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Park I, Jang WS, Lim CS, Kim J. Evaluation of Pre-Transfusion Crossmatch Test Using Microscanner C3. Diagnostics (Basel) 2024; 14:1231. [PMID: 38928646 PMCID: PMC11202519 DOI: 10.3390/diagnostics14121231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
A pre-transfusion crossmatch test is crucial for ensuring safe blood transfusions by identifying the compatibility between donor and recipient blood samples. Conventional tube methods for crossmatching have limitations, including subjectivity in result interpretation and the potential for human error. In this study, we evaluated the diagnostic performance of a new crossmatch test using Microscanner C3, which can overcome these shortcomings. The crossmatch test results using the method were obtained in 323 clinical samples. The sensitivity, specificity, positive predictive value, negative predictive value, and concordance rate of the crossmatch test using Microscanner C3 were 98.20%, 100.00%, 100.00%, 98.11%, and 99.07%, respectively. The diagnostic performance of the new system offers a promising alternative to conventional tube methods for pre-transfusion crossmatch testing. Microscanner C3 could also increase the automation, standardization, and accuracy of crossmatch tests. The crossmatch test using Microscanner C3 is thought to increase the efficiency and reliability in identifying blood samples suitable for transfusion, thereby improving patient safety and optimizing the use of blood products in clinical settings.
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Affiliation(s)
- Insu Park
- BK21 Graduate Program, Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 02841, Republic of Korea;
| | - Woong Sik Jang
- Departments of Emergency Medicine, College of Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea
| | - Chae Seung Lim
- Departments of Laboratory Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Departments of Laboratory Medicine, College of Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea
| | - Jeeyong Kim
- Departments of Laboratory Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Departments of Laboratory Medicine, College of Medicine, Korea University Ansan Hospital, Ansan-si 15355, Republic of Korea
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Mikame M, Tsuno NH, Miura Y, Kitazaki H, Uchimura D, Miyagi T, Miyazaki T, Onodera T, Ohashi W, Kameda T, Ohkawa R, Kino S, Muroi K. Anti-A and anti-B titers, age, gender, biochemical parameters, and body mass index in Japanese blood donors. Immunohematology 2023; 39:155-165. [PMID: 38179781 DOI: 10.2478/immunohematology-2023-023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
It has been reported that anti-A and anti-B (ABO antibody) titers decrease with age, but little is known about the association between ABO antibody titers and physiologic/biochemical parameters such as body mass index (BMI), gamma-glutamyl transpeptidase (GGT), and total cholesterol (T-Cho). We investigated the present situation of ABO antibody titers among healthy blood donors in Japan and the physiologic/biochemical factors that may be associated with changes in ABO antibody titers. Plasma from 7450 Japanese blood donors was tested for ABO antibody titers using ABO reverse typing reagents by an automated microplate system; donor samples were classified into low, middle, and high titers according to the agglutination results obtained with diluted plasma samples. Multivariate regression analysis was performed to analyze the association between ABO antibody titers and age, gender, biochemical parameters (alanine transaminase [ALT], GGT, globulin, T-Cho, and glycosylated albumin [GA]), and BMI according to the ABO blood groups. A significant correlation between ABO antibody titers and age/gender, except for gender in anti-A of blood group B donors, was observed. BMI showed significant but negative correlations with anti-A and anti-B (β = -0.085 and -0.062, respectively; p < 0.01) in blood group O donors. In addition, significant but negative correlations between GGT and T-Cho with anti-B of blood group A donors (β = -0.055 and -0.047, respectively; p < 0.05) were observed. Although differences existed among the ABO blood groups, ABO antibody titers seem to be associated with physiologic and biochemical parameters of healthy individuals.
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Affiliation(s)
- M Mikame
- Development Researcher, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, and Central Blood Institute, Clinical Bioanalysis and Molecular Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 2-1-67, Tatsumi, Koto-ku, Tokyo, 135-8521, Japan
| | - N H Tsuno
- Deputy General Manager, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, and Central Blood Institute, Tokyo, Japan
| | - Y Miura
- Clinical Laboratory Staff, Japanese Red Cross Hokkaido Block Blood Center, Hokkaido, Japan
| | - H Kitazaki
- Clinical Laboratory Staff, Japanese Red Cross Hokkaido Block Blood Center, Hokkaido, Japan
| | - D Uchimura
- Clinical Laboratory Staff, Japanese Red Cross Hokkaido Block Blood Center, Hokkaido, Japan
| | - T Miyagi
- Section Head, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, and Central Blood Institute, Tokyo, Japan
| | - T Miyazaki
- Section Head, Japanese Red Cross Central Blood Institute, Tokyo, Japan
| | - T Onodera
- Head of Department, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - W Ohashi
- Head of Department, Japanese Red Cross Hokkaido Block Blood Center, Hokkaido, Japan
| | - T Kameda
- Senior Lecturer, Department of Clinical Laboratory Science, Teikyo University, and Clinical Bioanalysis and Molecular Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - R Ohkawa
- Professor, Clinical Bioanalysis and Molecular Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - S Kino
- General Manager, Japanese Red Cross Hokkaido Block Blood Center, Hokkaido, Japan
| | - K Muroi
- General Manager, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
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3
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Christensen RD, Bahr TM, Ilstrup SJ, Dizon-Townson DS. Alloimmune hemolytic disease of the fetus and newborn: genetics, structure, and function of the commonly involved erythrocyte antigens. J Perinatol 2023; 43:1459-1467. [PMID: 37848604 DOI: 10.1038/s41372-023-01785-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023]
Abstract
Hemolytic disease of the fetus and newborn (HDFN) can occur when a pregnant woman has antibody directed against an erythrocyte surface antigen expressed by her fetus. This alloimmune disorder is restricted to situations where transplacental transfer of maternal antibody to the fetus occurs, and binds to fetal erythrocytes, and significantly shortens the red cell lifespan. The pathogenesis of HDFN involves maternal sensitization to erythrocyte "non-self" antigens (those she does not express). Exposure of a woman to a non-self-erythrocyte antigen principally occurs through either a blood transfusion or a pregnancy where paternally derived erythrocyte antigens, expressed by her fetus, enter her circulation, and are immunologically recognized as foreign. This review focuses on the genetics, structure, and function of the erythrocyte antigens that are most frequently involved in the pathogenesis of alloimmune HDFN. By providing this information we aim to convey useful insights to clinicians caring for patients with this condition.
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Affiliation(s)
- Robert D Christensen
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA.
- Obstetric and Neonatal Operations, Intermountain Health, Salt Lake City, UT, USA.
| | - Timothy M Bahr
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA
- Obstetric and Neonatal Operations, Intermountain Health, Salt Lake City, UT, USA
| | - Sarah J Ilstrup
- Intermountain Health Transfusion Services and Department of Pathology, Intermountain Medical Center, Murray, UT, USA
| | - Donna S Dizon-Townson
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, and Intermountain Health, Salt Lake City, UT, USA
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4
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Mironov AA, Savin MA, Zaitseva AV, Dimov ID, Sesorova IS. Mechanisms of Formation of Antibodies against Blood Group Antigens That Do Not Exist in the Body. Int J Mol Sci 2023; 24:15044. [PMID: 37894724 PMCID: PMC10606600 DOI: 10.3390/ijms242015044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
The system of the four different human blood groups is based on the oligosaccharide antigens A or B, which are located on the surface of blood cells and other cells including endothelial cells, attached to the membrane proteins or lipids. After transfusion, the presence of these antigens on the apical surface of endothelial cells could induce an immunological reaction against the host. The final oligosaccharide sequence of AgA consists of Gal-GlcNAc-Gal (GalNAc)-Fuc. AgB contains Gal-GlcNAc-Gal (Gal)-Fuc. These antigens are synthesised in the Golgi complex (GC) using unique Golgi glycosylation enzymes (GGEs). People with AgA also synthesise antibodies against AgB (group A [II]). People with AgB synthesise antibodies against AgA (group B [III]). People expressing AgA together with AgB (group AB [IV]) do not have these antibodies, while people who do not express these antigens (group O [0; I]) synthesise antibodies against both antigens. Consequently, the antibodies are synthesised against antigens that apparently do not exist in the body. Here, we compared the prediction power of the main hypotheses explaining the formation of these antibodies, namely, the concept of natural antibodies, the gut bacteria-derived antibody hypothesis, and the antibodies formed as a result of glycosylation mistakes or de-sialylation of polysaccharide chains. We assume that when the GC is overloaded with lipids, other less specialised GGEs could make mistakes and synthesise the antigens of these blood groups. Alternatively, under these conditions, the chylomicrons formed in the enterocytes may, under this overload, linger in the post-Golgi compartment, which is temporarily connected to the endosomes. These compartments contain neuraminidases that can cleave off sialic acid, unmasking these blood antigens located below the acid and inducing the production of antibodies.
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Affiliation(s)
- Alexander A. Mironov
- Department of Cell Biology, IFOM ETS—The AIRC Institute of Molecular Oncology, Via Adamello, 16, 20139 Milan, Italy
| | - Maksim A. Savin
- The Department for Welding Production and Technology of Constructional Materials, Perm National Research Polytechnic University, Komsomolsky Prospekt, 29, 614990 Perm, Russia;
| | - Anna V. Zaitseva
- Department of Anatomy, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
| | - Ivan D. Dimov
- Department of Cell Biology, IFOM ETS—The AIRC Institute of Molecular Oncology, Via Adamello, 16, 20139 Milan, Italy
| | - Irina S. Sesorova
- Department of Anatomy, Ivanovo State Medical Academy, 153012 Ivanovo, Russia
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5
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Crawford T, Andersen C, Marks DC, Robertson SA, Stark M. Does donor sex influence the potential for transfusion with washed packed red blood cells to limit transfusion-related immune responses in preterm newborns? Arch Dis Child Fetal Neonatal Ed 2023; 108:471-477. [PMID: 36690436 DOI: 10.1136/archdischild-2022-324531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the association of donor sex with transfusion-associated recipient immune responses in preterm newborns receiving unwashed and washed blood. DESIGN A cohort study using data collected during the Effect of Washed versus Unwashed Packed Red Blood Cell Transfusion on Immune Responses in the Extremely Preterm Newborn randomised trial. SETTING Participants were recruited from two South Australian hospitals between September 2015 and December 2020. PATIENTS Preterm newborns (<29 weeks). INTERVENTIONS Transfusion with unwashed and washed packed red blood cells (PRBCs) from either exclusively male or any female donor for the first three transfusions. MAIN OUTCOMES MEASURES The primary outcome was the change from baseline in post-transfusion plasma cytokine concentrations, specifically interferon gamma, interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12, IL-17A and tumour necrosis factor (TNF). RESULTS In total, 153 newborns were evaluated. By the third transfusion, the magnitude of pretransfusion to post-transfusion change in cytokines between the groups differed for IL-6 (p=0.003), IL-12 (p=0.008), IL-17A (p=0.003) and TNF (p=0.007). On post hoc comparison, compared with the unwashed-any female donor group, IL-6 (p<0.05), IL-12 (p<0.05) and IL-17A (p<0.01) were lower in the washed-exclusively male donor group, and IL-6 (p<0.01), IL-12 (p<0.05) and TNF (p<0.01) were lower in the washed-any female donor group. CONCLUSION These findings suggest that transfusion with unwashed PRBCs from female donors is associated with an increased recipient immune response, an effect that can be ameliorated with pretransfusion washing. Larger randomised controlled studies confirming this mechanistic link between donor sex and transfusion-associated morbidity are warranted. TRIAL REGISTRATION NUMBER ACTRN12613000237785.
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Affiliation(s)
- Tara Crawford
- Neonatal Medicine, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
- The University of Adelaide Robinson Research Institute, North Adelaide, South Australia, Australia
| | - Chad Andersen
- Neonatal Medicine, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
- The University of Adelaide Robinson Research Institute, North Adelaide, South Australia, Australia
| | - Denese C Marks
- Product Development and Storage, Australian Red Cross Blood Service New South Wales and Australian Capital Territory, Alexandria, New South Wales, Australia
| | - Sarah A Robertson
- The University of Adelaide Robinson Research Institute, North Adelaide, South Australia, Australia
| | - Michael Stark
- Neonatal Medicine, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
- The University of Adelaide Robinson Research Institute, North Adelaide, South Australia, Australia
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6
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Saidin NIS, Noor NHM, Yusoff SM, Sauli MS. Characteristics of ABO Antibodies in Group O Malaysian Blood Donors. Malays J Med Sci 2023; 30:61-70. [PMID: 37655148 PMCID: PMC10467587 DOI: 10.21315/mjms2023.30.4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 11/12/2022] [Indexed: 09/02/2023] Open
Abstract
Background Haemolytic transfusion reactions (HTRs) due to anti-A and anti-B antibodies in Group O blood products are rare but potentially fatal. This study aimed to identify the prevalence of high ABO antibody titre and the immunoglobulin (Ig) classes (IgM only or with IgG) and the prevalence of haemolysin antibodies in Group O blood donors. Methods Plasma from Group O blood donors was tested by using antibody titration at room temperature. Titres ≥ 64 were considered high. The plasma was treated with 0.01 M dithiothreitol (DTT) to determine the presence of IgG antibodies and titre. IgG titres ≥ 64 were considered high. Tests for haemolysis were conducted by mixing the plasma with 3% fresh A1 and B cell suspensions and incubating at 37 °C. The haemolysis was observed macroscopically. Results Of 311 donors, 238 (76.5%) showed high anti-A and/or anti-B antibody titres. The highest antibody titre obtained was 256. Female and younger donors (< 40 years old) had higher anti-A and anti-B titres. The anti-B titre showed an association with gender (P < 0.001), and was high in female donors (77.8%). Males aged over 50 years old were found to have low mean titre antibodies. Most donors had both IgM and IgG ABO antibodies. The prevalence of haemolysins in our population was 3.5%. Conclusion Most of our O blood donors had a high ABO antibody titre but a low prevalence of haemolysins. Males aged over 50 years old are the best O donors for preventing HTRs, particularly when mismatch transfusion is required. We recommend a transfusion unit screen for ABO antibody titre in younger female donors (< 40 years old), to prevent the transfusion of high titre O blood products into non-O recipients.
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Affiliation(s)
- Nur Ilyia Syazwani Saidin
- Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | - Noor Haslina Mohd Noor
- Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | - Shafini Mohamed Yusoff
- Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd Shafiq Sauli
- Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kelantan, Malaysia
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7
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Ucar İ, Koyuncu MB, Solmaz AA, Ugurludogan AC, Mercan S, Kucuk M, Unal T, Mazman S, Atilla E. Don't neglect the rare adverse event with intravenous immunoglobulin: Hemolytic anemia. Transfus Clin Biol 2023; 30:11-15. [PMID: 36028153 DOI: 10.1016/j.tracli.2022.08.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 02/07/2023]
Abstract
Intravenous immunoglobulin (IVIG) associated hemolytic anemia is an under-recognized complication of IVIG therapy. The incidence of this adverse event is not clear. Patients at high risk for IVIG-associated hemolytic anemia include non-O blood group recipients and those undergoing high-dose administration for inflammatory or autoimmune disorders. Here, two different cases of IVIG-associated hemolytic anemia are demonstrated. The first patient, a 66 year-old male with Guillain-Barré syndrome, had a severe attack for which erythrocyte replacement was required. Mild hemolysis was detected during IVIG administration in the second patient, a 57 year-old female with chronic immune thrombocytopenic purpura. Following IVIG termination, the hemolysis diminished gradually. Although it is rare and often manageable, clinicians should be aware of and monitor patients for hemolytic anemia following IVIG therapy.
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Affiliation(s)
- İsmail Ucar
- Mersin City Hospital, Department of Rhemautology, Turkey
| | | | | | | | | | | | - Tufan Unal
- Mersin City Hospital, Blood Bank, Turkey
| | - Semir Mazman
- Mersin City Hospital, Department of Neurology, Turkey
| | - Erden Atilla
- Mersin City Hospital, Department of Hematology, Turkey.
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Jajosky RP, Wu SC, Zheng L, Jajosky AN, Jajosky PG, Josephson CD, Hollenhorst MA, Sackstein R, Cummings RD, Arthur CM, Stowell SR. ABO blood group antigens and differential glycan expression: Perspective on the evolution of common human enzyme deficiencies. iScience 2023; 26:105798. [PMID: 36691627 PMCID: PMC9860303 DOI: 10.1016/j.isci.2022.105798] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Enzymes catalyze biochemical reactions and play critical roles in human health and disease. Enzyme variants and deficiencies can lead to variable expression of glycans, which can affect physiology, influence predilection for disease, and/or directly contribute to disease pathogenesis. Although certain well-characterized enzyme deficiencies result in overt disease, some of the most common enzyme deficiencies in humans form the basis of blood groups. These carbohydrate blood groups impact fundamental areas of clinical medicine, including the risk of infection and severity of infectious disease, bleeding risk, transfusion medicine, and tissue/organ transplantation. In this review, we examine the enzymes responsible for carbohydrate-based blood group antigen biosynthesis and their expression within the human population. We also consider the evolutionary selective pressures, e.g. malaria, that may account for the variation in carbohydrate structures and the implications of this biology for human disease.
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Affiliation(s)
- Ryan Philip Jajosky
- Joint Program in Transfusion Medicine, Brigham and Women’s Hospital, Harvard Medical School, 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
- Biconcavity Inc, Lilburn, GA, USA
| | - Shang-Chuen Wu
- Joint Program in Transfusion Medicine, Brigham and Women’s Hospital, Harvard Medical School, 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
| | - Leon Zheng
- Joint Program in Transfusion Medicine, Brigham and Women’s Hospital, Harvard Medical School, 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
| | - Audrey N. Jajosky
- University of Rochester Medical Center, Department of Pathology and Laboratory Medicine, West Henrietta, NY, USA
| | | | - Cassandra D. Josephson
- Cancer and Blood Disorders Institute and Blood Bank/Transfusion Medicine Division, Johns Hopkins All Children’s Hospital, St. Petersburg, FL, USA
- Departments of Oncology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marie A. Hollenhorst
- Department of Pathology and Department of Medicine, Stanford University, Stanford, CA, USA
| | - Robert Sackstein
- Translational Glycobiology Institute, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Richard D. Cummings
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Connie M. Arthur
- Joint Program in Transfusion Medicine, Brigham and Women’s Hospital, Harvard Medical School, 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
| | - Sean R. Stowell
- Joint Program in Transfusion Medicine, Brigham and Women’s Hospital, Harvard Medical School, 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
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9
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Cuesta H, El Menyawi I, Hubsch A, Hoefferer L, Mielke O, Gabriel S, Shebl A. Incidence and risk factors for intravenous immunoglobulin-related hemolysis: A systematic review of clinical trial and real-world populations. Transfusion 2022; 62:1894-1907. [PMID: 35916266 PMCID: PMC9545798 DOI: 10.1111/trf.17028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 11/30/2022]
Abstract
Background Severe hemolysis rarely occurs in patients receiving intravenous immunoglobulin (IVIG) therapy. A systematic review was performed to assess the incidence of IVIG‐related hemolysis and the impact of patient and product risk factors. Study Design and Methods A systematic literature search for terms related to “IVIG products”, “hemolysis,” and “adverse events” was conducted in Embase for articles published between January 1, 2015, and May 31, 2021. Studies with no clinical datasets, no IVIG treatment, or where IVIG was used to treat hemolytic conditions were excluded. Of the 430 articles retrieved, 383 were excluded based on titles/abstracts and 14 were excluded after in‐depth review. Results In total, 33 articles were analyzed and separated into observational studies (n = 16), clinical trials (n = 8), and case reports (n = 9). The incidence proportion for IVIG‐related hemolysis ranged from 0% to 19% in observational studies and 0%–21% in clinical trials. A higher incidence of IVIG‐related hemolysis was consistently reported in patients with blood groups A and AB. Hemolysis occurred more frequently in patients treated with IVIG for some conditions such as Kawasaki disease; however, this may be confounded by the high dose of IVIG therapy. IVIG‐related hemolysis incidence was lower in studies using IVIG products citing manufacturing processes to reduce isoagglutinin levels than products that did not. Conclusion This analysis identified patient and product risk factors including blood group, IVIG dose, and IVIG manufacturing processes associated with elevated IVIG‐related hemolysis incidence.
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Affiliation(s)
| | | | | | | | | | | | - Amgad Shebl
- CSL Behring Innovation GmbH, Marburg, Germany
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10
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Wang Y, Khalenkov A, Scott DE. An optimized microplate-based method to evaluate complement-dependent hemolysis mediated by intravenous immunoglobulins (IVIG). Biologicals 2022; 78:1-9. [PMID: 35842374 DOI: 10.1016/j.biologicals.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 05/12/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022] Open
Abstract
Hemolytic reactions can cause serious complications after administration of Intravenous Immunoglobulin (IVIG), due to passive transfer of anti-A and anti-B IgG antibodies (isoagglutinins). A maximum allowable amount of isoagglutinins is established in the US and EU for licensed IVIG, as measured by a specified direct hemagglutination test (DHAT). Despite this limit, reports of hemolysis have increased over time, raising the question of how well the DHAT predicts clinically significant hemolysis. This study was undertaken to develop a microplate-based complement-dependent hemolysis assay (CDHA) that reproducibly measures functional hemolytic activity of IVIG, for assessment of IVIG products. An IVIG working reference reagent (NIBSC 14/160) was qualified as an assay control and for quantitation purposes. Hemolytic activities of 36 IVIG product lots encompassing seven brands and including 6 clinically hemolytic lots were measured. Hemolytic activity varied among IVIG product brands, and to a lesser extent, from lot-to-lot for individual brands. Correlation between the CDHA and DHAT was not robust which may reflect imprecision of the DHAT method or additional variables that influence complement-dependent hemolysis after opsonization. In conclusion, the CDHA provides a simple, specific, and sensitive tool for IVIG product characterization and investigation of hemolytic events by manufacturers, researchers, and regulatory authorities.
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Affiliation(s)
- Yonggang Wang
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
| | - Alexey Khalenkov
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Dorothy E Scott
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
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11
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Pereira E, Felipe S, de Freitas R, Araújo V, Soares P, Ribeiro J, Henrique Dos Santos L, Alves JO, Canabrava N, van Tilburg M, Guedes MI, Ceccatto V. ABO blood group and link to COVID-19: A comprehensive review of the reported associations and their possible underlying mechanisms. Microb Pathog 2022; 169:105658. [PMID: 35764188 PMCID: PMC9233352 DOI: 10.1016/j.micpath.2022.105658] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/20/2022]
Abstract
ABO blood group is long known to be an influencing factor for the susceptibility to infectious diseases, and many studies have been describing associations between ABO blood types and COVID-19 infection and severity, with conflicting findings. This narrative review aims to summarize the literature regarding associations between the ABO blood group and COVID-19. Blood type O is mostly associated with lower rates of SARS-CoV-2 infection, while blood type A is frequently described as a risk factor. Although results regarding the risk of severe outcomes are more variable, blood type A is the most associated with COVID-19 severity and mortality, while many studies describe O blood type as a protective factor for the disease progression. Furthermore, genetic associations with both the risk of infection and disease severity have been reported for the ABO locus. Some underlying mechanisms have been hypothesized to explain the reported associations, with incipient experimental data. Three major hypotheses emerge: SARS-CoV-2 could carry ABO(H)-like structures in its envelope glycoproteins and would be asymmetrically transmitted due to a protective effect of the ABO antibodies, ABH antigens could facilitate SARS-CoV-2 interaction with the host’ cells, and the association of non-O blood types with higher risks of thromboembolic events could confer COVID-19 patients with blood type O a lower risk of severe outcomes. The hypothesized mechanisms would affect distinct aspects of the COVID-19 natural history, with distinct potential implications to the disease transmission and its management.
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Affiliation(s)
- Eric Pereira
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil.
| | - Stela Felipe
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Raquel de Freitas
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Valdevane Araújo
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Paula Soares
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Jannison Ribeiro
- Hematology and Hemotherapy Center of Ceará, José Bastos Av., Fortaleza, 60431-086, Ceará, Brazil
| | - Luiz Henrique Dos Santos
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Juliana Osório Alves
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Natália Canabrava
- Biotechnology and Molecular Biology Laboratory, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Mauricio van Tilburg
- Biotechnology and Molecular Biology Laboratory, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Maria Izabel Guedes
- Biotechnology and Molecular Biology Laboratory, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Vânia Ceccatto
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
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12
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Youk HJ, Ryu HY, Seo SW, Kim JS, Chung Y, Kim H, Hwang SH, Oh HB, Min WK, Ko DH. A New Trial to Measure ABO Antibodies Using Complement-Dependent Cytotoxicity. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060830. [PMID: 35744093 PMCID: PMC9231086 DOI: 10.3390/medicina58060830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/07/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022]
Abstract
Background and objectives: The ABO antibody (Ab) titration tests are used in monitoring in ABO-incompatible (ABOi) solid organ transplantation (SOT). However, currently developed ABO Ab tests show Ab binding reactions. This study attempted to measure ABO Ab level using complement-dependent cytotoxicity (CDC). Materials and methods: We studied 93 blood group O serum samples from patients who underwent ABOi SOT from January 2019 to May 2021. Patients’ sera were incubated with A1 or B cells and added to a human complement solution. Supernatants were collected after centrifugation, and free hemoglobin (Hb) was measured by spectrophotometry. We converted plasma Hb value to hemolysis (%), which were compared with ABO Ab titer. Results: We found a mild correlation between hemolysis and ABO Ab titers. In simple regression analysis, the correlation coefficients were within 0.3660−0.4968 (p < 0.0001) before transplantation. In multiple linear regression analysis, anti-A hemolysis (%) was higher in immunoglobulin M (IgM) (β = 12.9) than in immunoglobulin G (IgG) (β = −3.4) (R2 = 0.5216). Anti-B hemolysis was higher in IgM (β = 8.7) than in IgG (β = 0.0) (R2 = 0.5114). There was a large variation in hemolysis within the same Ab titer. Conclusions: CDC can be used in a new trial for ABO Ab measurement. Furthermore, IgM rather than IgG seems to play a significant role in vivo activity, consistent with previous knowledge. Thus, this study may help in the development of the ABO Ab titration supplement test for post-transplant treatment policy establishment and pre-transplant desensitization.
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Affiliation(s)
- Hee-Jeong Youk
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.-J.Y.); (H.-y.R.); (S.W.S.); (J.S.K.); (S.-H.H.); (H.-B.O.); (W.-K.M.)
| | - Ho-yoon Ryu
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.-J.Y.); (H.-y.R.); (S.W.S.); (J.S.K.); (S.-H.H.); (H.-B.O.); (W.-K.M.)
| | - Suk Won Seo
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.-J.Y.); (H.-y.R.); (S.W.S.); (J.S.K.); (S.-H.H.); (H.-B.O.); (W.-K.M.)
| | - Jin Seok Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.-J.Y.); (H.-y.R.); (S.W.S.); (J.S.K.); (S.-H.H.); (H.-B.O.); (W.-K.M.)
| | - Yousun Chung
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Seoul 05355, Korea;
| | - Hyungsuk Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul 03080, Korea;
| | - Sang-Hyun Hwang
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.-J.Y.); (H.-y.R.); (S.W.S.); (J.S.K.); (S.-H.H.); (H.-B.O.); (W.-K.M.)
| | - Heung-Bum Oh
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.-J.Y.); (H.-y.R.); (S.W.S.); (J.S.K.); (S.-H.H.); (H.-B.O.); (W.-K.M.)
| | - Won-Ki Min
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.-J.Y.); (H.-y.R.); (S.W.S.); (J.S.K.); (S.-H.H.); (H.-B.O.); (W.-K.M.)
| | - Dae-Hyun Ko
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.-J.Y.); (H.-y.R.); (S.W.S.); (J.S.K.); (S.-H.H.); (H.-B.O.); (W.-K.M.)
- Correspondence:
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13
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Abstract
Red blood cell (RBC) transfusion is one of the most frequently performed clinical procedures and therapies to improve tissue oxygen delivery in hospitalized patients worldwide. Generally, the cross-match is the mandatory test in place to meet the clinical needs of RBC transfusion by examining donor-recipient compatibility with antigens and antibodies of blood groups. Blood groups are usually an individual's combination of antigens on the surface of RBCs, typically of the ABO blood group system and the RH blood group system. Accurate and reliable blood group typing is critical before blood transfusion. Serological testing is the routine method for blood group typing based on hemagglutination reactions with RBC antigens against specific antibodies. Nevertheless, emerging technologies for blood group testing may be alternative and supplemental approaches when serological methods cannot determine blood groups. Moreover, some new technologies, such as the evolving applications of blood group genotyping, can precisely identify variant antigens for clinical significance. Therefore, this review mainly presents a clinical overview and perspective of emerging technologies in blood group testing based on the literature. Collectively, this may highlight the most promising strategies and promote blood group typing development to ensure blood transfusion safety.
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Affiliation(s)
- Hong-Yang Li
- Department of Blood Transfusion, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Kai Guo
- Department of Transfusion Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Kai Guo
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14
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Koo Y, Yun T, Chae Y, Lee D, Choi D, Oh J, Kim J, Kim H, Yang MP, Kang BT. Suspected human intravenous immunoglobulin-induced acute haemolytic anaemia in a dog. J Small Anim Pract 2021; 63:482-485. [PMID: 34874062 DOI: 10.1111/jsap.13449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 10/18/2021] [Accepted: 10/31/2021] [Indexed: 11/28/2022]
Abstract
A 2-year-old mixed breed dog presented with a 1-year history of crust and erosion on the nasal planum. Because histopathological examination revealed ruptured intraepidermal pustules and superficial dermal inflammation, the dog was diagnosed with pemphigus foliaceus. Human intravenous immunoglobulin was administered in two consecutive doses of 0.5 g/kg/day due to poor therapeutic response to previous immunosuppressive therapy. From Day 3 after the first dose of human intravenous immunoglobulin, tachypnoea, pale mucous membrane, haemoglobinuria and haemoglobinemia were observed, thus confirming haemolytic anaemia. Other drug-induced haemolytic anaemias were excluded because no additional drugs had been administered before the haemolysis occurred. Immune-mediated haemolytic anaemia was also excluded because the direct antiglobulin test was negative. Two transfusions were performed, and haemolysis was not observed from Day 4 of haemolytic anaemia onset. In conclusion, human intravenous immunoglobulin-induced haemolytic anaemia should be considered in dogs that develop haemolysis following the administration of human intravenous immunoglobulin.
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Affiliation(s)
- Y Koo
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - T Yun
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Y Chae
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - D Lee
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - D Choi
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - J Oh
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - J Kim
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - H Kim
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - M P Yang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - B T Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
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15
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Perazzio SF, Palmeira P, Moraes-Vasconcelos D, Rangel-Santos A, de Oliveira JB, Andrade LEC, Carneiro-Sampaio M. A Critical Review on the Standardization and Quality Assessment of Nonfunctional Laboratory Tests Frequently Used to Identify Inborn Errors of Immunity. Front Immunol 2021; 12:721289. [PMID: 34858394 PMCID: PMC8630704 DOI: 10.3389/fimmu.2021.721289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
Inborn errors of immunity (IEI), which were previously termed primary immunodeficiency diseases, represent a large and growing heterogeneous group of diseases that are mostly monogenic. In addition to increased susceptibility to infections, other clinical phenotypes have recently been associated with IEI, such as autoimmune disorders, severe allergies, autoinflammatory disorders, benign lymphoproliferative diseases, and malignant manifestations. The IUIS 2019 classification comprises 430 distinct defects that, although rare individually, represent a group affecting a significant number of patients, with an overall prevalence of 1:1,200-2,000 in the general population. Early IEI diagnosis is critical for appropriate therapy and genetic counseling, however, this process is deeply dependent on accurate laboratory tests. Despite the striking importance of laboratory data for clinical immunologists, several IEI-relevant immunoassays still lack standardization, including standardized protocols, reference materials, and external quality assessment programs. Moreover, well-established reference values mostly remain to be determined, especially for early ages, when the most severe conditions manifest and diagnosis is critical for patient survival. In this article, we intend to approach the issue of standardization and quality control of the nonfunctional diagnostic tests used for IEI, focusing on those frequently utilized in clinical practice. Herein, we will focus on discussing the issues of nonfunctional immunoassays (flow cytometry, enzyme-linked immunosorbent assays, and turbidimetry/nephelometry, among others), as defined by the pure quantification of proteins or cell subsets without cell activation or cell culture-based methods.
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Affiliation(s)
- Sandro Félix Perazzio
- Division of Rheumatology, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Immunology Division, Fleury Medicine and Health Laboratory, Sao Paulo, Brazil
| | - Patricia Palmeira
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | - Dewton Moraes-Vasconcelos
- Laboratório de Investigação Médica (LIM-56), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | - Andréia Rangel-Santos
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | | | - Luis Eduardo Coelho Andrade
- Division of Rheumatology, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Immunology Division, Fleury Medicine and Health Laboratory, Sao Paulo, Brazil
| | - Magda Carneiro-Sampaio
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil.,Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
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16
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Ozcelik F, Tanoglu A, Guven BB, Keskin U, Kaplan M. Assessment of severity and mortality of COVID-19 with anti-A1 and anti-B IgM isohaemagglutinins, a reflection of the innate immune status. Int J Clin Pract 2021; 75:e14624. [PMID: 34251730 PMCID: PMC8420313 DOI: 10.1111/ijcp.14624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022] Open
Abstract
AIMS The relationship between the innate immune system that creates the polysaccharide antibody response and COVID-19 is not fully understood. In this study, it was aimed to determine the predictive values of isohaemagglutinins in COVID-19 severity/mortality. METHODS Approximately 15 440 patients diagnosed with COVID-19 were examined, and a total of 286 patients with anti-B and anti-A1 IgM isohaemagglutinins test results were randomly enrolled in the study. These patients were stratified into two groups according to anti-A1 (n: 138 blood type B or O) and anti-B (n: 148 blood type A) IgM isohaemagglutinins. Anti-A1 or/and anti-B IgM, biochemical parameters, symptoms, chronic diseases, hospitalisation status, intubation status, admission to intensive care unit (ICU) and exitus status were recorded and evaluated for all patients. RESULTS Anti-A1 IgM and anti-B IgM were significantly lower in ICU patients (7.5 ± 9.9 vs 18.0 ± 20.4 and 5.5 ± 6.3 vs 19.3 ± 33.6 titres, respectively; P < .01) and in exitus patients (3.8 ± 3.6 vs 16.7 ± 18.7 and 3.5 ± 4.7 vs 16.9 ± 29.6 titres respectively; P < .01). In the ROC analysis performed to differentiate between exitus and discharge within groups, the sensitivity of anti-B IgM and anti-A1 IgM at cut-off ≤4 was 88.9% and 79.6%, specificity 66.0% and 73.4%, and AUC 0.831 and 0.861, respectively (P < .01). Anti-A1 IgM decreased the mortality risk 0.811 times per unit while anti-B IgM decreased 0.717 times (P < .01). CONCLUSION Anti-B and anti-A1 isohaemagglutinins, which are an expression of the innate immune system, can be used to predict the severity and mortality of COVID-19 disease.
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Affiliation(s)
- Fatih Ozcelik
- Department of Medical BiochemistryUniversity of Health Sciences TurkeySultan 2. Abdulhamid Han Training and Research HospitalIstanbulTurkey
| | - Alpaslan Tanoglu
- Department of GastroenterologyUniversity of Health Sciences TurkeySancaktepe Şehit Prof Dr Ilhan Varank Training and Research HospitalIstanbulTurkey
| | - Bulent Barıs Guven
- Department of Anesthesia and ReanimationUniversity of Health Sciences TurkeySultan 2. Abdulhamid Han Training and Research HospitalIstanbulTurkey
| | - Umran Keskin
- Department of Internal MedicineUniversity of Health Sciences TurkeyHaydarpasa Numune Training and Research HospitalIstanbulTurkey
| | - Mustafa Kaplan
- Department of Internal MedicineUniversity of Health Sciences TurkeySultan 2. Abdulhamid Han Training and Research HospitalIstanbulTurkey
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17
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Schooley N, Chabra S, Stolla M. From A to AB: A Caucasian Mother with High Anti-B Titer Causing Hemolytic Disease of the Newborn. Lab Med 2021; 53:e33-e35. [PMID: 34388252 DOI: 10.1093/labmed/lmab067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We report on a term infant with clinically significant hemolysis and hyperbilirubinemia. Testing revealed ABO incompatibility between maternal type A and infant type AB. The maternal alloantibody screen was negative. The infant's direct antiglobulin test was positive, and anti-B IgG was eluted off the infant's red blood cells (RBCs). Testing of the mother's plasma revealed a high anti-B titer. The infant was successfully treated with phototherapy and intravenous immunoglobulin. The bilirubin and hematocrit stabilized, and the infant was discharged home. This case was unusual because of its severity and unusual ABO constellation. Furthermore, this report is an exemplary educational case study on how effective collaboration between the clinical team and the blood bank laboratory is critical in reaching the correct diagnosis. In summary, the differential diagnosis of more unusual and atypical ABO-incompatible constellations must be considered when an infant presents with unexplained hemolysis.
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Affiliation(s)
| | - Shilpi Chabra
- Seattle Children's Hospital, Seattle, Washington, US.,Department of Neonatology, University of Washington School of Medicine, Seattle, Washington, US
| | - Moritz Stolla
- Bloodworks Northwest Research Institute, Seattle, Washington, US.,Department of Medicine, Division of Hematology, University of Washington School of Medicine, Seattle, Washington, US
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18
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Ramsey G. Landsteiner's legacy: The continuing challenge to make transfusions safe. Transfusion 2021; 60:2772-2779. [PMID: 33285006 DOI: 10.1111/trf.16205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Glenn Ramsey
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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19
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Suresh J, Kyle BD. Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report. BMC Infect Dis 2021; 21:288. [PMID: 33743628 PMCID: PMC7981890 DOI: 10.1186/s12879-021-05986-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/15/2021] [Indexed: 05/31/2023] Open
Abstract
Background Many clinicians are aware that certain therapies administered to their patients can have downstream consequences in the form of clinical laboratory test interferences. This is particularly true of laboratory tests that depend on, or directly involve the use of, antibody-based methodology. Intravenously-administered immunoglobulin therapy is one such treatment that can in theory directly impact the results of particular tests in the area of viral serology. This study can help serve as a reference for clinicians researching the impact of intravenously-administered immunoglobulin therapy in the context of positive results that do not reflect the clinical background of the patient. Case presentation We describe a case whereby an intravenously-administered immunoglobulin therapy led to a series of clinical false positives in viral serology, inconsistent with the known patient history as well as recent laboratory results. The patient presented to hospital with petechiae-type bleeding rashes and was investigated for thrombocytopenia after initial blood investigations indicated very low platelets. Subsequent testing of the potential causes for low-platelet involved several viral serology investigations, including hepatitis, cytomegalovirus and human immunodeficiency virus. Initial testing indicated patient exhibited negative status for all viral antibodies and antigens (except immunity for hepatitis B surface antigen antibody). As part of the thrombocytopenia treatment, intravenously-administered immunoglobulin therapy was administered, and subsequent viral serology was ordered. These investigations indicated a positive status for several hepatitis antibodies as well as cytomegalovirus. Conclusions This case study illustrates the potential for improper diagnosis of previous or ongoing infection status in patients administered IVIg therapy. Caution should be exercised particularly when interpreting results involving cytomegalovirus and hepatitis.
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Affiliation(s)
- Janarthanee Suresh
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, S7N 0W8, Canada
| | - Barry D Kyle
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, S7N 0W8, Canada.
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20
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Goel R, Bloch EM, Pirenne F, Al-Riyami AZ, Crowe E, Dau L, Land K, Townsend M, Jecko T, Rahimi-Levene N, Patidar G, Josephson CD, Arora S, Vermeulen M, Vrielink H, Montemayor C, Oreh A, Hindawi S, van den Berg K, Serrano K, So-Osman C, Wood E, Devine DV, Spitalnik SL. ABO blood group and COVID-19: a review on behalf of the ISBT COVID-19 working group. Vox Sang 2021; 116:849-861. [PMID: 33578447 PMCID: PMC8014128 DOI: 10.1111/vox.13076] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 12/30/2022]
Abstract
Growing evidence suggests that ABO blood group may play a role in the immunopathogenesis of SARS-CoV-2 infection, with group O individuals less likely to test positive and group A conferring a higher susceptibility to infection and propensity to severe disease. The level of evidence supporting an association between ABO type and SARS-CoV-2/COVID-19 ranges from small observational studies, to genome-wide-association-analyses and country-level meta-regression analyses. ABO blood group antigens are oligosaccharides expressed on red cells and other tissues (notably endothelium). There are several hypotheses to explain the differences in SARS-CoV-2 infection by ABO type. For example, anti-A and/or anti-B antibodies (e.g. present in group O individuals) could bind to corresponding antigens on the viral envelope and contribute to viral neutralization, thereby preventing target cell infection. The SARS-CoV-2 virus and SARS-CoV spike (S) proteins may be bound by anti-A isoagglutinins (e.g. present in group O and group B individuals), which may block interactions between virus and angiotensin-converting-enzyme-2-receptor, thereby preventing entry into lung epithelial cells. ABO type-associated variations in angiotensin-converting enzyme-1 activity and levels of von Willebrand factor (VWF) and factor VIII could also influence adverse outcomes, notably in group A individuals who express high VWF levels. In conclusion, group O may be associated with a lower risk of SARS-CoV-2 infection and group A may be associated with a higher risk of SARS-CoV-2 infection along with severe disease. However, prospective and mechanistic studies are needed to verify several of the proposed associations. Based on the strength of available studies, there are insufficient data for guiding policy in this regard.
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Affiliation(s)
- Ruchika Goel
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine and Mississippi Valley Regional Blood Center, Springfield, IL, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - France Pirenne
- Etablissement Français du Sang Ile de France, Hôpital Henri Mondor, Créteil, France
| | - Arwa Z Al-Riyami
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Elizabeth Crowe
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laetitia Dau
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kevin Land
- Vitalant, Scottsdale, AZ, USA.,Department of Pathology, UT, San Antonio, TX, USA
| | | | | | | | - Gopal Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Satyam Arora
- Super Speciality Pediatric Hospital and Post Graduate Teaching Institute, Noida, India
| | - Marion Vermeulen
- The South African National Blood Service, Port Elizabeth, South Africa
| | - Hans Vrielink
- Dept Unit Transfusion Medicine, Sanquin Bloodbank, Amsterdam, the Netherlands
| | | | - Adaeze Oreh
- National Blood Transfusion Service, Department of Hospital Services, Federal Ministry of Health, Abuja, Nigeria
| | | | - Karin van den Berg
- Translational Research Department, Medical Division, South African National Blood Service, Port Elizabeth, South Africa.,Division of Clinical Haematology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Katherine Serrano
- Canadian Blood Services, Vancouver, BC, Canada.,Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Cynthia So-Osman
- Dept Unit Transfusion Medicine, Sanquin Bloodbank, Amsterdam, the Netherlands.,Dept. of Haematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Erica Wood
- Monash University, Melbourne, VIC, Australia
| | - Dana V Devine
- Canadian Blood Services, Vancouver, BC, Canada.,Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Steven L Spitalnik
- Department of Pathology & Cell Biology, Columbia University, New York, NY, USA
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21
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Casadevall A, Grossman BJ, Henderson JP, Joyner MJ, Shoham S, Pirofski LA, Paneth N. The Assessment of Convalescent Plasma Efficacy against COVID-19. MED 2020; 1:66-77. [PMID: 33363284 PMCID: PMC7747676 DOI: 10.1016/j.medj.2020.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Antibody-based therapy for infectious diseases predates modern antibiotics and, in the absence of other therapeutic options, was deployed early in the SARS-CoV-2 pandemic through COVID-19 convalescent plasma (CCP) administration. Although most studies have demonstrated signals of efficacy for CCP, definitive assessment has proved difficult under pandemic conditions, with rapid changes in disease incidence and the knowledge base complicating the design and implementation of randomized controlled trials. Nevertheless, evidence from a variety of studies demonstrates that CCP is as safe as ordinary plasma and strongly suggests that it can reduce mortality if given early and with sufficient antibody content.
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Affiliation(s)
- Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Brenda J Grossman
- Departments of Medicine and Pathology & Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Jeffrey P Henderson
- Departments of Medicine and Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shmuel Shoham
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Liise-Anne Pirofski
- Departments of Medicine and Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nigel Paneth
- Departments of Department of Epidemiology & Biostatistics and Pediatrics & Human Development, Michigan State University, East Lansing, MI, USA
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22
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Kumar V. Understanding the complexities of SARS-CoV2 infection and its immunology: A road to immune-based therapeutics. Int Immunopharmacol 2020; 88:106980. [PMID: 33182073 PMCID: PMC7843151 DOI: 10.1016/j.intimp.2020.106980] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 02/07/2023]
Abstract
Emerging infectious diseases always pose a threat to humans along with plant and animal life. SARS-CoV2 is the recently emerged viral infection that originated from Wuhan city of the Republic of China in December 2019. Now, it has become a pandemic. Currently, SARS-CoV2 has infected more than 27.74 million people worldwide, and taken 901,928 human lives. It was named first 'WH 1 Human CoV' and later changed to 2019 novel CoV (2019-nCoV). Scientists have established it as a zoonotic viral disease emerged from Chinese horseshoe bats, which do not develop a severe infection. For example, Rhinolophus Chinese horseshoe bats harboring severe acute respiratory syndrome-related coronavirus (SARSr-CoV) or SARSr-Rh-BatCoV appear healthy and clear the virus within 2-4 months period. The article introduces first the concept of EIDs and some past EIDs, which have affected human life. Next section discusses mysteries regarding SARS-CoV2 origin, its evolution, and human transfer. Third section describes COVID-19 clinical symptoms and factors affecting susceptibility or resistance. The fourth section introduces the SARS-CoV2 entry in the host cell, its replication, and the establishment of productive infection. Section five describes the host's immune response associated with asymptomatic, symptomatic, mild to moderate, and severe COVID-19. The subsequent seventh and eighth sections mention the immune status in COVID-19 convalescent patients and re-emergence of COVID-19 in them. Thereafter, the eighth section describes viral strategies to hijack the host antiviral immune response and generate the "cytokine storm". The ninth section describes about transgenic humane ACE2 (hACE2) receptor expressing mice to study immunity, drugs, and vaccines. The article ends with the development of different immunomodulatory and immunotherapeutics strategies, including vaccines waiting for their approval in humans as prophylaxis or treatment measures.
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Affiliation(s)
- V Kumar
- Children's Health Queensland Clinical Unit, School of Clinical Medicine, Faculty of Medicine, Mater Research, University of Queensland, ST Lucia, Brisbane, Queensland 4078, Australia; School of Biomedical Sciences, Faculty of Medicine, University of Queensland, ST Lucia, Brisbane, Queensland 4078, Australia.
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23
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Tong TN, Blacquiere M, Sakac D, Burke-Murphy E, Yi Q, Callum J, Cserti-Gazdewich C, Parmar N, Shehata N, Pavenski K, Lau W, Lin Y, Lieberman L, Branch DR, Pendergrast J. The utility of a monocyte monolayer assay in the assessment of intravenous immunoglobulin-associated hemolysis. Transfusion 2020; 60:3010-3018. [PMID: 33091964 DOI: 10.1111/trf.16131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 09/10/2020] [Accepted: 09/28/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Hemolysis following the administration of intravenous immunoglobulin (IVIG) is an important adverse event (AE). While the monocyte monolayer assay (MMA) has been used to predict in vivo hemolysis when serologically incompatible blood may be transfused, it has also been shown to correlate with IVIG-associated hemolysis. In this study, the MMA was examined for its utility in assessing the risk of hemolysis after IVIG. STUDY DESIGN AND METHODS Forty-two non-blood group O patients receiving high-dose IVIG (≥2 g/kg) were examined using an autologous and allogeneic MMA. Hemolysis was defined by a drop in hemoglobin of ≥1 g/L, a positive direct antiglobulin test (DAT) and eluate, and a decrease in haptoglobin or increase in lactate dehydrogenase and/or reticulocytes. RESULTS Forty-two patients provided 50 assessable postinfusion samples, with hemolysis observed in 20 (40%) of cases. Autologous MMA using post-IVIG red blood cells significantly correlated with clinical outcomes when compared to allogeneic MMA (P = .0320 vs .5806, t test). No significant difference in receiver operating characteristics was observed when comparing autologous MMA testing against DAT for the diagnosis of IVIG-associated hemolysis. However, when using samples collected 5 to 10 days after receipt of high-dose IVIG, the autologous MMA had higher sensitivity than the DAT. CONCLUSION MMA testing with autologous monocytes collected 5 to 10 days after receipt of high-dose IVIG can be used for the diagnosis of IVIG-associated hemolysis and may be of particular value in cases in which the Day 5 to 10 DAT is negative.
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Affiliation(s)
- Tik Nga Tong
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | - Megan Blacquiere
- Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | - Darinka Sakac
- Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | | | - Qilong Yi
- Centre for Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Jeannie Callum
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Christine Cserti-Gazdewich
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Nagina Parmar
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Nadine Shehata
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Canadian Blood Services, Toronto, Ontario, Canada
| | - Katerina Pavenski
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Wendy Lau
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Canadian Blood Services, Toronto, Ontario, Canada.,Department of Transfusion Medicine, Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yulia Lin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Lani Lieberman
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Donald R Branch
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada.,Departments of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jacob Pendergrast
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
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24
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Adkins BD, Andrews J, Sharma D, Hughes C, Kassim AA, Eichbaum Q. Low rates of anti-recipient isohemagglutinins in ABO incompatible hematopoietic stem cell transplants. Transfus Apher Sci 2020; 60:102965. [PMID: 33127310 DOI: 10.1016/j.transci.2020.102965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Isohemagglutinins occur naturally and form in an 'opposite' (antigen-negative) pattern to a patient's ABO blood type. Patients undergoing minor and bidirectional ABO incompatible hematopoietic stem cell transplantation (HSCT) may demonstrate detectable antibodies against their native blood type. In this study, we sought to characterize the rates of such antibody formation and evaluate the clinical significance of our findings. MATERIALS AND METHODS An internal database of HSCT patients at an academic medical center was queried for ABO incompatible transplant patients from 2009-2019. Serum typing results, clinical histories, and laboratory data were compiled and reviewed. RESULTS A total of 182 minor and bidirectional ABO incompatible HSCT patients were identified. Anti-recipient isohemagglutinins were found in 9% (16/182) of the HSCT patients. The rate was higher in patients with minor incompatibility (12%: 15/127) versus bidirectional ABO incompatibility (2%: 1/55) (p = 0.04). No anti-recipient isohemagglutinins were identified in umbilical cord HSCT patients (0%: 0/7). Serologic agglutination reactions of recipient isohemagglutinins were overall mostly weak (13/16 weak + to 1+). There was a trend towards a higher rate of acute graft-versus-host-disease in patients with anti-recipient isohemagglutinins compared to those without (75% vs. 53%; p = 0.12), though not statistically significant. Rates of alloimmunization to minor red cell antigens were similar between the two groups. Few patients showed laboratory evidence of hemolysis at 12 months follow up. DISCUSSION AND CONCLUSIONS Anti-recipient isohemagglutinins occur at low rates in ABO incompatible HSCT and are significantly more common in minor ABO incompatible transplant compared to bidirectional transplants. Larger cohort studies are needed to better understand the relationship between anti-recipient isohemagglutinins and HSCT outcomes.
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Affiliation(s)
- Brian D Adkins
- Vanderbilt University Medical Center, Department of Pathology, Microbiology and Immunology, Division of Transfusion Medicine, USA; University of Virginia Health System, Department of Pathology, Charlottesville, VA, USA.
| | - Jennifer Andrews
- Vanderbilt University Medical Center, Department of Pathology, Microbiology and Immunology, Division of Transfusion Medicine, USA; Vanderbilt University Medical Center, Department of Pediatrics, Division of Hematology/Oncology, USA
| | - Deva Sharma
- Vanderbilt University Medical Center, Department of Pathology, Microbiology and Immunology, Division of Transfusion Medicine, USA; Vanderbilt University Medical Center, Department of Medicine, Division of Hematology/Oncology, USA
| | - Caitlin Hughes
- Vanderbilt University Medical Center, Department of Pathology, Microbiology and Immunology, Division of Transfusion Medicine, USA
| | - Adetola A Kassim
- Vanderbilt University Medical Center, Department of Medicine, Division of Hematology/Oncology, USA
| | - Quentin Eichbaum
- Vanderbilt University Medical Center, Department of Pathology, Microbiology and Immunology, Division of Transfusion Medicine, USA; Veterans Administration Hospital, Tennessee Valley Health Care System, TN, USA
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25
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Kappler K, Restin T, Lasanajak Y, Smith DF, Bassler D, Hennet T. Limited Neonatal Carbohydrate-Specific Antibody Repertoire Consecutive to Partial Prenatal Transfer of Maternal Antibodies. Front Immunol 2020; 11:573629. [PMID: 33162988 PMCID: PMC7591393 DOI: 10.3389/fimmu.2020.573629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022] Open
Abstract
Despite the prominence of carbohydrate-specific antibodies in human sera, data on their emergence and antigen specificities are limited. Whereas maternal IgG are transferred prenatally to the fetal circulation, IgM present in cord blood originate from fetal B lymphocytes. Considering the limited exposure of the fetus to foreign antigens, we assessed the repertoire of carbohydrate-specific antibodies in human cord blood and matched maternal blood samples using glycan arrays. Carbohydrate-specific IgM was absent in cord blood, whereas low cord blood IgG reactivity to glycans was detectable. Comparing IgG reactivities of matched pairs, we observed a general lack of correlation in the antigen specificity of IgG from cord blood and maternal blood due to a selective exclusion of most carbohydrate-specific IgG from maternofetal transfer. Given the importance of intestinal bacteria in inducing carbohydrate-specific antibodies, we analyzed global antibody specificities toward commensal bacteria. Similar IgG reactivities to specific Bacteroides species were detected in matched cord and maternal blood samples, thus pointing to an efficient maternal transfer of anti-microbial IgG. Due to the observed selectivity in maternofetal IgG transfer, the lack of fetal antibodies to carbohydrate epitopes is only partially compensated by maternal IgG, thus resulting in a weak response to carbohydrate antigens in neonates.
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Affiliation(s)
| | - Tanja Restin
- Institute of Physiology, University of Zurich, Zurich, Switzerland.,Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Yi Lasanajak
- Emory Comprehensive Glycomics Core, Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, United States
| | - David F Smith
- Emory Comprehensive Glycomics Core, Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, United States
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Thierry Hennet
- Institute of Physiology, University of Zurich, Zurich, Switzerland
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26
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Hadjesfandiari N, Levin E, Serrano K, Yi QL, Devine DV. Risk analysis of transfusion of cryoprecipitate without consideration of ABO group. Transfusion 2020; 61:29-34. [PMID: 33037661 DOI: 10.1111/trf.16125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Transfusion medicine standards in Canada state that adult recipients can be transfused with cryoprecipitate of any ABO group, however, not all hospitals follow this guideline. There is a paucity of data on cryoprecipitate anti-A/B levels to reinforce standards. STUDY DESIGN AND METHODS Manual tube antibody titration was performed on 7 units of group O plasma and the corresponding cryosupernatant plasma and cryoprecipitate. IgG/IgM levels were determined by nephelometry. Additionally, 10 cryoprecipitate each from groups A, B, and O were similarly assessed. From the antibody titer distribution among these samples, the probability of making a pool of cryoprecipitate with a titer ≥1:100 was calculated using bootstrap analysis. RESULTS Anti-A/B titers in cryoprecipitate were equivalent to those in corresponding plasma; partitioning of anti-A/B activity into cryoprecipitate was not observed. Average IgM concentration was higher in cryoprecipitate than in plasma (P < .01). However, no correlation between IgM levels and anti-A/B titers was established. Among 30 cryoprecipitates from routine blood bank inventory, the median antibody titer and mode were 1:32 and 1:16, respectively. Of the samples tested, 4 of 30 and 9 of 30 had titers above 1:100 and 1:50, respectively. The probability of transfusing an adult dose of cryoprecipitate (pool of 10 cryoprecipitate) with a titer higher than 1:100 was calculated to be less than 1 in 3 million. CONCLUSIONS This study provides strong evidence to support current Canadian transfusion medicine standards on the safety of transfusion of cryoprecipitate without the need for blood group matching in adult recipients.
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Affiliation(s)
- Narges Hadjesfandiari
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Elena Levin
- Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia, Canada
| | - Katherine Serrano
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia, Canada
| | - Qi-Long Yi
- Donor & Clinical Services, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Dana V Devine
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia, Canada
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27
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Luetscher RND, McKitrick TR, Gao C, Mehta AY, McQuillan AM, Kardish R, Boligan KF, Song X, Lu L, Heimburg-Molinaro J, von Gunten S, Alter G, Cummings RD. Unique repertoire of anti-carbohydrate antibodies in individual human serum. Sci Rep 2020; 10:15436. [PMID: 32963315 PMCID: PMC7509809 DOI: 10.1038/s41598-020-71967-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022] Open
Abstract
Humoral immunity to pathogens and other environmental challenges is paramount to maintain normal health, and individuals lacking or unable to make antibodies are at risk. Recent studies indicate that many human protective antibodies are against carbohydrate antigens; however, little is known about repertoires and individual variation of anti-carbohydrate antibodies in healthy individuals. Here we analyzed anti-carbohydrate antibody repertoires (ACARs) of 105 healthy individual adult donors, aged 20-60+ from different ethnic backgrounds to explore variations in antibodies, as defined by binding to glycan microarrays and by affinity purification. Using microarrays that contained > 1,000 glycans, including antigens from animal cells and microbes, we profiled the IgG and IgM ACARs from all donors. Each donor expressed many ACAs, but had a relatively unique ACAR, which included unanticipated antibodies to carbohydrate antigens not well studied, such as chitin oligosaccharides, Forssman-related antigens, globo-type antigens, and bacterial glycans. We also saw some expected antibodies to ABO(H) blood group and α-Gal-type antigens, although these also varied among individuals. Analysis suggests differences in ACARs are associated with ethnicity and age. Thus, each individual ACAR is relatively unique, suggesting that individualized information could be useful in precision medicine for predicting and monitoring immune health and resistance to disease.
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Affiliation(s)
- Ralph N D Luetscher
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, National Center for Functional Glycomics, CLS 11087 - 3 Blackfan Circle, Boston, MA, 02115, USA
- Department of Biology, Institute of Microbiology, ETH Zurich, 8093, Zurich, Switzerland
| | - Tanya R McKitrick
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, National Center for Functional Glycomics, CLS 11087 - 3 Blackfan Circle, Boston, MA, 02115, USA
| | - Chao Gao
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, National Center for Functional Glycomics, CLS 11087 - 3 Blackfan Circle, Boston, MA, 02115, USA
| | - Akul Y Mehta
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, National Center for Functional Glycomics, CLS 11087 - 3 Blackfan Circle, Boston, MA, 02115, USA
| | - Alyssa M McQuillan
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, National Center for Functional Glycomics, CLS 11087 - 3 Blackfan Circle, Boston, MA, 02115, USA
| | - Robert Kardish
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, National Center for Functional Glycomics, CLS 11087 - 3 Blackfan Circle, Boston, MA, 02115, USA
- Scienion US, 2640 West Medtronic Way, Tempe, AZ, 85281, USA
| | | | - Xuezheng Song
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, 30303, USA
| | - Lenette Lu
- The Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, 02139, USA
- Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Jamie Heimburg-Molinaro
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, National Center for Functional Glycomics, CLS 11087 - 3 Blackfan Circle, Boston, MA, 02115, USA
| | | | - Galit Alter
- The Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, 02139, USA
| | - Richard D Cummings
- Department of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, National Center for Functional Glycomics, CLS 11087 - 3 Blackfan Circle, Boston, MA, 02115, USA.
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28
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Yazdanbakhsh K, Zhong H. IVIg and hemolytic anemia risk: dump the anti-A/B already! Transfusion 2020; 60:1337-1339. [PMID: 32681818 DOI: 10.1111/trf.15939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 06/06/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Karina Yazdanbakhsh
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Hui Zhong
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
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29
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Lewis BJ, Branch DR. Mouse Models of Rheumatoid Arthritis for Studies on Immunopathogenesis and Preclinical Testing of Fc Receptor-Targeting Biologics. Pharmacology 2020; 105:618-629. [DOI: 10.1159/000508239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/27/2020] [Indexed: 11/19/2022]
Abstract
<b><i>Background:</i></b> Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation, swelling, and pain in the joints and involves systemic complications. Mouse models of RA have been extensively used to model the pathogenesis of RA and to develop effective therapies. Although many components of the immune system have been studied in these models, the role of crystallizable fragment (Fc) gamma receptors (FcγRs) in RA has been sorely neglected. The aim of this review was to introduce the different mouse models of RA and to describe the different drug development strategies that have been tested in these models to target FcγR function, with the focus being on drugs that have been made from the Fc of immunoglobulin G (IgG). <b><i>Summary:</i></b> Evidence suggests that FcγRs play a major role in immune complex-induced inflammation in autoimmune diseases, such as RA. However, there is limited knowledge on the importance of FcγRs in the human disease even though there has been extensive work in mouse models of RA. Numerous mouse models of RA are available, with each model depicting certain aspects of the disease. Induced models of RA have nonspecific immune activation with cartilage-directed autoimmunity, whereas spontaneous models of RA develop without immunization, which results in a more chronic form of arthritis. These models have been used to test FcγR-targeting monoclonal antibodies, intravenous immunoglobulin (IVIg), subcutaneously administered IVIg, and recombinant Fcs for their ability to interact with and modify FcγR function. Recombinant Fcs avidly bind FcγRs and exhibit enhanced therapeutic efficacy in mouse models of RA. <b><i>Key Message:</i></b> The therapeutic utility of targeting FcγRs with recombinant Fcs is great and should be explored in human clinical trials for autoimmune diseases, such as RA.
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30
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Negrini R, Villanacci V, Poiesi C, Savio A. Anti-Glycan Autoantibodies Induced by Helicobacter pylori as a Potential Risk Factor for Myocardial Infarction. Front Immunol 2020; 11:597. [PMID: 32322255 PMCID: PMC7158853 DOI: 10.3389/fimmu.2020.00597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/16/2020] [Indexed: 12/15/2022] Open
Abstract
A number of epidemiological studies have evaluated the potential association between H. pylori and cardiovascular disease, but with contrasting results. We have previously shown that Helicobacter pylori infection is able to induce in mice and humans autoantibodies cross-reacting with histo–blood group Lewis antigens, expressed in different organs and in plasma glycoproteins and glycolipids. The aim of this study was to assess whether immunization of animals with H. pylori might induce myocardial histopathological changes. We have retrospectively examined, in detail, the histology of archived organs from mice and rabbits immunized with H. pylori in our previous studies. Human sera and cross-reacting monoclonal antibodies were also tested against bacterial preparations and tissue sections. Areas of myocardial necrosis, associated with coronary thrombotic occlusion, were found in 5 of 20 mice and 2 of 5 rabbits previously immunized with suspensions of H. pylori. No similar lesions were found in control animals, suggesting a causal link with H. pylori immunization. The animals bearing myocardial lesions had not been infected but only immunized months earlier with parenteral injections of dead H. pylori cells. This strongly suggests that immunization, by itself, might play a causative role. We propose that the cross-reactive autoimmune response induced by H. pylori could promote thrombotic occlusion through direct endothelial damage or by perturbing the coagulation process.
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Affiliation(s)
- Riccardo Negrini
- Department of Laboratory Medicine, Presidio di Gardone VT-ASST Spedali Civili, Brescia, Italy
| | | | - Claudio Poiesi
- Institute of Microbiology and Virology, ASST Spedali Civili, Brescia, Italy
| | - Antonella Savio
- Histopathology and Cytology Department, The Royal Marsden NHS Foundation Trust, London, United Kingdom
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31
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Seyedi SS, Parvin P, Jafargholi A, Hashemi N, Tabatabaee SM, Abbasian A, Khorrami A. Spectroscopic properties of various blood antigens/antibodies. BIOMEDICAL OPTICS EXPRESS 2020; 11:2298-2312. [PMID: 32341884 PMCID: PMC7173882 DOI: 10.1364/boe.387112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/10/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
Since the traditional method generates biological waste, there is a significant demand for an easy, quick technique of blood type identification without contamination. In fact, individuals can be divided into four main blood groups whose antigens are available in red blood cell (RBC) membranes and the antibodies in the plasma. Here, UV-vis and photoluminescence (PL) spectroscopic methods are systematically used to find the spectra of blood typing antigens (A, B and AB) and antibodies i.e. A-Anti, B-Anti, AB-Anti and D reagent. The PL spectra of RBCs in different blood groups as well as the corresponding antibodies are successfully resolved for the purpose of blood typing. The unique photophysical characteristics of these biomolecules including signal intensity and peak emission wavelength in PL spectra are lucidly anticipated to accurately discriminate ABO groups. PL spectra of RBC in positive blood typing indicate larger signal and shorter emission peak wavelength corresponding to negative ones. Furthermore, the monoclonal antibody PL emissions emphasize that Anti-A benefits higher intensity and shorter peak wavelength (blue shift) than B-Anti. In the following, lucid blue shifts are obtained in terms of antibody concentrations accompanying the elevation of fluorescence signal, most likely due to the aggregation induced emission (AIE) phenomenon, quite the opposite of the aggregation-caused quenching (ACQ) that is widely observed from conventional chromophore. Those are envisaged as unique properties of each antibody to utilize in the spectral blood typing.
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Affiliation(s)
- Seyedeh Solaleh Seyedi
- Physics Department, Amirkabir University of Technology, P.O. Box 15875- 4413, Tehran, Iran
| | - Parviz Parvin
- Physics Department, Amirkabir University of Technology, P.O. Box 15875- 4413, Tehran, Iran
| | - Amir Jafargholi
- Physics Department, Amirkabir University of Technology, P.O. Box 15875- 4413, Tehran, Iran
| | - Nazanin Hashemi
- Chemistry Department, Amirkabir University of Technology, P.O.Box 15875- 4413, Tehran, Iran
| | | | - Ali Abbasian
- Tehran Blood Transfusion Center, P.O.Box 1416613141, Tehran, Iran
| | - Ahmad Khorrami
- CinnaGen Medical Biotechnology Research Center, Alborz University of Medical Sciences, P.O.Box 3165933155, Alborz, Iran
- CinnaGen Research and Production Co., P.O.Box 3165933155, Alborz, Iran
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32
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Cen SY, Branch DR. Isoagglutinin-reduced immunoglobulin retains efficacy in mouse models of immune thrombocytopenia and rheumatoid arthritis and is less likely to cause intravenous immunoglobulin-associated hemolysis. Transfusion 2019; 60:250-255. [PMID: 31837028 PMCID: PMC7496430 DOI: 10.1111/trf.15622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/11/2019] [Accepted: 11/15/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Immunoglobulin therapy including intravenous immunoglobulin (IVIg) has been used as an effective treatment for autoimmune/inflammatory conditions with few side effects. However, high‐dose IVIg (1‐2 g/kg) has been recognized as a cause of hemolytic anemia in non–blood group O patients. Hemolysis when observed has been due to anti‐A/anti‐B isoagglutinins contained in the IVIg. Recently, an isoagglutinin‐reduced IVIg, whereby the anti‐A and anti‐B titers have been reduced by immunoaffinity chromatography, has been introduced; however, whether this new product is as efficacious as nonreduced immunoglobulin (Ig) or will result in less IVIg‐associated hemolysis has not been resolved. STUDY DESIGN AND METHODS We used in vitro phagocytosis by monocytes and proinflammatory/anti‐inflammatory macrophages, with isoagglutinin‐reduced and ‐nonreduced Ig opsonized group A1, B, and A1B red blood cells, to estimate clinical significance of the IgG isoagglutinins. We also used immune thrombocytopenia (ITP) and rheumatoid arthritis (RA) mouse models to examine the in vivo efficacy of isoagglutinin‐reduced versus ‐nonreduced Ig on the amelioration of the diseases. RESULTS In contrast to nonreduced Ig, phagocytosis was largely absent when isoagglutinin‐reduced Ig was used at a concentration equivalent to a patient receiving 2 g/kg. The in vivo efficacy of isoagglutinin‐reduced versus nonreduced Ig on the amelioration of experimental ITP and RA was similar, indicating no loss of efficacy due to the chromatographic removal of isoagglutinins. CONCLUSION Isoagglutinin‐reduced Ig should have efficacy similar to nonreduced Ig and result in less IVIg‐associated hemolysis.
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Affiliation(s)
- Selena Y Cen
- Center for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | - Donald R Branch
- Center for Innovation, Canadian Blood Services, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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33
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Abstract
ABO incompatibility (ABOi), the most common cause of hemolytic disease of the newborn (HDN), is nearly always mild and treatable with phototherapy. Reports of ABOi HDN requiring neonatal exchange transfusion are extremely rare since the inception of modern guidelines. Here, a case of ABOi HDN clearly met criteria for exchange transfusion. An O-positive African American mother delivered a B-positive neonate that quickly developed hyperbilirubinemia. The neonatal DAT was positive from anti-B and anti-A,B, and maternal IgG titer was 1024. Double volume exchange transfusion resulted in a favorable outcome. Given early discharge of newborns, further understanding of factors predicting severe disease is needed.
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Platt JL, Garcia de Mattos Barbosa M, Cascalho M. The five dimensions of B cell tolerance. Immunol Rev 2019; 292:180-193. [PMID: 31609002 PMCID: PMC10387221 DOI: 10.1111/imr.12813] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
B cell tolerance has been generally understood to be an acquired property of the immune system that governs antibody specificity in ways that avoid auto-toxicity. As useful as this understanding has proved, it fails to fully explain the existence of auto-reactive specificities in healthy individuals and contribution these may have to health. Mechanisms underlying B cell tolerance are considered to select a clonal repertoire that generates a collection of antibodies that do not bind self, ie tolerance operates more or less in three dimensions that largely spare autologous cells and antigens. Yet, most B lymphocytes in humans and probably in other vertebrates are auto-reactive and absence of these auto-reactive B cells is associated with disease. We suggest that auto-reactivity can be embodied by extending the concept of tolerance by two further dimensions, one of time and circumstance and one that allows healthy cells to actively resist injury. In this novel concept, macromolecular recognition by the B cell receptor leading to deletion, anergy, receptor editing or B cell activation is extended by taking account of the time of development of normal immune responses (4th dimension) and the accommodation (or tolerance) of normal cells to bound antibody, activation of complement, and interaction with inflammatory cells (fifth dimension). We discuss how these dimensions contribute to understanding B cell biology in health or disease.
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Affiliation(s)
- Jeffrey L. Platt
- Department of Surgery University of Michigan Ann Arbor MI USA
- Department of Microbiology and Immunology and Department of Surgery University of Michigan Ann Arbor MI USA
- Lead Contacts Ann Arbor MI USA
| | | | - Marilia Cascalho
- Department of Surgery University of Michigan Ann Arbor MI USA
- Department of Microbiology and Immunology and Department of Surgery University of Michigan Ann Arbor MI USA
- Lead Contacts Ann Arbor MI USA
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35
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Marsh RA, Orange JS. Antibody deficiency testing for primary immunodeficiency: A practical review for the clinician. Ann Allergy Asthma Immunol 2019; 123:444-453. [PMID: 31446132 DOI: 10.1016/j.anai.2019.08.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/14/2019] [Accepted: 08/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review selected published studies related to the diagnostic evaluation of antibody deficiency. DATA SOURCES Published literature. STUDY SELECTIONS Studies related to the diagnostic evaluation of antibody deficiency and existing recommendations were selected. RESULTS Many primary immunodeficiency diseases include humoral deficiency. Practical tests used in the clinical evaluation of patients for possible antibody deficiency include immunoglobulin measurement, specific antibody titers, and B-cell enumeration and phenotyping. CONCLUSION Clinically available tests can be used to readily evaluate patients for antibody deficiencies.
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Affiliation(s)
- Rebecca A Marsh
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio; Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jordan S Orange
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York; NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
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36
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Kidney transplantation across minor ABO incompatibility: the use of A2 to B transplants. Curr Opin Organ Transplant 2019; 24:365-369. [DOI: 10.1097/mot.0000000000000672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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37
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Yung GP, Seebach JD, Baerenzung N, Pendergrast J, Cserti‐Gazdewich C, Branch DR. Eluates from DAT‐positive patients with or without hemolysis after high‐dose IVIG yield predominantly IgG isoagglutinins of IgG
2
subclass. Transfusion 2019; 59:1882-1883. [DOI: 10.1111/trf.15229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/31/2018] [Accepted: 01/23/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Gisella Puga Yung
- Division of Immunology and AllergyUniversity Hospitals and Medical Facility Geneva Switzerland
| | - Joerg D. Seebach
- Division of Immunology and AllergyUniversity Hospitals and Medical Facility Geneva Switzerland
| | - Natasha Baerenzung
- Division of Immunology and AllergyUniversity Hospitals and Medical Facility Geneva Switzerland
| | - Jacob Pendergrast
- Laboratory Medicine ProgramUniversity Health Network Toronto Ontario Canada
- Departments of Medicine and Laboratory Medicine and PathobiologyUniversity of Toronto Toronto Ontario Canada
| | - Christine Cserti‐Gazdewich
- Laboratory Medicine ProgramUniversity Health Network Toronto Ontario Canada
- Departments of Medicine and Laboratory Medicine and PathobiologyUniversity of Toronto Toronto Ontario Canada
| | - Donald R. Branch
- Departments of Medicine and Laboratory Medicine and PathobiologyUniversity of Toronto Toronto Ontario Canada
- Centre for InnovationCanadian Blood Services Toronto Ontario Canada
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38
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Uno S, Tanaka T, Ashiba H, Fujimaki M, Tanaka M, Hatta Y, Takei M, Awazu K, Makishima M. Sensitive typing of reverse ABO blood groups with a waveguide-mode sensor. J Biosci Bioeng 2018; 126:131-137. [PMID: 29499994 DOI: 10.1016/j.jbiosc.2018.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/24/2018] [Accepted: 01/27/2018] [Indexed: 01/14/2023]
Abstract
Portable, on-site blood typing methods will help provide life-saving blood transfusions to patients during an emergency or natural calamity, such as significant earthquakes. We have previously developed waveguide-mode (WM) sensors for forward ABO and Rh(D) blood typing and detection of antibodies against hepatitis B virus and hepatitis C virus. In this study, we evaluated a WM-sensor for reverse ABO blood typing. Since reverse ABO blood typing is a method for detection of antibodies against type A and type B oligosaccharide antigens on the surface of red blood cells (RBCs), we fixed a synthetic type A or type B trisaccharide antigen on the sensor chip of the WM sensor. We obtained significant changes in the reflectance spectra from a WM sensor on type A antigen with type B plasma and type O plasma and on type B antigen with type A plasma and type O plasma, and no spectrum changes on type A antigen or type B antigen with type AB plasma. Signal enhancement with the addition of a peroxidase reaction failed to increase the sensitivity for detection on oligosaccharide chips. By utilizing hemagglutination detection using regent type A and type B RBCs, we successfully determined reverse ABO blood groups with higher sensitivity compared to a method using oligosaccharide antigens. Thus, functionality of a portable device utilizing a WM sensor can be expanded to include reverse ABO blood typing and, in combination with forward ABO typing and antivirus antibody detection, may be useful for on-site blood testing in emergency settings.
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Affiliation(s)
- Shigeyuki Uno
- Division of Biochemistry, Department of Biomedical Sciences, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan
| | - Torahiko Tanaka
- Division of Biochemistry, Department of Biomedical Sciences, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan
| | - Hiroki Ashiba
- Electronics and Photonics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba, Ibaraki 305-8565, Japan
| | - Makoto Fujimaki
- Electronics and Photonics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba, Ibaraki 305-8565, Japan
| | - Mutsuo Tanaka
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba, Ibaraki 305-8566, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan
| | - Masami Takei
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan
| | - Koichi Awazu
- Electronics and Photonics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba, Ibaraki 305-8565, Japan
| | - Makoto Makishima
- Division of Biochemistry, Department of Biomedical Sciences, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan.
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39
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ABO zygosity, but not secretor or Fc receptor status, is a significant risk factor for IVIG-associated hemolysis. Blood 2018; 131:830-835. [PMID: 29305554 DOI: 10.1182/blood-2017-07-796151] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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40
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Kang BH, Choi D, Cho J, Kwon J, Huh Y, Moon J, Kim Y, Jung K, Lee JCJ. Efficacy of Uncross-Matched Type O Packed Red Blood Cell Transfusion to Traumatic Shock Patients: a Propensity Score Match Study. J Korean Med Sci 2017; 32:2058-2063. [PMID: 29115091 PMCID: PMC5680508 DOI: 10.3346/jkms.2017.32.12.2058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/05/2017] [Indexed: 12/20/2022] Open
Abstract
A new blood bank system was established in our trauma bay, which allowed immediate utilization of uncross-matched type O packed red blood cells (UORBCs). We investigated the efficacy of UORBC compared to that of the ABO type-specific packed red blood cells (ABO RBCs) from before the bank was installed. From March 2016 to February 2017, data from trauma patients who received UORBCs in the trauma bay were compared with those of trauma patients who received ABO RBCs from January 2013 to December 2015. Propensity matching was used to overcome retrospective bias. The primary outcome was 24-hour mortality, while the secondary outcomes were in-hospital mortality and intensive care unit (ICU) length of stay (LOS). Data from 252 patients were reviewed and UORBCs were administered to 64 patients. The time to transfusion from emergency room admission was shorter in the UORBC group (11 [7-16] minutes vs. 44 [29-72] minutes, P < 0.001). After propensity matching, 47 patients were included in each group. The 24-hour mortality (4 [8.5%] vs. 9 [13.8%], P = 0.135), in-hospital mortality (14 [29.8%] vs. 18 [38.3%], P = 0.384), and ICU LOS (9 [4-19] days vs. 5 [0-19] days, P = 0.155) did not differ significantly between groups. The utilization of UORBCs resulted in a faster transfusion but did not significantly improve the clinical outcomes in traumatic shock patients in this study. However, the tendency for lower mortality in the UORBC group suggested the need for a large study.
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Affiliation(s)
- Byung Hee Kang
- Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Donghwan Choi
- Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Jayun Cho
- Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Junsik Kwon
- Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Yo Huh
- Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Jonghwan Moon
- Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Younghwan Kim
- Department of Trauma Surgery, National Medical Center, Seoul, Korea
| | - Kyoungwon Jung
- Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea
| | - John Cook Jong Lee
- Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea.
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41
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Kang BH, Jung K, Heo Y, Lee JCJ. Safety and Efficacy of Type-O Packed Red Blood Cell Transfusion in Traumatic Hemorrhagic Shock Patients: Preliminary Study. JOURNAL OF ACUTE CARE SURGERY 2017. [DOI: 10.17479/jacs.2017.7.2.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Byung Hee Kang
- Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Kyoungwon Jung
- Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Yunjung Heo
- Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Korea
| | - John Cook-Jong Lee
- Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
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42
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Cabezas-Cruz A, Mateos-Hernández L, Chmelař J, Villar M, de la Fuente J. Salivary Prostaglandin E2: Role in Tick-Induced Allergy to Red Meat. Trends Parasitol 2017; 33:495-498. [DOI: 10.1016/j.pt.2017.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 12/20/2016] [Accepted: 03/10/2017] [Indexed: 01/31/2023]
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43
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Xu T, Zhang Q, Fan YH, Li RQ, Lu H, Zhao SM, Jiang TL. Quantitative and multiplexed detection for blood typing based on quantum dot-magnetic bead assay. Int J Nanomedicine 2017; 12:3347-3356. [PMID: 28490874 PMCID: PMC5413539 DOI: 10.2147/ijn.s133247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Accurate and reliable blood grouping is essential for safe blood transfusion. However, conventional methods are qualitative and use only single-antigen detection. We overcame these limitations by developing a simple, quantitative, and multiplexed detection method for blood grouping using quantum dots (QDs) and magnetic beads. Methods In the QD fluorescence assay (QFA), blood group A and B antigens were quantified using QD labeling and magnetic beads, and the blood groups were identified according to the R value (the value was calculated with the fluorescence intensity from dual QD labeling) of A and B antigens. The optimized performance of QFA was established by blood typing 791 clinical samples. Results Quantitative and multiplexed detection for blood group antigens can be completed within 35 min with more than 105 red blood cells. When conditions are optimized, the assay performance is satisfactory for weak samples. The coefficients of variation between and within days were less than 10% and the reproducibility was good. The ABO blood groups of 791 clinical samples were identified by QFA, and the accuracy obtained was 100% compared with the tube test. Receiver-operating characteristic curves revealed that the QFA has high sensitivity and specificity toward clinical samples, and the cutoff points of the R value of A and B antigens were 1.483 and 1.576, respectively. Conclusion In this study, we reported a novel quantitative and multiplexed method for the identification of ABO blood groups and presented an effective alternative for quantitative blood typing. This method can be used as an effective tool to improve blood typing and further guarantee clinical transfusion safety.
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Affiliation(s)
- Ting Xu
- Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Qiang Zhang
- Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Ya-Han Fan
- Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Ru-Qing Li
- Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Hua Lu
- Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Shu-Ming Zhao
- Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Tian-Lun Jiang
- Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China
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44
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Marks DC, van der Meer PF. Serum eye drops: a survey of international production methods. Vox Sang 2017; 112:310-317. [PMID: 28332214 DOI: 10.1111/vox.12502] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Serum eye drops (SEDs) are used to treat dry eye syndrome and non-healing corneal lesions when other treatments fail. Despite many clinical studies demonstrating the efficacy of both autologous and allogeneic SEDs, there is no internationally harmonized method for producing SEDs. MATERIALS AND METHODS A 40-question survey requesting information regarding donor selection, blood collection and processing, infectious disease screening, shelf life and regulatory requirements for the production of autologous and allogeneic SEDs was developed by the Biomedical Excellence for Safer Transfusion Collaborative. Survey data were collected into a database via a secure web interface and then downloaded into Excel for further analysis. RESULTS A total of 55 responses were received, with 21 responses from centres indicating they produce SEDs. Based on the responses, collection and processing practices differ widely, according to the size of the centre making the SEDs, and their ability to collect, process and test the blood. CONCLUSION Despite divergences in the methods for producing SEDs, the end result is a small-volume aliquot of serum that can be administered by a patient at home. If more centres move from producing autologous to allogeneic SEDs, this may provide an opportunity for production methods to become more standardized internationally.
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Affiliation(s)
- D C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - P F van der Meer
- Department of Product and Process Development, Sanquin Blood Supply, Amsterdam, The Netherlands
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45
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Effect of blood type on anti-α-Gal immunity and the incidence of infectious diseases. Exp Mol Med 2017; 49:e301. [PMID: 28280265 PMCID: PMC5382557 DOI: 10.1038/emm.2016.164] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/03/2016] [Accepted: 11/07/2016] [Indexed: 02/08/2023] Open
Abstract
The identification of factors affecting the susceptibility to infectious diseases is essential toward reducing their burden on the human population. The ABO blood type correlates with susceptibility to malaria and other infectious diseases. Due to the structural similarity between blood antigen B and Galα1-3Galβ1-(3)4GlcNAc-R (α-Gal), we hypothesized that self-tolerance to antigen B affects the immune response to α-Gal, which in turn affects the susceptibility to infectious diseases caused by pathogens carrying α-Gal on their surface. Here we found that the incidence of malaria and tuberculosis, caused by pathogens with α-Gal on their surface, positively correlates with the frequency of blood type B in endemic regions. However, the incidence of dengue fever, caused by a pathogen without α-Gal, was not related to the frequency of blood type B in these populations. Furthermore, the incidence of malaria and tuberculosis was negatively correlated with the anti-α-Gal antibody protective response. These results have implications for disease control and prevention.
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46
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Lindemann M, Lenz V, Nyadu B, Heinemann FM, Heinold A, Guberina H, Eisenberger U, Lachmann N, Schönemann C, Kribben A, Paul A, Horn PA, Witzke O. Effect of ABO incompatibility on T-cell flow cytometry cross-match results prior to living donor kidney transplantation. CYTOMETRY PART B-CLINICAL CYTOMETRY 2016; 94:623-630. [PMID: 27860206 DOI: 10.1002/cyto.b.21496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/11/2016] [Accepted: 11/15/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND Due to its high sensitivity, the flow cytometry cross-match (FCXM) has been described as valuable tool for identifying an optimal donor. We here focused on the impact of ABO incompatibility on FCXM results. METHODS We analyzed 29 ABO incompatible and 89 ABO compatible donor-recipient pairs (73 and 175 datasets, respectively) prior to living donor kidney transplantation. In all patients, lymphocytotoxic cross-matches for B and T cells were negative. RESULTS Recipients with blood group O (A to O and B to O) displayed significantly (P < 0.05) higher T-FCXM results than those with blood group A and B (A to B, B to A and AB to A), respectively. Donor-specific T-FCXM responses (ΔMFI values) were significantly higher (P < 0.05) in ABO incompatible vs. compatible pairs (ABO incompatible recipients with blood group O: 32 ± 6; with blood group A: 19 ± 7; with blood group B: 7 ± 4; recipients with ABO compatibility: 3 ± 2, respectively, data represent mean ± SEM). Consistent with the T-FCXM results donor-specific isohemagglutinins (IgG titers) were significantly higher in recipients with blood group O vs. A, both prior to rituximab treatment and plasmapheresis/immune adsorption (P = 0.004) and immediately prior to transplantation, i.e., after rituximab and antibody-depleting therapies (P = 0.04). CONCLUSIONS ABO incompatibility was associated with higher T-FCXM responses, especially in recipients with blood group O. This finding has major impact on the interpretation of flow cross-match results. Current cut-off values need to be reassessed in the ABO incompatible setting. © 2016 International Clinical Cytometry Society.
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Affiliation(s)
- M Lindemann
- Institute for Transfusion Medicine, University Hospital, Essen, Germany
| | - V Lenz
- Institute for Transfusion Medicine, University Hospital, Essen, Germany
| | - B Nyadu
- Institute for Transfusion Medicine, University Hospital, Essen, Germany
| | - F M Heinemann
- Institute for Transfusion Medicine, University Hospital, Essen, Germany
| | - A Heinold
- Institute for Transfusion Medicine, University Hospital, Essen, Germany
| | - H Guberina
- Department of Nephrology, University Hospital, Essen, Germany
| | - U Eisenberger
- Department of Nephrology, University Hospital, Essen, Germany
| | - N Lachmann
- Campus Virchow Clinic, Center for Tumor Medicine, HLA Typing Laboratory, Charité University Medicine, Berlin, Germany
| | - C Schönemann
- Campus Virchow Clinic, Center for Tumor Medicine, HLA Typing Laboratory, Charité University Medicine, Berlin, Germany
| | - A Kribben
- Department of Nephrology, University Hospital, Essen, Germany
| | - A Paul
- Department of General, Visceral and Transplantation Surgery, University Hospital, Essen, Germany
| | - P A Horn
- Institute for Transfusion Medicine, University Hospital, Essen, Germany
| | - O Witzke
- Department of Nephrology, University Hospital, Essen, Germany.,Department of Infectious Disease, University Hospital, Essen, Germany
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47
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Grube M, Wolff D, Ahrens N, Herzberg PY, Herr W, Holler E. ABO blood group antigen mismatch has an impact on outcome after allogeneic peripheral blood stem cell transplantation. Clin Transplant 2016; 30:1457-1465. [PMID: 27618621 DOI: 10.1111/ctr.12840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 11/29/2022]
Abstract
ABO blood group antigen incompatibility (ABO mismatch) is not an obstacle to allogeneic stem cell transplantation (allo-SCT). However, the impact on clinical outcome after allo-SCT remains controversial. We analyzed 512 patients after allogeneic peripheral blood SCT (allo-PBSCT) for an association of ABO mismatch with transfusion requirements, myeloid and platelet engraftment, the incidence of GvHD, relapse, transplant-related mortality (TRM), and overall survival (OS). A total of 260 patients underwent ABO-mismatched transplantation and the control group consisted of 252 patients with ABO-matched allo-PBSCT. We found a significant association between major-0 ABO mismatch (group 0 recipient/group A, B, or AB donor) and increased red blood cell (RBC) and platelet transfusion requirements (both P<.001) as well as delayed platelet engraftment (P<.001). Minor-A (group A recipient/group 0 donor) and minor-AB (group AB recipient/group 0, A, or B donor) ABO mismatch was significantly associated with an increased TRM after allo-PBSCT (P=.001 and P=.02). In multivariate analysis performed using Cox regression, minor ABO mismatch appeared as independent risk factor for TRM after allo-PBSCT. No association was found for ABO mismatch with the incidence of GvHD, relapse, and OS. Our results suggest that ABO blood group mismatch has a significant impact on the outcome and that minor-A and minor-AB ABO mismatch represents a risk factor for increased TRM after allo-PBSCT.
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Affiliation(s)
- Matthias Grube
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany.
| | - Daniel Wolff
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Norbert Ahrens
- Institute for Laboratory and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Philipp Y Herzberg
- Department of Personality Psychology and Psychological Assessment, Helmut-Schmidt-University/University of the German Federal Armed Forces Hamburg, Hamburg, Germany
| | - Wolfgang Herr
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Ernst Holler
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
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48
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Flegel WA. Pathogenesis and mechanisms of antibody-mediated hemolysis. Transfusion 2015; 55 Suppl 2:S47-58. [PMID: 26174897 DOI: 10.1111/trf.13147] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND The clinical consequences of antibodies to red blood cells (RBCs) have been studied for a century. Most clinically relevant antibodies can be detected by sensitive in vitro assays. Several mechanisms of antibody-mediated hemolysis are well understood. Such hemolysis after transfusion is reliably avoided in a donor-recipient pair, if one individual is negative for the cognate antigen to which the other has the antibody. STUDY DESIGN AND RESULTS Mechanisms of antibody-mediated hemolysis were reviewed based on a presentation at the Strategies to Address Hemolytic Complications of Immune Globulin Infusions Workshop addressing intravenous immunoglobulin (IVIG) and ABO antibodies. The presented topics included the rates of intravascular and extravascular hemolysis; immunoglobulin (Ig)M and IgG isoagglutinins; auto- and alloantibodies; antibody specificity; A, B, A,B, and A1 antigens; A1 versus A2 phenotypes; monocytes-macrophages, other immune cells, and complement; monocyte monolayer assay; antibody-dependent cell-mediated cytotoxicity; and transfusion reactions due to ABO and other antibodies. CONCLUSION Several clinically relevant questions remained unresolved, and diagnostic tools were lacking to routinely and reliably predict the clinical consequences of RBC antibodies. Most hemolytic transfusion reactions associated with IVIG were due to ABO antibodies. Reducing the titers of such antibodies in IVIG may lower the frequency of this kind of adverse event. The only way to stop these events is to have no anti-A or anti-B in the IVIG products.
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Affiliation(s)
- Willy A Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland
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49
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Scott DE, Epstein JS. Safeguarding immune globulin recipients against hemolysis: what do we know and where do we go? Transfusion 2015; 55 Suppl 2:S122-6. [DOI: 10.1111/trf.13196] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Dorothy E. Scott
- Office of Blood Research and Review, Center for Biologics Evaluation and Research; US Food and Drug Administration; Silver Spring Maryland
| | - Jay S. Epstein
- Office of Blood Research and Review, Center for Biologics Evaluation and Research; US Food and Drug Administration; Silver Spring Maryland
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