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https://www.readbyqxmd.com/read/28535529/looking-into-the-graft-without-a-biopsy-biomarkers-of-acute-rejection-in-renal-transplantation
#1
Andrea Angeletti, Paolo Cravedi
Immunosuppression in kidney transplantation is still largely driven by center-specific protocols and adjusted according to the presence of graft dysfunction, drug toxicity or infection. Due to the current inability to titrate immunosuppression to the needs of every single patient, this approach is burdened by an increased risk of under or over-immunosuppression. To extend allograft survival, immunosuppression should be decided based on reliable biomarkers capable of quantifying the alloimmune response and/or noninvasively diagnosing acute rejection...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535394/red-blood-cell-alloimmunization-in-184-patients-with-myeloid-neoplasms-treated-with-azacitidine-a-retrospective-single-center-experience
#2
M Leisch, L Weiss, N Lindlbauer, C Jungbauer, A Egle, E Rohde, R Greil, C Grabmer, L Pleyer
Alloimmunization to Red Blood Cell (RBC) antigens frequently occurs in patients with myeloid neoplasms (AML, MDS and CMML) and potentially poses the patient at risk for delayed hemolytic transfusion reactions and limited supply of compatible RBC-units. However, there is comparatively little data on transfusion associated characteristics in this patient cohort. We therefore retrospectively analyzed transfusion requirements and clinical outcomes of 184 patients with myloid neoplasms treated with azacitidine at the Paracelsus Medical University Salzburg, which were included in the Austrian Registry of Hypomethylating Agents...
May 9, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28518345/severe-neonatal-alloimmune-thrombocytopenia-caused-by-maternal-sensitization-against-a-new-low-frequency-alloantigen-dom-b-located-on-platelet-glycoprotein-iiia
#3
Mia J Sullivan, Randy Kuhlmann, Julie A Peterson, Brian R Curtis
No abstract text is available yet for this article.
May 18, 2017: Transfusion
https://www.readbyqxmd.com/read/28511387/erythrocyte-alloimmunization-and-autoimmunization-among-blood-donors-and-recipients-visiting-a-tertiary-care-hospital
#4
Daljit Kaur, Lovenish Bains, Manoj Kandwal, Indu Parmar
INTRODUCTION: The ultimate aim of pretransfusion testing is the acceptable survival of donor red cells in recipient's body and antibody detection plays a critical role in achieving the same. The cornerstone of antibody detection method is detecting an unexpected antibody as against the expected antibodies of ABO blood group system. Autoantibodies can also interfere with the detection of clinically significant alloantibodies. AIM: To study the frequency of alloantibodies and autoantibodies in the healthy blood donors and patient population visiting our hospital...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28508562/can-serological-methods-help-distinguish-between-prophylactic-and-alloimmune-anti-d
#5
C Irving, M Crennan, T Vanniasinkam
OBJECTIVES: Enzyme indirect antiglobulin test (EIAT) and polyethylene glycol IAT (PIAT) were evaluated for their potential use as tests to distinguish between prophylactic and alloimmune anti-D in plasma by comparing with a tube variation of the standard low ionic strength solution-IAT (LISS-IAT). BACKGROUND: Laboratories performing the screening of RhD-negative pregnant women are required to provide clinicians with guidance as to the source of detected RhD antibodies...
May 15, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28508247/in-human-cell-cultures-everolimus-is-inferior-to-tacrolimus-in-inhibiting-cellular-alloimmunity-but-equally-effective-as-regards-humoral-alloimmunity
#6
Theodoros Eleftheriadis, Georgios Pissas, Maria Sounidaki, Georgia Antoniadi, Nikolaos Antoniadis, Vassilios Liakopoulos, Ioannis Stefanidis
PURPOSE: Acute cellular rejection is the major cause of immune-mediated graft failure early in the course of kidney transplantation, whereas chronic antibody-mediated rejection is a major contributor to graft loss in the late post-transplant phase. Based mainly on the results of short-term studies, the calcineurin inhibitor tacrolimus prevails over the mammalian target of rapamycin (mTOR) inhibitors. However, the toxicity profile of the two drug categories differs, making the interchange between them appealing...
May 15, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28507611/the-impact-of-extended-typing-on-red-blood-cell-alloimmunization-in-transfused-patients
#7
Tatjana Makarovska-Bojadzieva, Emilija Velkova, Milenka Blagoevska
BACKGROUND: Red blood cell (RBC) alloimmunization is still an actual problem in our transfusion practice. In 2011, in addition to the regular ABO/D blood group typing, phenotyping for Rh (C, c, E, e) and Kell antigens was introduced for blood donors and patients undergoing blood transfusion. Our aim was to evaluate the impact of the extended RBC typing and donor/recipient matching on the incidence of RBC alloimmunization. METHODS: A retrospective comparative study was conducted by reviewing RBC request records for about 36,000 patients transfused with RBC in the period from 2013 to 2015 in comparison to the similar study conducted on 47,000 transfused patients in the period from 2005 to 2008...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28503958/neonatal-management-and-outcome-in-alloimmune-hemolytic-disease
#8
Isabelle M C Ree, Vivianne E H J Smits-Wintjens, Johanna G van der Bom, Jeanine M M van Klink, Dick Oepkes, Enrico Lopriore
Hemolytic disease of the fetus and newborn (HDFN) occurs when fetal and neonatal erythroid cells are destroyed by maternal erythrocyte alloantibodies, it leads to anemia and hydrops in the fetus, and hyperbilirubinemia and kernicterus in the newborn. Postnatal care consists of intensive phototherapy and exchange transfusions to treat severe hyperbilirubinemia and top-up transfusions to treat early and late anemia. Other postnatal complications have been reported such as thrombocytopenia, iron overload and cholestasis requiring specific management...
May 13, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28481225/impact-of-environmental-factors-on-alloimmunity-and-transplant-fate
#9
Leonardo V Riella, Jessamyn Bagley, John Iacomini, Maria-Luisa Alegre
Although gene-environment interactions have been investigated for many years to understand people's susceptibility to autoimmune diseases or cancer, a role for environmental factors in modulating alloimmune responses and transplant outcomes is only now beginning to emerge. New data suggest that diet, hyperlipidemia, pollutants, commensal microbes, and pathogenic infections can all affect T cell activation, differentiation, and the kinetics of graft rejection. These observations reveal opportunities for novel therapeutic interventions to improve graft outcomes as well as for noninvasive biomarker discovery to predict or diagnose graft deterioration before it becomes irreversible...
May 8, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28477373/uric-acid-increases-cellular-and-humoral-alloimmunity-in-primary-human-peripheral-blood-mononuclear-cells
#10
Theodoros Eleftheriadis, Georgios Pissas, Maria Sounidaki, Georgia Antoniadi, Nikolaos Antoniadis, Vassilios Liakopoulos, Ioannis Stefanidis
BACKGROUND: Hyperuricemia is common among kidney transplant recipients and has been associated with worse graft outcome. Since episodes of acute cellular rejection and chronic humoral rejection contribute to decreased graft survival, in this study the effect of uric acid on cellular and humoral alloimmunity was evaluated. METHODS: Cellular alloimmunity was assessed by cell proliferation in two-way mixed lymphocyte reaction (MLR) with human peripheral blood mononuclear cells (PBMC)...
May 5, 2017: Nephrology
https://www.readbyqxmd.com/read/28458583/current-perspectives-on-fetal-and-neonatal-alloimmune-thrombocytopenia-increasing-clinical-concerns-and-new-treatment-opportunities
#11
REVIEW
Heidi Tiller, Anne Husebekk, Maria Therese Ahlen, Tor B Stuge, Bjørn Skogen
Differences in platelet type between the fetus and the mother can lead to maternal immunization and destruction of the fetal platelets, a condition named fetal and neonatal alloimmune thrombocytopenia (FNAIT). FNAIT is reported to occur in ~1 per 1,000 live born neonates. The major risk is intracranial hemorrhage in the fetus or newborn, which is associated with severe neurological complications or death. Since no countries have yet implemented a screening program to detect pregnancies at risk, the diagnosis is typically established after the birth of a child with symptoms...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28445940/suppression-of-allograft-rejection-by-cd8-cd122-pd-1-tregs-is-dictated-by-their-fas-ligand-initiated-killing-of-effector-t-cells-versus-fas-mediated-own-apoptosis
#12
Huazhen Liu, Yeshu Wang, Qiaohuang Zeng, Yu-Qun Zeng, Chun-Ling Liang, Feifei Qiu, Hong Nie, Zhenhua Dai
Mounting evidence has shown that naturally occurring CD8+CD122+ T cells are regulatory T cells (Tregs) that suppress both autoimmunity and alloimmunity. We have previously shown that CD8+CD122+PD-1+ Tregs not only suppress allograft rejection, but also are more potent in suppression than conventional CD4+CD25+ Tregs. However, the mechanisms underlying their suppression of alloimmunity are not well understood. In an adoptive T-cell transfer model of mice lacking lymphocytes, we found that suppression of skin allograft rejection by CD8+CD122+PD-1+ Tregs was mostly dependent on their expression of Fas ligand as either lacking Fas ligand or blocking it with antibodies largely abolished their suppression of allograft rejection mediated by transferred T cells...
April 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28436749/differential-diagnosis-of-neonatal-alloimmune-thrombocytopenia-type-2b-von-willebrand-disease
#13
Mathilde Penel-Page, Sandrine Meunier, Mathilde Fretigny, Sandra Le Quellec, Pierre Boisseau, Christine Vinciguerra, Catherine Ternisien, Lucia Rugeri
At birth, severe thrombocytopenia without context of infection should mainly suggest neonatal alloimmune thrombocytopenia (NAIT), especially in case of a platelet count below 20 GL(-1). We report two cases of severe neonatal thrombocytopenia, first suspected as being NAIT. Both had a platelet count below 20 GL(-1) with platelet clumps. The absence of alloantibodies and failure of platelet transfusion and intravenous immunoglobulins to improve the platelet count led to question the diagnosis and to evoke inherited bleeding disorders...
April 24, 2017: Platelets
https://www.readbyqxmd.com/read/28427861/divergent-function-of-programmed-death-ligand-1-in-donor-tissue-versus-recipient-immune-system-in-a-murine-model-of-bronchiolitis-obliterans
#14
Katharina Schütte-Nütgen, Olaf Boenisch, Hakima Harrach, Alicia Casey, Indira Guleria, Nader Najafian, Mohamed H Sayegh, Craig J Gerard, Meera Subramaniam
Costimulatory molecules, such as the programmed death ligand (PD-L1), might exert differential effects on T-cell function, depending on the clinical setting and/or immunological environment. Given the impact of T cells on bronchiolitis obliterans (BO) in lung transplantation, we used an established tracheal transplant model inducing BO-like lesions to investigate the impact of PD-L1 on alloimmune responses and histopathological outcome in BO. In contrast to other transplant models in which PD-L1 generally shows protective functions, we demonstrated that PD-L1 has divergent effects depending on its location in donor versus recipient tissue...
June 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28427432/anti-human-platelet-antigen-hpa-1a-antibodies-may-affect-trophoblast-functions-crucial-for-placental-development-a-laboratory-study-using-an-in-vitro-model
#15
Mariana Eksteen, Gøril Heide, Heidi Tiller, Yan Zhou, Nora Hersoug Nedberg, Inigo Martinez-Zubiaurre, Anne Husebekk, Bjørn R Skogen, Tor B Stuge, Mette Kjær
BACKGROUND: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a bleeding disorder caused by maternal antibodies against paternal human platelet antigens (HPAs) on fetal platelets. Antibodies against HPA-1a are accountable for the majority of FNAIT cases. We have previously shown that high levels of maternal anti-HPA-1a antibodies are associated with clinically significant reduced birth weight in newborn boys. Chronic inflammatory placental lesions are associated with increased risk of reduced birth weight and have previously been reported in connection with FNAIT pregnancies...
April 21, 2017: Reproductive Biology and Endocrinology: RB&E
https://www.readbyqxmd.com/read/28425750/modeling-alloantibody-formation-to-high-incidence-red-blood-cell-antigens-in-immune-responders-using-genotypic-data
#16
Patricia A R Brunker, Keerthana Ravindran, R S Shirey
Alloimmunization to red blood cell antigens is unpredictable and poorly understood. Patients who are negative for high-incidence antigens (HIAs) are at risk for developing the corresponding antibodies. Molecular methods can easily predict the lack of an antigen and thus, the risk of an individual to become immunized. We examined the prevalence and risk factors for HIA alloimmunization in patients at risk based on genotyping results. Genotyping using a molecular method (HEA BeadChip™, Immucor, Warren, NJ) was performed on all patient specimens referred for molecular testing over 45 months; serologic and clinical data were analyzed...
January 2017: Immunohematology
https://www.readbyqxmd.com/read/28421078/genetic-association-of-hematopoietic-stem-cell-transplantation-outcome-beyond-histocompatibility-genes
#17
REVIEW
Rihab Gam, Pranali Shah, Rachel E Crossland, Jean Norden, Anne M Dickinson, Ralf Dressel
The outcome of hematopoietic stem cell transplantation (HSCT) is controlled by genetic factors among which the leukocyte antigen human leukocyte antigen (HLA) matching is most important. In addition, minor histocompatibility antigens and non-HLA gene polymorphisms in genes controlling immune responses are known to contribute to the risks associated with HSCT. Besides single-nucleotide polymorphisms (SNPs) in protein coding genes, SNPs in regulatory elements such as microRNAs (miRNAs) contribute to these genetic risks...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28419453/obstetrics-and-gynecology-physician-knowledge-of-rh-immune-globulin-prophylaxis
#18
Amy Yu, Erin Morris, Richard Adams, Mark K Fung
BACKGROUND: Previous studies have shown that more than 20% of laboratories would have recommended inaccurate doses of Rh immune globulin (RhIG) in hypothetical cases. Efforts have been made in educating laboratories in correct dosing calculations; however, obstetricians are most often responsible for ordering RhIG. The objective of this study was to assess knowledge of RhIG indications and dosing among obstetrics and gynecology (OB/GYN) physicians in the United States. STUDY DESIGN AND METHODS: An anonymous 17- question online survey was distributed to all OB/GYN resident and attending physicians affiliated with US residency training programs...
April 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28419427/how-i-manage-children-with-neutropenia
#19
REVIEW
David C Dale
Neutropenia, usually defined as a blood neutrophil count <1·5 × 10(9) /l, is a common medical problem for children and adults. There are many causes for neutropenia, and at each stage in life the clinical pattern of causes and consequences differs significantly. I recommend utilizing the age of the child and clinical observations for the preliminary diagnosis and primary management. In premature infants, neutropenia is quite common and contributes to the risk of sepsis with necrotizing enterocolitis...
April 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28413208/anti-m-induced-severe-haemolytic-disease-of-foetus-and-newborn-in-a-malay-woman-with-recurrent-pregnancy-loss
#20
H Mohd Nazri, M N Noor Haslina, M Y Shafini, A R Noor Shaidatul Akmal, M Rapiaah, A Wan Zaidah
Haemolytic disease of the foetus and newborn (HDFN) is caused by maternal red blood cells (RBC) alloimmunisation resulted from incompatibility of maternal and foetal RBCs. However, only a few HDFN attributed to anti-M were reported, varying from asymptomatic to severe anaemia with hydrops foetalis and even intrauterine death. A case of severe HDFN due to anti-M alloantibody from an alloimmunized grandmultiparous Malay woman with recurrent pregnancy loss is reported here. The newborn was delivered with severe and prolonged anaemia which required frequent RBC transfusions, intensive phototherapy and intravenous immunoglobulin administration...
April 2017: Malaysian Journal of Pathology
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