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Johanna Reckhaus, Markus Jutzi, Stefano Fontana, Vera Ulrike Bacher, Marco Vogt, Michael Daslakis, Behrouz Mansouri Taleghani
Background: Platelet concentrates (PC) contain residual contaminating red blood cells (RBC), being higher in pooled buffy coat PC (BC-PC) than in apheresis units (AP-PC). Data about PC-induced alloimmunization against non-D Rhesus (Rh) antigens are limited. Methods: For all newly detected RhD and non-D alloantibodies between August 2015 and September /2017 we prospectively evaluated if they were triggered through PC by analyzing for incompatible RBC and/or PC transfusions...
May 2018: Transfusion Medicine and Hemotherapy
Ana Villalba, Marta Santiago, Carmen Freiria, Pau Montesinos, Ines Gomez, Carolina Fuentes, Rebeca Rodriguez-Veiga, José María Fernandez, Guillermo Sanz, Miguel Angel Sanz, Nelly Carpio, Pilar Solves
Background: Anti-D alloimmunization can occur when platelets from RhD-positive donors are transfused to RhD-negative patients, due to red blood cell residues in the platelet concentrates. Methods: Our objective was to analyze the anti-D alloimmunization rate in a selected group of women under 55 years of age diagnosed with acute leukemia over an 18-year period. We focused the analysis on RhD-negative patients who received RhD-positive platelet transfusions. Results: From January 1998 to October 2016, 382 women under 55 years were diagnosed with acute leukemia...
May 2018: Transfusion Medicine and Hemotherapy
Dandan Huang, Zhiyi Bai, Jiexuan Shen, Liting Zhao, Jiale Li
Tumor necrosis factor receptor-associated factor 6 (TRAF6) acts as a central intracellular signal adapter molecule that mediates the tumor necrosis factor receptor superfamily and the interleukin-1 receptor/Toll-like receptor family in vertebrates and invertebrates. In the present study, HcTRAF6, a molluscan homologue of TRAF6 from Hyriopsis cumingii, has been cloned and identified. The entire open reading frame of HcTRAF6 was found to comprise a 1965-bp region that encodes a predicted protein of 654 amino acids, which contains conserved characteristic domains including a RING domain, two TRAF-type zinc finger domains, a typical coiled coil and the MATH domain...
June 18, 2018: Fish & Shellfish Immunology
Gemma D Banham, Shaun M Flint, Nicholas Torpey, Paul A Lyons, Don N Shanahan, Adele Gibson, Christopher J E Watson, Ann-Marie O'Sullivan, Joseph A Chadwick, Katie E Foster, Rachel B Jones, Luke R Devey, Anna Richards, Lars-Peter Erwig, Caroline O Savage, Kenneth G C Smith, Robert B Henderson, Menna R Clatworthy
BACKGROUND: B cells produce alloantibodies and activate alloreactive T cells, negatively affecting kidney transplant survival. By contrast, regulatory B cells are associated with transplant tolerance. Immunotherapies are needed that inhibit B-cell effector function, including antibody secretion, while sparing regulators and minimising infection risk. B lymphocyte stimulator (BLyS) is a cytokine that promotes B-cell activation and has not previously been targeted in kidney transplant recipients...
June 14, 2018: Lancet
Carolien Zwiers, Johanna G van der Bom, Inge L van Kamp, Nan Van Geloven, Enrico Lopriore, John Smoleniec, Roland Devlieger, Pauline E Sim, Marie Anne Ledingham, Eleonor Tiblad, Kenneth J Moise, Karl-Philip Gloning, Mark D Kilby, Timothy G Overton, Ditte S Jørgensen, Katrine V Schou, Bettina Paek, Martin Walker, Emma Parry, Dick Oepkes, Masja de Haas
BACKGROUND: Intrauterine transfusion for severe alloimmunization in pregnancy performed before 20 weeks' gestation is associated with a higher fetal death rate. Intravenous immunoglobulins may prevent hemolysis and could therefore be a non-invasive alternative for early transfusions. OBJECTIVE(S): We evaluated whether maternal treatment with intravenous immunoglobulins defers the development of severe fetal anemia and its consequences in a retrospective cohort to which 12 fetal therapy centers contributed...
June 11, 2018: American Journal of Obstetrics and Gynecology
Charline Bertholdt, Olivier Morel, Matthieu Dap, Marion Choserot, Hélène Minebois
INTRODUCTION: The primary objective of the study was to evaluate the success of labor induction for indicated moderate and late preterm birth. As secondary objectives, the mode of delivery was assessed. MATERIAL AND METHODS: This is an observational study conducted in a tertiary care unit between 2013 and 2015. All patients who underwent labor induction for indicated preterm birth between 32 + 0 and 36 + 6 weeks of gestation (as premature rupture of membranes, preeclampsia, intrauterine growth restriction, fetomaternal alloimmunization, or intrahepatic cholestasis) were included...
June 10, 2018: Journal of Maternal-fetal & Neonatal Medicine
Umbreen Hafeez, Hui K Gan, Andrew M Scott
Since Nobel laureate Paul Ehrlich proposed the concept of magic bullet in 1906, Köhler and Milstein discovered Hybridoma technology in 1975, and Greg Winter pioneered the technique to humanize monoclonal antibodies in 1988, monoclonal antibodies have been successfully developed to treat medical illnesses. Monoclonal antibodies are effective treatments for inhibition of alloimmune reactivity, haematological malignancies, solid organ malignancies, viral illnesses and are also used as antiplatelet therapy. Their successful use in cancer and autoimmune diseases in humans have made them one of the fastest growing classes of new drugs approved for these indications in last few decades...
June 5, 2018: Current Opinion in Pharmacology
Carlos Galvez, Abdulrahman Abutaleb, Wade T Iams, Paul F Lindholm, Hau C Kwaan
Delayed hemolytic transfusion reactions (DHTRs) occur secondary to slow, mild IgG-mediated processes against minor red blood cell antigens. Herein, we report the case of a rapidly fatal alloimmune anti-c IgM-mediated hemolysis, a rare, previously undescribed, pathophysiologic scenario. Early recognition of such phenomena can expedite supportive measures and optimize patient outcomes.
June 2018: Clinical Case Reports
E A Lendermon, J M Dodd-O, T A Coon, X Wang, C R Ensor, N Cardenes, C L Koodray, H L Heusey, M F Bennewitz, P Sundd, G C Bullock, I Popescu, L Guo, C P O'Donnell, M Rojas, J F McDyer
BACKGROUND: Cellular and molecular mechanisms of acute and chronic lung allograft rejection have yet to be clearly defined, and obliterative bronchiolitis (OB) remains the primary limitation to survival in lung transplant recipients (LTRs). We have previously shown that T-bet-deficient recipients of full major histocompatibility complex (MHC)-mismatched, orthotopic left lung transplants develop accelerated obliterative airway disease (OAD) in the setting of acute cellular rejection characterized by robust alloimmune CD8+ interleukin (IL)-17 and interferon (IFN)-γ responses that are attenuated with neutralization of IL-17...
June 2018: Transplantation Proceedings
L Huang, F Li, Q Fu, X Yang, S Deng, L Wei
BACKGROUND: Acute rejection is a significant challenge after organ transplantation. The CD4+ T-cell‒mediated immune response plays an important role in acute transplant rejection. It was also found that miR-449a microRNA regulates the alloimmune response in a model of heart transplantation in mice. Our goal was to determine the role of miR-449a in the regulation of CD4+ T cells. METHODS: We examined miR-449a expression in peripheral blood mononuclear cells (PBMCs) and graft-infiltrating lymphocytes (GILs) between syngeneic transplant and allogeneic transplant groups on day 7 post‒heart transplantation...
June 2018: Transplantation Proceedings
K Osickova, A Parikova, J Maluskova, J Fronek, O Viklicky
ABO-incompatible (ABOi) kidney transplantation represents a viable tool to increase the donor pool for kidney transplantation, however, increased alloimmune response has been debated. The early outcomes of 25 low-risk ABOi kidney transplant recipients were compared with thoroughly matched 50 ABO-compatible (ABOc) ones. The matching process was based on gender and age of recipients and immunologic parameters, such as panel reactive antibodies, number of human leukocyte antigen mismatches, and transplantation era...
June 2018: Transplantation Proceedings
Vassilis L Tzounakas, Serena I Valsami, Anastasios G Kriebardis, Issidora S Papassideri, Jerard Seghatchian, Marianna H Antonelou
Notwithstanding the high safety level of the currently available blood for transfusion and the decreasing frequency of transfusion-related complications, administration of labile blood products to paediatric patients still poses unique challenges and considerations. The incidence of thalassaemia and sickle cell disease in the paediatric population may be high enough under specific racial and geographical contexts. Red cell transfusion is the cornerstone of β-thalassaemia treatment and one of the most effective ways to prevent or correct specific acute and chronic complications of sickle cell disease...
June 4, 2018: Transfusion and Apheresis Science
Man-Chiu Poon, Roseline d'Oiron
Glanzmann's thrombasthenia (GT) and Bernard-Soulier's syndrome (BSS) are well-understood congenital bleeding disorders, showing defect/deficiency of platelet glycoprotein (GP) IIb/IIIa (integrin αIIbβ3) and GPIb-IX-V complexes respectively, with relevant clinical, laboratory, biochemical, and genetic features. Following platelet transfusion, affected patients may develop antiplatelet antibodies (to human leukocyte antigen [HLA], and/or αIIbβ3 in GT or GPIb-IX in BSS), which may render future platelet transfusion ineffective...
June 7, 2018: Seminars in Thrombosis and Hemostasis
Alexander C Wiseman, Erik Stites, Peter Kennealey
PURPOSE OF REVIEW: To define the natural history of kidney allograft loss related to recurrent diabetes following transplant, and to understand the potential benefit of pancreas transplantation upon kidney allograft survival. RECENT FINDINGS: A postulated benefit of simultaneous pancreas kidney transplant is that, unlike kidney transplant alone, euglycemia from the added pancreas allograft may confer a nephroprotective benefit and prevent recurrent diabetic nephropathy in the renal allograft...
June 6, 2018: Current Opinion in Organ Transplantation
Hannah C Copley, Madhivanan Elango, Vasilis Kosmoliaptsis
PURPOSE OF REVIEW: Donor-recipient human leukocyte antigen (HLA) matching improves outcomes after solid-organ transplantation, but current assessment of HLA incompatibility is inadequate as it does not consider the relative immunogenicity of individual HLA mismatches. In this article, we review existing strategies for assessing HLA immunogenicity and discuss current challenges and future opportunities in this field. RECENT FINDINGS: Current HLA immunogenicity algorithms focus primarily on the humoral component of the alloimmune response and aim to determine a measure of 'dissimilarity' between donor and recipient HLA...
June 4, 2018: Current Opinion in Organ Transplantation
Kirsten Sørensen, Jens Kjeldsen-Kragh, Henrik Husby, Çiğdem Akalın Akkök
Alloimmunization against the RhD antigen is the most common cause of hemolytic disease of the fetus and newborn. Antenatal anti-D prophylaxis in addition to postnatal anti-D prophylaxis reduces the number of RhD-immunizations compared to only postnatal administration. Cell-free fetal DNA released from the apoptotic trophoblastic placental cells into the maternal circulation can be used to determine the fetal RHD type in a blood sample from an RhD negative mother. Based on this typing, antenatal anti-D prophylaxis can be recommended only to RhD negative women carrying an RhD positive fetus, since only these women are at risk of developing anti-D...
June 5, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
Cesar A Speck-Hernandez, Amanda F Assis, Rafaela F Felicio, Larissa Cotrim-Sousa, Nicole Pezzi, Gabriel S Lopes, Karina F Bombonato-Prado, Silvana Giuliatti, Geraldo A Passos
The function of medullary thymic epithelial cells (mTECs) is associated with thymocyte adhesion, which is crucial for the negative selection of autoreactive thymocytes in the thymus. This process represents the root of central tolerance of self-components and prevents the onset of autoimmune diseases. Since thymic epithelia correspond to an important target of donor T cells during the onset of chronic graft-vs-host-disease, mTEC-thymocyte adhesion may have implications for alloimmunity. The Aire and Fezf2 genes function as transcriptome controllers in mTECs...
2018: Frontiers in Immunology
L Laget, C Izard, E Durieux-Roussel, J Gouvitsos, I Dettori, J Chiaroni, V Ferrera-Tourenc
OBJECTIVES: For pregnant women, the serologic test results of D antigen will determine the frequency of RBC antibody detection as well as the indication for RhIG prophylaxis. RHD genotyping is the only method that may provide clear guidance on prophylaxis for women with a weak D phenotype. This analysis evaluated the economical implications of using RHD genotyping to guide RhIG prophylaxis among pregnant women with a serological weak D phenotype. METHODS: We compared the costs of 2 strategies in a cohort of 273 women with weak D phenotype...
June 1, 2018: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Sandrine Delignat, Julie Rayes, Jules Russick, Srinivas V Kaveri, Sebastien Lacroix-Desmazes
The immunogenicity of therapeutic factor VIII (FVIII) in patients with hemophilia A has been puzzling scientific and clinical communities for more than 3 decades. Indeed, the development of inhibitory antibodies to FVIII remains a major clinical challenge and is associated with enormous societal costs. Thus, the reasons for which a presumably innocuous, short-lived, intravenously administered glycoprotein triggers such a deleterious, long-lasting neutralizing immune response is an enigma. This review does not pretend to bring an answer to this challenging question...
June 4, 2018: Seminars in Thrombosis and Hemostasis
Çiğdem Akalın Akkök, Jerard Seghatchian
The aim of pediatric transfusions should be based on the concept of avoiding unnecessary transfusions without jeopardizing the patient safety and providing correct blood components when there are well founded indications to transfuse. Despite considerable efforts from transfusion services to increase transfusion safety, transfusions are still associated with preventable and unpreventable adverse effects that may, in the worst case, have severe and fatal consequences. Transfusions to pediatric patients constitute a small proportion of all transfusions but have higher incidence of adverse events compared to adults...
May 16, 2018: Transfusion and Apheresis Science
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