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Alloimmunity

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https://www.readbyqxmd.com/read/29675950/risk-factors-for-red-blood-cell-alloimmunization-in-the-recipient-epidemiology-and-donor-evaluation-study-reds-iii-database
#1
Matthew S Karafin, Matt Westlake, Ronald G Hauser, Christopher A Tormey, Philip J Norris, Nareg H Roubinian, Yanyun Wu, Darrell J Triulzi, Steve Kleinman, Jeanne E Hendrickson
Despite the significance of red blood cell (RBC) alloimmunization, the lack of standardized registries in the US has prevented the completion of large studies. Data from 3·5 years of the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) recipient database, containing information from 12 hospitals, were studied. A RBC alloantibody responder had an antibody identified at any point during the study, and a non-responder had a negative antibody screen at least 15 days post-RBC transfusion. Demographics, blood type, ICD9/10 codes, and other potential correlates were evaluated...
April 19, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29669341/management-and-neonatal-outcomes-of-pregnancies-with-fetal-neonatal-alloimmune-thrombocytopenia-a-single-center-retrospective-cohort-study
#2
Stefania Ronzoni, Johannes Keunen, Prakeshkumar S Shah, Edmond N Kelly, Rory Windrim, P Gareth Seaward, Greg Ryan
BACKGROUND: There is no consensus regarding the optimal antenatal treatment of fetal/neonatal alloimmune thrombocytopenia (F/NAIT). We aimed to review the fetal blood sampling (FBS)-related risk, fetal response to maternal intravenous immunoglobulin (IVIG), and cesarean section (CS) rate in pregnancies with a history of F/NAIT. METHODS: Maternal demographics, alloantibodies, pregnancy management, fetal and neonatal outcomes, and index case characteristics were collected...
April 18, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29664198/hemoglobin-a-clearance-in-children-with-sickle-cell-anemia-on-chronic-transfusion-therapy
#3
Marianne E M Yee, Cassandra D Josephson, Anne M Winkler, Jennifer Webb, Naomi L C Luban, Traci Leong, Sean R Stowell, John D Roback, Ross M Fasano
BACKGROUND: Chronic transfusion therapy for sickle cell anemia reduces disease complications by diluting sickle-erythrocytes with hemoglobin A (HbA)-containing erythrocytes and suppressing erythropoiesis. Minor antigen mismatches may result in alloimmunization, but it is unknown if antigen mismatches or recipient characteristics influence HbA clearance posttransfusion. STUDY DESIGN AND METHODS: Children with sickle cell anemia on chronic transfusion therapy were followed prospectively for 12 months...
April 17, 2018: Transfusion
https://www.readbyqxmd.com/read/29664113/peripartum-management-of-hla-alloimmune-platelet-refractoriness
#4
Jeremy Ryan Peña, Leanna Sudhof, Barbara O'Brien
BACKGROUND: Platelet (PLT) refractoriness presents a challenging problem for transfusion support, especially in the perioperative setting, where there is urgency for human leukocyte antigen (HLA)-compatible units, yet identification and provision of compatible PLT concentrates requires time. CASE REPORT: A 22-year-old G3P1 woman with thrombocytopenia due to aplastic anemia, likely autoimmune, presented in her third trimester for peripartum care and newly diagnosed HLA alloimmune PLT refractoriness...
April 17, 2018: Transfusion
https://www.readbyqxmd.com/read/29656904/donor-specific-hypo-responsiveness-occurs-in-simultaneous-liver-kidney-transplant-recipients-after-the-first-year
#5
Timucin Taner, Michael P Gustafson, Michael J Hansen, Walter D Park, Svetlana Bornschlegl, Allan B Dietz, Mark D Stegall
Kidney allografts of patients who undergo simultaneous liver-kidney transplantation incur less immune-mediated injury, and retain better function compared to other kidney allografts. To characterize the host alloimmune responses in 28 of these patients, we measured the donor-specific alloresponsiveness and phenotypes of peripheral blood cells after the first year. These values were then compared to those of 61 similarly immunosuppressed recipients of a solitary kidney or 31 recipients of liver allografts. Four multicolor, non-overlapping flow cytometry protocols were used to assess the immunophenotypes...
April 12, 2018: Kidney International
https://www.readbyqxmd.com/read/29649585/effects-of-different-serotonin-receptor-subtype-antagonists-on-the-development-of-cardiac-allograft-vasculopathy-in-murine-aortic-allografts
#6
Annika Gocht, Jörg H W Distler, Bernd Spriewald, Martina Ramsperger-Gleixner, Michael Weyand, Stephan M Ensminger, Christian Heim
BACKGROUND: Cardiac allograft vasculopathy (CAV) is the main obstacle for long-term survival after heart transplantation. Alloimmune mediated chronic vascular rejection results in several mechanisms like platelet activation, immigration of inflammatory cells through the endothelial layer and proliferation and migration of smooth muscle cells (SMCs). Serotonin (5-HT) promotes these processes via activation of 5-HT2 receptors. We hypothesized that inhibiting 5-HT2 receptors ameliorates the development of CAV...
April 9, 2018: Transplant Immunology
https://www.readbyqxmd.com/read/29624682/abo-incompatibility-and-rhig-immunoprophylaxis-protect-against-non-d-alloimmunization-by-pregnancy
#7
Carolien Zwiers, Joke M Koelewijn, Lisa Vermij, Joost van Sambeeck, Dick Oepkes, Masja de Haas, C Ellen van der Schoot
BACKGROUND: Hemolytic disease of the fetus and newborn (HDFN) is caused by maternal antibodies against fetal red blood cell antigens, most often anti-D, -K, or -c. ABO incompatibility between mother and child and anti-D immunoprophylaxis (RhIG) are known to reduce the risk of D immunization and subsequent HDFN. However, no immunoprophylaxis has been developed to prevent non-D immunizations. STUDY DESIGN AND METHODS: We evaluated whether ABO incompatibility has a preventive effect on formation of non-D alloantibodies, by performing a case-control study including pregnant women with newly detected non-D antibodies, identified within a nationwide data set, immunized during their first pregnancy and/or delivery...
April 6, 2018: Transfusion
https://www.readbyqxmd.com/read/29611387/flow-cytometric-analysis-of-hna-2-expression-and-phenotypes-among-thai-blood-donors
#8
Oytip Nathalang, Kanokpol Siriphanthong, Sawang Petvises, Nichapa Jeumjanya
BACKGROUND: Antibodies specific to human neutrophil antigen (HNA), especially HNA-2, are implicated in various conditions, including neonatal alloimmune neutropenia, febrile non-hemolytic transfusion reactions, and transfusion-related acute lung injury. The distribution of the HNA-2 phenotype frequencies in the Thai population remains unknown. This study aimed to investigate HNA-2 phenotype frequencies in Thai blood donors and to compare the relationships of sex and age with HNA-2 expression...
July 2018: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/29610181/neonatal-alloimmune-thrombocytopenia-with-amegakaryocytosis-b-lymphopenia-and-villitis
#9
Arthur Dony, Annie Buenerd, Corinne Pondarre
Neonatal alloimmune thrombocytopenia (NAIT) is a common but significant challenge for neonatologists and a potentially devastating disease that may lead to intracranial bleeding. The underlying mechanism of thrombocytopenia is expected to be mediated by accelerated clearance of antibody-opsonized fetal platelets. We report severe recurrent NAIT related to human platelet antigen (HPA)-15 systems in 2 consecutive siblings. The first child presented with intracranial hemorrhage at birth and subsequently died. The diagnosis of NAIT, although initially suspected, was ruled out after negative investigation of only HPA-1, HPA-3, and HPA-5 systems...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29609844/does-vaccination-in-solid-organ-transplant-recipients-result-in-adverse-immunologic-sequelae-a-systematic-review-and-meta-analysis
#10
William R Mulley, Claire Dendle, Jonathan E H Ling, Simon R Knight
BACKGROUND: Clinical guidelines recommend vaccinations for solid-organ transplant recipients. However, concern exists that vaccination may stimulate adverse alloimmune responses. METHODS: We systematically reviewed the published literature regarding this aspect of vaccine safety. Electronic databases were searched for interventional and observational studies assessing de novo donor-specific antibodies (DSA) and rejection episodes after vaccination against infectious pathogens...
March 10, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29608322/a-review-of-in-vitro-methods-to-predict-the-clinical-significance-of-red-blood-cell-alloantibodies
#11
Sandra J Nance
This review was derived from a presentation made on September 2, 2016, for the first Academy Day presented by the Working Party on Immunohematology at the International Society of Blood Transfusion (ISBT) Congress in Dubai. The focus of this review is on the clinical significance of alloimmunization in transfusion-specifically, the parameters that contribute to a clinically significant alloantibody. The areas of focus were as follows: Introduction, Technical Aspects, and Indications and Limitations. Each section contains a brief review of selected literature and experiential knowledge...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29603821/lymphocytes-immunotherapy-for-preserving-pregnancy-mechanisms-and-challenges
#12
REVIEW
Hamed Hajipour, Hamid Reza Nejabati, Zeinab Latifi, Kobra Hamdi, Zahra Bahrami-Asl, Amir Fattahi, Mohammad Nouri
Due to the expression of paternal antigens by the embryo, pregnancy is considered as a semi-allograft and so immunological dysregulation is considered as one of the important causes in repeated implantation failure (RIF) and recurrent pregnancy loss (RPL). It has been revealed that lymphocytes immunotherapy (LIT) could be an appropriate approach to prevent pregnancy loss in such patients. Various mechanisms have been suggested for effectiveness of LIT such as enhancing expression of anti-paternal cytotoxic antibodies (APCA), progesterone-induced blocking factor (PIBF), anti-idiotypic antibodies (Ab2), and mixed lymphocyte reaction blocking antibodies (MLR-Bf), as well as reduction in the T helper 1/T helper 2 ratio and deviation in the pattern of cytokines production...
March 31, 2018: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29603641/donor-kidney-injury-molecule-1-promotes-graft-recovery-by-regulating-systemic-necroinflammation
#13
Ji Yun Lee, Ola Z Ismail, Xizhong Zhang, Aaron Haig, Dameng Lian, Lakshman Gunaratnam
Ischemia-reperfusion injury during kidney transplantation predisposes to delayed graft function, rejection, and premature graft failure. Exacerbation of tissue damage and alloimmune responses may be explained by necroinflammation: an autoamplification loop of cell death and inflammation, which is mediated by the release of damage-associated molecular patterns (e.g. HMGB1) from necrotic cells that activate both innate and adaptive immune pathways. Kidney Injury Molecule-1 (KIM-1) is a phosphatidylserine receptor that is upregulated on injured proximal tubular epithelial cells and enables them to clear apoptotic and necrotic cells...
March 30, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29603637/carpe-diem-time-to-transition-from-empiric-to-precision-medicine-in-kidney-transplantation
#14
Chris Wiebe, Julie Ho, Ian W Gibson, David N Rush, Peter W Nickerson
The current immunosuppressive pipeline in kidney transplantation is limited. In part, this is due to excellent 1-year allograft outcomes with the current standard of care (i.e. calcineurin inhibitor in combination with anti-proliferative agents). Despite this success, a recent Federal government sponsored systematic review has identified gaps/limits in the evidence of what constitutes optimal calcineurin inhibitor use in the short- and long-term. Moreover, recent empiric approaches to minimize/withdraw/convert from calcineurin inhibitors have come with the price of increased alloreactivity...
March 30, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29603617/engineering-therapeutic-t-cells-to-suppress-alloimmune-responses-using-tcrs-cars-or-bars
#15
Antoine Sicard, Megan K Levings, David W Scott
Adoptive cell therapy with therapeutic T cells has become one of the most promising strategies to stimulate or suppress immune responses. Using viral-mediated genetic manipulation, the antigen-specificity of T cells can now be precisely redirected. Tailored specificity has not only overcome technical limitations and safety concerns, but it has also considerably broadened the spectrum of therapeutic applications. Different T cell-engineering strategies have now become available to suppress alloimmune responses...
March 30, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29603613/sensitization-in-transplantation-assessment-of-risk-star-2017-working-group-meeting-report
#16
Anat R Tambur, Patricia Campbell, Frans H Claas, Sandy Feng, Howard M Gebel, Annette M Jackson, Roslyn B Mannon, Elaine F Reed, Kathryn Tinckam, Medhat Askar, Anil Chandraker, Patricia P Chang, Monica Colvin, Anthony-Jake Demetris, Joshua M Diamond, Anne I Dipchand, Robert L Fairchild, Mandy L Ford, John Friedewald, Ronald G Gill, Denis Glotz, Hilary Goldberg, Ramsey Hachem, Stuart Knechtle, Jon Kobashigawa, Deborah J Levine, Joshua Levitsky, Michael Mengel, Edgar Milford, Kenneth A Newell, Jacqueline G O'Leary, Scott Palmer, Parmjeet Randhawa, John Smith, Laurie Snyder, Randall C Starling, Stuart Sweet, Timucin Taner, Craig J Taylor, Steve Woodle, Adriana Zeevi, Peter Nickerson
The presence of pre-existing (memory) or de novo donor specific HLA antibodies (DSA) is a known barrier to successful long-term organ transplantation. Yet, despite the fact that laboratory tools and our understanding of histocompatibility have advanced significantly in recent years, the criteria to define presence of a DSA and assign a level of risk for a given DSA varies markedly between centers. A collaborative effort between ASHI and the AST provided the logistical support for generating a dedicated multidisciplinary working group, which included experts in histocompatibility as well as renal, liver, heart and lung transplantation...
March 30, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29603363/transfusion-related-adverse-events-are-decreased-in-pregnant-women-with-sickle-cell-disease-by-a-change-in-policy-from-systematic-transfusion-to-prophylactic-oxygen-therapy-at-home-a-retrospective-survey-by-the-international-sickle-cell-disease-observatory
#17
Jean-Antoine Ribeil, Myriam Labopin, Aurélie Stanislas, Benjamin Deloison, Delphine Lemercier, Anoosha Habibi, Souha Albinni, Caroline Charlier, Olivier Lortholary, François Lefrere, Mariane De Montalembert, Stéphane Blanche, Frédéric Galactéros, Jean-Marc Tréluyer, Eliane Gluckman, Yves Ville, Laure Joseph, Delville Marianne, Alexandra Benachi, Marina Cavazzana
Sickle cell disease (SCD) in pregnancy can be associated with adverse maternal and perinatal outcomes. Furthermore, complications of SCD can be aggravated by pregnancy. Optimal prenatal care aims to decrease the occurrence of maternal and fetal complications. A retrospective, French, two-center study compared two care strategies for pregnant women with SCD over two time periods. In the first study period (2005-2010), the women were systematically offered prophylactic transfusions. In the second study period (2011-2014), a targeted transfusion strategy was applied whenever possible, and home-based prophylactic nocturnal oxygen therapy was offered to all the pregnant women...
March 30, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29593460/association-of-il-6-c-572g-gene-polymorphism-with-anti-e-production
#18
Jeong-Shi Lin, Li-Hsuan Lee, Hsueng-Mei Liu, Ying-Ju Chen, Tzeon-Jye Chiou
Background: Interleukin 6 (IL-6) is involved in regulation of immunoglobulin production. The aim of this study was to investigate the association between IL-6 single nucleotide polymorphisms (SNPs) in the IL-6 promoter and anti-E in red blood cell (RBC) transfusion recipients. Methods: 50 healthy subjects, 54 patients with RBC alloantibody anti-E (responders), and 45 patients without alloantibody (non-responders) were recruited. All patients were E antigen-negative...
January 2018: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/29593357/patterns-of-acute-bilirubin-encephalopathy-in-nigeria-a-multicenter-pre-intervention-study
#19
Udochukwu M Diala, Richard P Wennberg, Isa Abdulkadir, Zubaida L Farouk, Carlos D Coda Zabetta, Efe Omoyibo, Abieyuwa Emokpae, Aleksandr Aravkin, Bose Toma, Stephen Oguche, Tina Slusher
BACKGROUND: Acute bilirubin encephalopathy (ABE) is an important cause of neonatal morbidity in Nigeria, accounting for 5-14% of neonatal deaths. Most newborns with severe ABE have irreversible damage before receiving treatment emphasizing the need for timely pre-admission monitoring and referral. There is limited evidence that educational interventions targeting mothers and health care providers will reduce delayed care. OBJECTIVE: To provide baseline data on the incidence of ABE and associated pre-admission risk factors in five centers of Nigeria in order to evaluate the effect of subsequent educational interventions on outcome...
March 28, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29579768/chronic-lung-allograft-dysfunction-evolving-concepts-and-therapies
#20
Ariss DerHovanessian, W Dean Wallace, Joseph P Lynch, John A Belperio, S Sam Weigt
Lung transplantation has become an established therapeutic option for a variety of end-stage lung diseases. Technical advances in graft procurement, implantation, perioperative care, immunosuppression, and posttransplant medical management have led to significant improvements in 1-year survival, but outcomes after the first year have improved minimally over the last two decades. The main limitation to better long-term survival after lung transplantation is chronic lung allograft dysfunction (CLAD). CLAD also impairs quality of life and increases the costs of medical care...
April 2018: Seminars in Respiratory and Critical Care Medicine
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