Maternal obesity associated with increase in natural killer T cells and CD8+ regulatory T cells in cord blood units

BACKGROUND

One of the major limitations of umbilical cord blood (UCB) as hematopoietic stem cell source is its restricted cell number. In mothers who are candidates for stem cell donation, there are variables that affect the quantity and quality of UCB units. The aim of this study was to determine if obstetric, maternal, and fetal factors modify the number of lymphocyte subsets in UCB units.

STUDY DESIGN AND METHODS

This was a prospective, observational study. In UCB units, the numbers of CD34, NK, NKT, iNKT, Type 1 dendritic cells (DCs), Type 2 DCs, T γδ, T CD4+, T CD8+ lymphocytes, CD4+CD25+FoxP3+, and CD8+CD25+FoxP3+ T regulatory (Treg) cells were quantified by flow cytometry.

RESULTS

Fifty-four UCB units were included; the donors' mean weight was 75 kg (range, 52 to 102 kg) and they had a mean body mass index (BMI) of 30 kg/m(2) (range 22 to 40 kg/m(2) ), of which 12 (22%) had a normal BMI, 14 (26%) were overweight, and 28 (52%) were obese. The mean number of CD34+ cells was 4.45 × 10(6) (range, 0.7 × 10(6) to 20.5 × 10(6) ). The number of NKT, CD3+, CD4+, CD8+, and CD8+CD25+FoxP3+ Treg cells was significantly higher in overweight or obese mothers; CD34+ cells were decreased in the same group. The number of iNKT and CD34+ cells was decreased in newborns weighing above the average.

CONCLUSIONS

Maternal factors such as BMI, and fetal factors such as weight at birth, should be added to the selection criteria of UCB donors.

[The cord blood bank at the Instituto Mexicano del Seguro Social]

BACKGROUND

Hematopoietic stem cells have been used for over 50 years in the treatment of diverse diseases. Umbilical cord blood (UCB) has proved to be a viable source of hematopoietic stem cells for transplantation purposes. The aim was to report the contribution of the umbilical cord blood bank over the past 9 years, in the treatment of various diseases.

METHODS

Since 2005 the number of units of blood from the umbilical cord and their use for transplantation in diverse disease were analyzed. A selection of volunteer pregnant women in labor was performed. Umbilical cord blood was obtained from them, which underwent processing, cryopreservation and validation, as well as compatibility test before using for transplantation.

RESULTS

Ten thousand and ninety nine candidates to donation were assessed, from whom 2481 unit of UCB were collected. Of these, 893 unit were processed and cryopreserved for transplantation. In 65% of cases there was histocompatibility between the cord cell and the receptors. Transplantation was done in 87 patients, 67% had hematologic neoplasias, who have received 140 units of UCB in 102 transplants. This Bank of UCB ranks second in the world in productivity according to the rate of utility of units in transplantation (3.3%).

CONCLUSIONS

Our bank of UCB has been able to develop a cell line (hematopoietic stem cells) with international quality standards and has been beneficial for patients served by our institution with need of a transplant mainly in hemato-oncologic patients.

[Hemolytic autoimmune anemia and perinatal HIV infection. A case report and brief review]

The hematological disorders are frequent in HIV infection; however the hemolytic anemia is a rare complication in pediatric patients. At this moment exist less than ten cases reported in medical literature. The authors reported a four month old girl with perinatal docu-mented infection by HIV associated to autoimmune hemolytic anemia, and they propose a critic route for diagnosis and initial treatment.

[Prevalence of hepatitis C virus in the blood bank at Centro Médico Nacional La Raza]

INTRODUCTION

There are no records on the prevalence of infection by HCV in Mexican population. The central area of Mexico is a highly dense demographic zone and is the influence area of the second blood bank in Latin America in terms of affluence.

MATERIAL AND METHODS

We prospectively studied the prevalence and genotypes of HCV infection in 5105 individuals attending the Central Blood Bank of Centro Médico Nacional La Raza regardless if they were accepted or rejected as donors. We applied a quimiolumiscence assay as a screening test. A recombinant immunoassay (RIBA) and a qualitative polymerase chain reaction (PCR) were performed as confirmatory tests and to detect viremia, respectively. Virus genotype was identified by means of a Line Immuno Probe Assay in PCR positive samples.

RESULTS

The overall prevalence of HCV infection was 0.195% (10/5105). Viremia was detected in 90% of the subjects. The prevalence of accepted donors (0.087%) was significantly lower (p = 0.017) than that of the rejected ones (0.421%). Among viremic subjects, 60 % were infected with genotype 2 and 40% with a subtype combination (a/b) of genotype 1.

DISCUSSION

The prevalence of HCV infection in our population was significantly lower than the world mean prevalence estimated in 3 %. A higher prevalence of genotype 2 in asymptomatic individuals contrasts with previous studies with a selected population where genotype 1 prevailed.