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Alloimmunity

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https://www.readbyqxmd.com/read/29043831/del-phenotype
#1
Dong H Kwon, S G Sandler, Willy A Flegel
DEL red blood cells (RBCs) type as D- by routine serologic methods and are transfused routinely, without being identified as expressing a very weak D antigen, to D- recipients. DEL RBCs are detected only by adsorption and elution of anti-D or by molecular methods. Most DEL phenotypes have been reported in population studies conducted in East Asia, although DEL phenotypes have been detected also among Caucasian individuals. Approximately 98 percent of DEL phenotypes in East Asians are associated with the RHD*DEL1 or RHD*01EL...
September 2017: Immunohematology
https://www.readbyqxmd.com/read/29043142/costimulation-pathway-blockade-in-kidney-transplant-recipients-with-de-novo-rheumatoid-arthritis
#2
Mohamed Sheta, Samy Riad, Udayakumar Deepak, Naim Issa, Mark Birkenbach, Hassan N Ibrahim, Aleksandra Kukla
The best approach to treatment of de-novo rheumatoid arthritis in solid organ transplant recipients on typical immunosuppression is not well established. The use of biologics targeting specific cell types, cytokines, and immunological pathways has been gaining interest in the treatment of both, auto- and alloimmunity. We present a case of de-novo rheumatoid arthritis in a kidney transplant recipient 10 years post-transplant while receiving cyclosporine, mycophenolate mofetil, and also prednisone. Initial presentation included features of polymyalgia rheumatica and nephrotic range proteinuria...
2017: Clin Nephrol Case Stud
https://www.readbyqxmd.com/read/29038423/regulation-of-t-cell-alloimmunity-by-pi3k%C3%AE-and-pi3k%C3%AE
#3
Mayuko Uehara, Martina M McGrath, Shunsuke Ohori, Zhabiz Solhjou, Naima Banouni, Sujit Routray, Catherine Evans, Jonathan P DiNitto, Abdallah Elkhal, Laurence A Turka, Terry B Strom, Stefan G Tullius, David G Winkler, Jamil Azzi, Reza Abdi
Phosphatidylinositol-3-kinases (PI3K) γ and δ are preferentially enriched in leukocytes, and defects in these signaling pathways have been shown to impair T cell activation. The effects of PI3Kγ and PI3Kδ on alloimmunity remain underexplored. Here, we show that both PI3Kγ (-/-) and PI3Kδ (D910A/D910A) mice receiving heart allografts have suppression of alloreactive T effector cells and delayed acute rejection. However, PI3Kδ mutation also dampens regulatory T cells (Treg). After treatment with low dose CTLA4-Ig, PI3Kγ (-/-) , but not PI3Κδ (D910A/D910A) , recipients exhibit indefinite prolongation of heart allograft survival...
October 16, 2017: Nature Communications
https://www.readbyqxmd.com/read/29031020/fetal-mri-lower-acceptance-by-women-in-research-vs-clinical-setting
#4
Bloeme J van der Knoop, Roland J Vermeulen, Jonathan I M L Verbeke, Lourens R Pistorius, Johanna I P de Vries
AIM: To determine acceptance of pregnant women to undergo fetal magnetic resonance imaging (MRI) examination in research and clinical setting. METHODS: A prospective study included a research group [part of a study comparing brain ultrasound (US) to MRI in fetuses at risk for acquired brain damage] and a clinical group [fetuses with suspected (brain) anomalies after structural US examination] from 2011 to 2014. All women were advised to use sedatives. MRI declinations, use of sedation, MRI duration and imaging quality were compared between both groups...
October 14, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29030871/fetal-neonatal-alloimmune-thrombocytopenia-due-to-anti-cd36-antibodies-antibody-evaluations-by-cd36-transfected-cell-lines
#5
Marie Lin, Xiuzhang Xu, Hui-Lin Lee, Der-Cheng Liang, Sentot Santoso
BACKGROUND: Isoantibodies against CD36 (platelet glycoprotein 4), developed in Type I CD36-deficient mothers are frequently reported as the cause of fetal/neonatal alloimmune thrombocytopenia in the Asian population. Therefore, further detailed characterization of anti-CD36-mediated fetal/neonatal alloimmune thrombocytopenia is warranted. Here, we report the characterization of a patient with fetal/neonatal alloimmune thrombocytopenia in a Taiwanese family caused by anti-CD36 isoantibodies using a novel antigen-capture method...
October 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29024716/accelerated-humoral-renal-allograft-rejection-due-to-hla-c14-mediated-allosensitization-to-hla-bw6
#6
Stephen P Persaud, Brian Duffy, Donna L Phelan, Thalachallour Mohanakumar, Rowena Delos Santos, Joseph P Gaut, Chang Liu
OBJECTIVES: To investigate immunological mechanisms underlying accelerated antibody-mediated rejection (AMR) of a living-related renal allograft in a patient with no detectable antibodies to donor human leukocyte antigens (HLA) in pre-transplant sera. METHODS: Pre- and post-transplant HLA antibody specificities were determined by single-antigen bead assay, and crossmatching was performed by flow cytometry- and complement-dependent cytotoxicity-based methods. Intermediate- and high-resolution HLA typing were performed by molecular methods...
October 9, 2017: Human Immunology
https://www.readbyqxmd.com/read/28983058/red-cell-alloimmunization-is-associated-with-development-of-autoantibodies-and-increased-red-cell-transfusion-requirements-in-myelodysplastic-syndrome
#7
Deepak Singhal, Monika M Kutyna, Rakchha Chhetri, Li Yan A Wee, Sophia Hague, Lakshmi Nath, Shriram V Nath, Romi Sinha, Nicholas Wickham, Ian D Lewis, David M Ross, Peter G Bardy, Luen Bik To, John Reynolds, Erica M Wood, David J Roxby, Devendra K Hiwase
Up to 90% of myelodysplastic syndrome patients require red blood cell transfusion, however comprehensive data addressing red cell alloimmunization are limited. This study evaluates the incidence and clinical impact of red cell alloimmunization in a large cohort of myelodysplastic syndrome patients registered in the statewide South Australian-MDS registry. Median age of the 817 patients was 73 years, and 66% were male. The cumulative incidence of alloimmunization was 11%. Disease-modifying therapy was associated with a lower risk of alloimmunization...
October 5, 2017: Haematologica
https://www.readbyqxmd.com/read/28979173/prevalence-of-rhd-variants-among-blood-donors-at-gulu-regional-blood-bank-gulu-northern-uganda
#8
Polycarp Ojok, Caesar Oyet, Fred Webbo, Bashir Mwambi, Ivan M Taremwa
AIM/OBJECTIVE: The aim of this study was to determine the prevalence of RhD variant phenotypes among voluntary non-remunerated blood donors (VNRBDs) at Gulu Regional Blood Bank (GRBB), Northern Uganda. MATERIALS AND METHODS: We conducted a cross-sectional study, in which the first 4.0 mL of ethylenediaminetetraacetic acid (EDTA) blood samples were collected from VNRBDs and typed for their ABO and RhD blood group status using IgM and IgG monoclonal typing antisera, respectively...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/28978860/development-of-ips-cell-derived-blood-products-and-production-guidelines
#9
Naoshi Sugimoto, Koji Eto
Blood products derived from iPS cells have been pursued as a blood donor-independent and genetically manipulative measure to complement or alternate current transfusion products. Erythrocytes and platelets are anucleate blood cells that are indispensable for oxygen delivery and hemostasis, respectively. Consequently, blood transfusions have been clinically established to treat severe anemia and thrombocytopenia. However, current blood products exhibit issues with regard to supply-demand imbalance and alloimmune responses and infections, and they also face a future shortage of donors in aging societies...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28978798/selective-blockade-of-cd28-on-human-t-cells-facilitates-regulation-of-alloimmune-responses
#10
Masaaki Zaitsu, Fadi Issa, Joanna Hester, Bernard Vanhove, Kathryn J Wood
T cells are central to the detrimental alloresponses that develop in autoimmunity and transplantation, with CD28 costimulatory signals being key to T cell activation and proliferation. CTLA4-Ig molecules that bind CD80/86 and inhibit CD28 costimulation offer an alternative immunosuppressive treatment, free from some of the chronic toxicities associated with calcineurin inhibition. However, CD80/86 blockade by CTLA4-Ig also results in the loss of coinhibitory CTLA4 signals that are critical to the regulation of T cell activation...
October 5, 2017: JCI Insight
https://www.readbyqxmd.com/read/28970962/ivig-associated-maternal-pancytopenia-during-treatment-for-neonatal-alloimmune-thrombocytopenia
#11
Alyssa Herrmann, Benjamin J Samelson-Jones, Sami Brake, Renee Samelson
Background  Treatment for neonatal alloimmune thrombocytopenia (NAIT) primarily involves maternal administration of intravenous immunoglobulin (IVIG) therapy and prednisone according to protocols based on risk stratification. While IVIG is generally well tolerated, hematologic side effects are a potential complication. Case  We present the successful management of a rare complication of maternal pancytopenia following standard IVIG treatment. Diagnosis was made during routine obstetric exams. Management included reducing IVIG dosage and adding daily prednisone...
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28970690/successful-surgical-procedure-in-a-patient-of-aplastic-anemia-with-platelet-refractoriness-using-cross-match-compatible-platelets
#12
Ritam Chakrabarty, Sudipta Sekhar Das
This case marks the beginning of issuing cross-matched platelet products in Eastern India. A known case of aplastic anemia, on regular transfusion support, now presented with obstructed ventral periumbilical hernia requiring urgent surgical intervention. Platelet count at presentation was 13,000/μL. Platelet cross-matching was done by solid phase method. Ten units of random donor platelets were crossmatched. Five units were compatible and transfused. Counts rose to 84,000/μL after 1 h. Surgery was completed successfully...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28970677/red-cell-alloimmunization-in-repeatedly-transfused-patients
#13
Dimel K Bhuva, Jitendra H Vachhani
INTRODUCTION: Repeated blood transfusions can result in the production of alloantibodies against one or more red cell antigens, which complicates subsequent transfusions. Aims: The study was done to find incidence of various red cell alloantibodies; to determine the type of alloantibody; to identify the factors such as frequency of transfusion, splenectomy status, donor ethnicity and gender and their association with the development of antibody in repeatedly transfused patients. MATERIALS AND METHODS: This study was carried out in Dept...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28966502/rare-presentation-of-mixed-autoimmune-hemolytic-anemia-in-children-report-of-2-cases
#14
Preeti Rai, Geetika Sharma, Deeksha Singh, Jyoti Garg
Immune hemolytic anemia is characterized by clinical and laboratory features of hemolytic anemia with direct antiglobulin test (DAT) positivity. It could be autoimmune hemolytic anemia (AIHA), alloimmune, or drug-induced hemolysis based on the antigenic stimulus. Furthermore, based on thermal amplitude of autoantibody, AIHA is classified as warm (65%), cold (30%), and mixed (5%) type. Mixed AIHA is extremely rare in children and must be differentiated from warm AIHA with clinically insignificant cold agglutinins and cold hemagglutinin disease as their treatment is different...
October 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28960321/how-do-i-%C3%A2-manage-the-platelet-transfusion-refractory-patient
#15
Justin E Juskewitch, Andrew P Norgan, Steven R De Goey, Patti M Duellman, Laurie L Wakefield, Manish J Gandhi, James R Stubbs, Justin D Kreuter
BACKGROUND: Platelet transfusion-refractoriness is a challenging and expensive clinical scenario seen most often in patients with hematologic malignancies. Although the majority of platelet transfusion-refractory cases are due to nonimmune causes, a significant minority are caused by alloimmunization against Class I human leukocyte antigens (HLAs) or human platelet antigens (HPAs). Such platelet transfusion-refractory patients can be effectively managed with appropriate antigen-negative products...
September 28, 2017: Transfusion
https://www.readbyqxmd.com/read/28939878/immunophysical-analysis-of-corneal-neovascularization-mechanistic-insights-and-implications-for-pharmacotherapy
#16
Youness Azimzade, Jiaxu Hong, Alireza Mashaghi
The cornea lacks adaptive immune cells and vasculature under healthy conditions, but is populated by both cell types under pathologic conditions and after transplantation. Here we propose an immunophysical approach to describe postoperative neovascularization in corneal grafts. We develop a simple dynamic model that captures not only the well-established interactions between innate immunity and vascular dynamics but also incorporates the contributions of adaptive immunity to vascular growth. We study how these interactions determine dynamic changes and steady states of the system as well as the clinical outcome, i...
September 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28937404/genotyping-to-prevent-rh-disease-has-the-time-come
#17
C Ellen van der Schoot, Masja de Haas, Frederik Banch Clausen
PURPOSE OF REVIEW: In this review, we analyzed the current literature on noninvasive fetal RHD typing to answer the question whether the administration of RhIg to prevent D-alloimmunization during pregnancy can be safely guided by fetal RHD typing. RECENT FINDINGS: Recently the first centers that implemented large-scale nationwide fetal RHD typing in the second trimester for targeted RhIg administration have published their studies evaluating the diagnostic accuracy of their screening programs...
September 20, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28926127/recall-features-and-allorecognition-in-innate-immunity
#18
REVIEW
Hirofumi Uehara, Koichiro Minami, Markus Quante, Yeqi Nian, Timm Heinbokel, Haruhito Azuma, Abdala El Khal, Stefan G Tullius
Alloimmunity traditionally distinguishes short-lived, rapid and non-specific innate immune responses from adaptive immune responses that are characterized by a highly specific response initiated in a delayed fashion. Key players of innate immunity such as natural killer (NK) cells and macrophages present the first-line defense of immunity. The concept of unspecific responses in innate immunity has recently been challenged. The discovery of pattern recognition receptors (PRRs) has demonstrated that innate immune cells respond in a semi-specific fashion through the recognition of pathogen-associated molecular patterns (PAMPs) representing conserved molecular structures shared by large groups of microorganisms...
September 19, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28924425/blood-group-distribution-in-switzerland-a-historical-comparison
#19
Thomas Volken, Rebecca J Crawford, Soraya Amar, Edgar Mosimann, Anita Tschaggelar, Behrouz Mansouri Taleghani
BACKGROUND: Ethnicities differ in prevalence of blood groups and antigens. Substantial donor-recipient mismatch within mixed-ethnic societies may render certain recipients at higher risk for alloimmunization. Data regarding antigen distribution within Switzerland by ethnicity is limited. We examined immigration patterns against the distribution of ABO blood groups using large cross-sectional Swiss samples spanning 70 years. METHODS: Historical ABO blood group distribution data (1940-1945) from Swiss army personnel (n = 275,664) were sourced from the literature...
August 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28921638/graft-infiltrating-pd-l1-hi-cross-dressed-dendritic-cells-regulate-anti-donor-t-cell-responses-in-mouse-liver-transplant-tolerance
#20
Yoshihiro Ono, Angelica Perez-Gutierrez, Toshimasa Nakao, Helong Dai, Geoffrey Camirand, Osamu Yoshida, Shinichiro Yokota, Donna Beer Stolz, Mark A Ross, Adrian E Morelli, David A Geller, Angus W Thomson
While a key role of cross-dressing has been established in immunity to viral infection and more recently in the instigation of transplant rejection, its role in tolerance is unclear. Here, we investigated the role of intra-graft dendritic cells (DC) and cross-dressing in mouse major histocompatibility complex (MHC)-mismatched liver transplant tolerance that occurs without therapeutic immunosuppression. While donor interstitial DC diminished rapidly following transplantation, they were replaced in the liver by host DC that peaked on postoperative day (POD) 7 and persisted indefinitely...
September 16, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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