stowell SR. "Are we forgetting about IgA? A re-examination of cornavirus disease 2019 convalescent plasma". Transfusion. 2021 Jun;61(6):1740-1748.
  14. Wade J, Yee M, Easley K, Pahz S, Zerra PE, Josephson C, Fasano R. “Procedural adverse events in pediatric patients with sickle cell disease undergoing chronic automated red cell exchange”. Transfusion. 2022 Mar;62(3):584-593.
  15. Arthur CM*, Zerra PE*, Shin S, Want J, Song X, Doering CB, Meeks S, Lollar P, Stowell SR. “Non-human glycans can regulate anti-FVIII antibody formation in mice”. Blood. 2022 Mar 3;139(9):1312-1317.
  16. Arthur CM, Patel SR, Sharma A, Zerra PE, Chonat S, Jajosky RP, Fasano RM, Patel R, Bennett A, Zhou X, Luckey CJ, Hudson KE, Eisenbarth SC, Josephson CD, Roback JD, Hendrickson JE, Stowell SR. “Clondronate inhibits alloimmunization against distinct red blood cell alloantigens in mice”. Transfusion. 2022 May;62(5):948-953.
  17. Patel SR, Lundgren TS, Baldwin WH, Cox C, Parker ET, Healey JF, Jajosky RP, Zerra PE, Josephson CD, Doering CB, Stowell SR, Meeks SL. “Neutralizing antibodies against factor VIII can occur through a non-germinal center pathway”. Frontiers in Immunology. 2022 May 11;13:880829.
  18. Zerra PE, Parker ET, Baldwin WH, Healey JF, Patel SR, McCoy JW, Cox C, Stowell SR, Meeks SL. “Engineering a therapeutic protein to enhance the study of anti-drug immunity”. Biomedicines. 2022 Jul 18;10(7):1724.
  19. Achram R, Zerra PE, Delvadia B, Thrompson L, Badell IR, Roback JD, Sullivan HC. “Indeterminate group A subtyping for prospective renal transplant donor”. Transfusion. 2022 Sep;62(9):1927-1928.
  20. Graciaa S, Adeagbo S, Rollins M, McElfresh P, Fong G, Zerra PE, Bennett C, Josephson CD, Briones M, Fasano RM, Chonat S. “Clinical features and neurological outcomes in pediatric immune-mediated thrombotic thrombocytopenic purpura: A report from a large pediatric hematology center”. Pediatric Blood & Cancer. 2022 Sep 24;69(12).
  21. Jajosky RP, Patel SR, Wu SC, patel KR, Covington ML, Vallecillo-Suniga ML, Ayona D, Bennett A, Luckey CJ, Hudson KE, Hendricksn JE, Eisenbarth SC, Josephson CD, Zerra PE, Stowell SR, Arthur CM. “Prior immunization to an intracellular antigen enhances subsequent red blood cell alloimmunization in mice”. Blood. 2023 Jan 13.
  22. Maier CL, Jajosky RP, Patel SR, Verkerke HP, Fuller MD, Allen JW, Zerra PE, Fasano RM, Chonat S, Josephson CD, Gibb DR, Eisenbarth SC, Luckey CJ, Hudson KE, Hendrickson JE, Arthur CM, Stowell SR. “Storage differentially impacts alloimmunization to distinct red cell antigens following transfusion in mice”. 2023 Jan 27.
  23. Zerra PE, Stowell J, Verkerke H, McCoy J, Jones J, Graciaa S, Lu A, Hussaini L, Anderson EJ, Rostad CA, Stowell SR, Chonat S. “Factor H autoantibodies contribute to complement dysregulation in multisystem inflammatory syndrome in children (MIS-C)”. American Journal of Hematology. 2023 Jan 30.
  24. Jajosky R, Patel SR, Wu SC, Patel K, Covington M, Vallecillo-Suniga M, Aona D, Bennett A, Luckey CJ, Hudson KE, Hendrickson JE, Eisenbarth SC, Josephson CD, Zerra PE, Stowell SR, Arthur CM. “Prior immunization against an intracellular antigen enhances subsequent red blood cell alloimmunization in mice”. Blood. 2023 May 25.
  25. Jajosky RP, Patel KR, Allen JWL, Zerra PE, Chonat S, Ayona D, Maier CL, Morais D, Wu SC, Luckey CJ, Eisenbarth SC, Roback JD, Fasano RM, Josephson CD, Manis JP, Chai L, Hendrickson JE, Hudson KE, Arthur CM, Stowell SR. Antibody-mediated antigen loss switches augmented immunity to antibody-mediated immunosuppression. Blood. 2023 Sep 21;142(12):1082-1098.
  26. Kandaswamy S, Josephson CD, Rollins MR, Jones J, Zerra PE, Goel R, Andrews J, Hendrickson JE, Lieberman L, Orenstein EW. “Development and evaluation of trigger tools to identify pediatric blood management errors”. Blood Transfusion. 2024 Mar.
  27. Yee MEM, Zerra PE, McCoy JW, Covington ML, Stowell SR, Joiner CH, Lough CM, Delvadia BB, Josephson CD, Roback JD, Fasano RM. Post-transfusion biotin-labeled red blood cell survival studies in pediatric sickle cell disease with antibodies of uncertain significance. Transfusion. 2024 May;64(5):800-807.
  28. Maarouf M, Patel SR, Baldwin WH, Zerra PE, Cox C, Parker ET, Stowell SR, Meeks SL. “Marginal zone B cells represent a conserved initiating player in the immune response to factor VIII in hemophilia A mice”. Thrombosis and Hemostasis. 2024 Sep;124(9):893-896.
  29. Yee MEM, Covington ML, Zerra PE, McCoy JW, Easley KA, Joiner CH, Bryksin J, Francis RO, Lough CM, Patel N, Kutlar A, Josephson CD, Roback JD, Stowell SR, Fasano RM. “Survival of transfused red blood cells from a donor with alpha-thalassemia trait in a recipient with sickle cell disease”. Transfusion. 2024 Jun;64(6):1109-1115.
  30. Jajosky RP, Zerra PE, Chonat S, Stowell SR, Arthur CM. “Harnessing the potential of red blood cells in immunotherapy”. Human Immunology. 2024 Nov;85(6):111084.
  31. Maier CL, Nakahara H, Barker NA, Auld SC, Truong AD, Friend S, Caridi-Scheible M, Connor M, Gaddh M, Cobb J, Polly DM, Guarner J, Powell C, Kempton CL, Daniels L, Wynn AT, Sniecinski R, Duncan A, Roback J, Masud T, Conlon S, Wade J, Wong A, Vekerke H, Zerra PE, Butler H, Sullivan HC, Easley KA, Josephson CD, Stowell SR. “Therapeutic plasma exchange for fibrinogen-associated hyperviscosity: Results of the COPLEX randomized controlled trial”. Journal of Thrombosis and Hemostasis. 2025 April;23(4):1393-1400.
  32. Jajosky RP, Covington ML, Liu J, Chai L, Zerra PE, Chonat S, Stowell SR, Arthur CM. “CD47 regulates antigen modulation and red blood cell clearance following an incompatible transfusion”. Frontiers in Immunology. 2025 April 4;16:1548548.
  33. Benjamin RJ, Ptman JP, Karim C, Huang S, Erickson A, Corash L, Mufti N, Roback JD, Zerra PE, Fasano RM, Yee MEM. “A novel acridine flow cytometry marker to track post-transfusion amustaline/glutathione pathogen-reduced red blood cell survival in sickle cell disease patients”. Transfusion. 2025 May;65(5):909-920.
  34. Chonat S, Jones JA, Patel SR, Briones WM, Schoettler ML, Maarouf M, Jeffers LA, Adisa O, Tan F, Fields E, Sterling MS, Jajosky RP, Verkerke H, Graciaa SH, Foppiani EM, Fasano RM, Zerra PE, Qiu Y, Arthur CM, Lam WA, Ofori-Acquah SF, Koval M, Joiner CH, Archer DR, Stowell SR. “Complement is activated in patients with acute chest syndrome caused by sickle cell disease and represents a therapeutic target”. Science Translational Medicine. 2025 July 16;17(807):eadi4922.


Book Chapters

  1. Zerra, PE and Josephson, C. Volume-Reduced Blood Products. In Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects, third edition. Elsevier. 2019.
  2. Zerra, PE and Josephson, C. Delayed Hemolytic Transfusion Reactions. In Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects, third edition. Elsevier. 2019.
  3. Zerra, PE and Briones, M. Vascular Bleeding Disorders. In Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects, third edition. Elsevier. 2019.
  4. Zerra, PE, Josephson, C and Hendrickson, J. Neonatal and Pediatric Transfusion Medicine. In Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects, third edition. Elsevier. 2019.
  5. Zerra PE and Josephson C. Nelson Textbook of Pediatrics, 22nd Multiple chapters contributed: Platelet Transfusions, Plasma Transfusions. Red Blood Cell Transfusion, Granulocyte Transfusions, and Risks of Transfusion. Elsevier. 2022.
  6. Zerra PE and Meeks S. Developmental Hemostasis. In Hemostasis Management of the Pediatric Surgical Patient. Elsevier. 2022.


Review Articles

  1. Zerra P, Cochran T, Franco V, Lipshultz S. “An expert opinion on pharmacologic approaches to reducing the cardiotoxicity of childhood acute lymphoblastic leukemia therapies.” Expert Opinion on Pharmacotherapy. 2013 Aug;14(11):1497-1513.
  2. Zerra PE, Josephson CD. “Transfusion in Neonatal Patients: Review of Evidence-Based Guidelines.” Clin Lab Medicine. 2021 Mar; 41(1):15-34.