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Juhl D, Luckner K, Brockmann C, Musiolik I, Bunge-Philipowski T, Görg S, Ziemann M. RHD-negative red cells may be avoided for patients with ambiguous serologic typing for the RHD antigen. Transfusion 2024; 64:281-288. [PMID: 38142051 DOI: 10.1111/trf.17691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND AND OBJECTIVES Serologic typing with monoclonal anti-D is mandatory for RHD antigen determination before transfusion, but due to aberrant (weak or partial) variants of RHD, results may be ambiguous and molecular RHD-typing is required. Before that, RHD-negative (RHD -) red blood cells concentrates (RBCs) shall be transfused to avoid anti-D formation, which probably leads to wastage of RHD - RBCs. STUDY DESIGN AND METHODS: All patients with ambiguous results in serologic RHD-typing and molecular RHD-typing were assessed retrospectively. The proportions of patients at risk for anti-D formation and the proportion of RHD - RBCs transfused unnecessarily were evaluated for the following transfusion strategies: (1) RHD-positive (RHD + )RBCs for all patients, (2) RHD + RBCs for patients with at least 2+ reaction with anti-D, (3) RHD + RBCs for patients with C and/or E in their RHCE-phenotype, (4) RHD + RBCs for patients with C and/or E and at least 2+ reaction, and (5) RHD - RBCs for all patients. RESULTS A total of 112 patients were included. Most had weak D type 1-3 and a minority had other, rare RHD variants. The risk of anti-D formation was 4.5%, 2.9%, 1.8%, 1.0%, and 0% for strategies 1-5, respectively. The proportion of RHD - RBCs transfused unnecessarily was 0%, 49.5%, 0.9%, 50.5%, and 95.5%. CONCLUSION Transfusing patients with a C and/or E in their RHCE-phenotype with RHD + RBCs resulted in a very low risk of immunization while avoiding wastage of RHD - RBCs. Therefore, this strategy should be used for some patients with ambiguous results in serologic RHD-typing and pending results of molecular RHD-typing.
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Affiliation(s)
- David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Kathrin Luckner
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Christian Brockmann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Ingrid Musiolik
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Tina Bunge-Philipowski
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Malte Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
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Offergeld R, Preußel K, Zeiler T, Aurich K, Baumann-Baretti BI, Ciesek S, Corman VM, Dienst V, Drosten C, Görg S, Greinacher A, Grossegesse M, Haller S, Heuft HG, Hofmann N, Horn PA, Houareau C, Gülec I, Jiménez Klingberg CL, Juhl D, Lindemann M, Martin S, Neuhauser HK, Nitsche A, Ohme J, Peine S, Sachs UJ, Schaade L, Schäfer R, Scheiblauer H, Schlaud M, Schmidt M, Umhau M, Vollmer T, Wagner FF, Wieler LH, Wilking H, Ziemann M, Zimmermann M, der Heiden MA. Monitoring the SARS-CoV-2 Pandemic: Prevalence of Antibodies in a Large, Repetitive Cross-Sectional Study of Blood Donors in Germany—Results from the SeBluCo Study 2020–2022. Pathogens 2023; 12:pathogens12040551. [PMID: 37111436 PMCID: PMC10144823 DOI: 10.3390/pathogens12040551] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
SARS-CoV-2 serosurveillance is important to adapt infection control measures and estimate the degree of underreporting. Blood donor samples can be used as a proxy for the healthy adult population. In a repeated cross-sectional study from April 2020 to April 2021, September 2021, and April/May 2022, 13 blood establishments collected 134,510 anonymised specimens from blood donors in 28 study regions across Germany. These were tested for antibodies against the SARS-CoV-2 spike protein and nucleocapsid, including neutralising capacity. Seroprevalence was adjusted for test performance and sampling and weighted for demographic differences between the sample and the general population. Seroprevalence estimates were compared to notified COVID-19 cases. The overall adjusted SARS-CoV-2 seroprevalence remained below 2% until December 2020 and increased to 18.1% in April 2021, 89.4% in September 2021, and to 100% in April/May 2022. Neutralising capacity was found in 74% of all positive specimens until April 2021 and in 98% in April/May 2022. Our serosurveillance allowed for repeated estimations of underreporting from the early stage of the pandemic onwards. Underreporting ranged between factors 5.1 and 1.1 in the first two waves of the pandemic and remained well below 2 afterwards, indicating an adequate test strategy and notification system in Germany.
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Affiliation(s)
- Ruth Offergeld
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Karina Preußel
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Thomas Zeiler
- German Red Cross Blood Service West, 58097 Hagen, Germany
| | - Konstanze Aurich
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, German Centre for Infection Research, External Partner Site Frankfurt, University Hospital, Goethe University Frankfurt am Main, 39120 Frankfurt am Main, Germany
| | - Victor M. Corman
- Institute of Virology, German National Reference Laboratory for Coronavirus, Charité—University Medicine Berlin, 10117 Berlin, Germany
| | | | - Christian Drosten
- Institute of Virology, German National Reference Laboratory for Coronavirus, Charité—University Medicine Berlin, 10117 Berlin, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany
| | | | | | - Hans-Gert Heuft
- Institute of Transfusion Medicine and Immunohaematology/Blood Bank, University Hospital Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | | | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | | | - Ilay Gülec
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen, Sandhofstraße 1, 60528 Frankfurt am Main, Germany
| | | | - David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Silke Martin
- Bavarian Red Cross Blood Service, Herzog-Heinrich-Str. 2, 80336 München, Germany
| | | | | | - Julia Ohme
- German Red Cross Blood Service NSTOB, Eldagsener Straße 38, 31832 Springe, Germany
| | - Sven Peine
- Institute of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ulrich J. Sachs
- Center for Transfusion Medicine and Haemotherapy, University Hospital Giessen and Marburg, Langhansstr. 7, 35392 Giessen, Germany
| | - Lars Schaade
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Richard Schäfer
- Institute for Transfusion Medicine and Gene Therapy, Faculty of Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | | | - Martin Schlaud
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Michael Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen, Sandhofstraße 1, 60528 Frankfurt am Main, Germany
| | - Markus Umhau
- Institute for Transfusion Medicine and Gene Therapy, Faculty of Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Tanja Vollmer
- Heart and Diabetes Centre NRW, Institute for Laboratory and Transfusion Medicine, Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany
| | - Franz F. Wagner
- German Red Cross Blood Service NSTOB, Eldagsener Straße 38, 31832 Springe, Germany
| | | | | | - Malte Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
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3
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Schröder J, Chegwidden L, Maj C, Gehlen J, Speller J, Böhmer AC, Borisov O, Hess T, Kreuser N, Venerito M, Alakus H, May A, Gerges C, Schmidt T, Thieme R, Heider D, Hillmer AM, Reingruber J, Lyros O, Dietrich A, Hoffmeister A, Mehdorn M, Lordick F, Stocker G, Hohaus M, Reim D, Kandler J, Müller M, Ebigbo A, Fuchs C, Bruns CJ, Hölscher AH, Lang H, Grimminger PP, Dakkak D, Vashist Y, May S, Görg S, Franke A, Ellinghaus D, Galavotti S, Veits L, Weismüller J, Dommermuth J, Benner U, Rösch T, Messmann H, Schumacher B, Neuhaus H, Schmidt C, Wissinowski TT, Nöthen MM, Dong J, Ong JS, Buas MF, Thrift AP, Vaughan TL, Tomlinson I, Whiteman DC, Fitzgerald RC, Jankowski J, Vieth M, Mayr A, Gharahkhani P, MacGregor S, Gockel I, Palles C, Schumacher J. GWAS meta-analysis of 16 790 patients with Barrett's oesophagus and oesophageal adenocarcinoma identifies 16 novel genetic risk loci and provides insights into disease aetiology beyond the single marker level. Gut 2023; 72:612-623. [PMID: 35882562 DOI: 10.1136/gutjnl-2021-326698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 07/07/2022] [Indexed: 12/08/2022]
Abstract
OBJECTIVE Oesophageal cancer (EC) is the sixth leading cause of cancer-related deaths. Oesophageal adenocarcinoma (EA), with Barrett's oesophagus (BE) as a precursor lesion, is the most prevalent EC subtype in the Western world. This study aims to contribute to better understand the genetic causes of BE/EA by leveraging genome wide association studies (GWAS), genetic correlation analyses and polygenic risk modelling. DESIGN We combined data from previous GWAS with new cohorts, increasing the sample size to 16 790 BE/EA cases and 32 476 controls. We also carried out a transcriptome wide association study (TWAS) using expression data from disease-relevant tissues to identify BE/EA candidate genes. To investigate the relationship with reported BE/EA risk factors, a linkage disequilibrium score regression (LDSR) analysis was performed. BE/EA risk models were developed combining clinical/lifestyle risk factors with polygenic risk scores (PRS) derived from the GWAS meta-analysis. RESULTS The GWAS meta-analysis identified 27 BE and/or EA risk loci, 11 of which were novel. The TWAS identified promising BE/EA candidate genes at seven GWAS loci and at five additional risk loci. The LDSR analysis led to the identification of novel genetic correlations and pointed to differences in BE and EA aetiology. Gastro-oesophageal reflux disease appeared to contribute stronger to the metaplastic BE transformation than to EA development. Finally, combining PRS with BE/EA risk factors improved the performance of the risk models. CONCLUSION Our findings provide further insights into BE/EA aetiology and its relationship to risk factors. The results lay the foundation for future follow-up studies to identify underlying disease mechanisms and improving risk prediction.
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Affiliation(s)
- Julia Schröder
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Laura Chegwidden
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Carlo Maj
- Center for Human Genetics, University Hospital of Marburg, Marburg, Germany
| | - Jan Gehlen
- Center for Human Genetics, University Hospital of Marburg, Marburg, Germany
| | - Jan Speller
- Institute of Medical Biometrics, Informatics and Epidemiology (IMBIE), Medical Faculty, University of Bonn, Bonn, Germany
| | - Anne C Böhmer
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Oleg Borisov
- Institute for Genomic Statistics and Bioinformatics, Medical Faculty, University of Bonn, Bonn, Germany
| | - Timo Hess
- Center for Human Genetics, University Hospital of Marburg, Marburg, Germany
| | - Nicole Kreuser
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Marino Venerito
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany
| | - Hakan Alakus
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - Andrea May
- Department of Gastroenterology, Oncology and Pneumology, Asklepios Paulinen Clinic Wiesbaden, Wiesbaden, Germany
| | - Christian Gerges
- Department of Internal Medicine II, Evangelisches Krankenhaus Dusseldorf, Dusseldorf, Germany
| | - Thomas Schmidt
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - Rene Thieme
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Dominik Heider
- Department of Mathematics and Computer Science, University of Marburg, Marburg, Germany
| | - Axel M Hillmer
- Institute of Pathology, Faculty of Medicine and University Hospital Cologne, University Hospital Cologne, Cologne, Germany
| | - Julian Reingruber
- Center for Human Genetics, University Hospital of Marburg, Marburg, Germany
| | - Orestis Lyros
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Arne Dietrich
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | | | - Matthias Mehdorn
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Florian Lordick
- University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany
| | - Gertraud Stocker
- University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany
| | - Michael Hohaus
- Department for General and Visceral Surgery, Städt. Klinikum Dresden Friedrichstadt, Dresden, Germany
| | - Daniel Reim
- Department of Surgery, Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, München, Germany
| | - Jennis Kandler
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty of Heinrich Heine University Dusseldorf, Dusseldorf, Germany
| | - Michaela Müller
- Department of Gastroenterology, Endocrinology, Metabolism and Infectiology, University Hospital Marburg and Philipps University, Marburg, Germany
| | - Alanna Ebigbo
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Claudia Fuchs
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - Christiane J Bruns
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - Arnulf H Hölscher
- Department for General, Visceral and Trauma Surgery, Elisabeth-Krankenhaus-Essen GmbH, Essen, Germany
| | - Hauke Lang
- Department of General, Visceral and Transplant Surgery, University Medical Center, University of Mainz, Mainz, Germany
| | - Peter P Grimminger
- Department of General, Visceral and Transplant Surgery, University Medical Center, University of Mainz, Mainz, Germany
| | - Dani Dakkak
- Department of Internal Medicine and Gastroenterology, Elisabeth Hospital Essen, Essen, Germany
| | | | - Sandra May
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - David Ellinghaus
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Sara Galavotti
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Lothar Veits
- Institute of Pathology, Friedrich-Alexander-Universiät Erlangen-Nürnberg, Klinikum Bayreuth, Bayreuth, Germany
| | | | | | - Udo Benner
- Gastroenterologische Gemeinschaftspraxis, Koblenz, Germany
| | - Thomas Rösch
- Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Helmut Messmann
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Brigitte Schumacher
- Department of Internal Medicine and Gastroenterology, Elisabeth Hospital Essen, Essen, Germany
| | - Horst Neuhaus
- Department of Internal Medicine II, Evangelisches Krankenhaus Dusseldorf, Dusseldorf, Germany
| | - Carsten Schmidt
- Medical Clinic II (Gastroenterology, Hepatology, Endocrinology, Diabetology and Infektiology), Klinikum Fulda, University Medicine Marburg-Campus Fulda, Fulda, Germany
- Medical Faculty, Friedrich Schiller University Jena, Jena, Germany
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Jing Dong
- Division of Hematology and Oncology, Department of Medicine, Cancer Center, and Genomic Sciences & Precision Medicine Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jue-Sheng Ong
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Matthew F Buas
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Aaron P Thrift
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Thomas L Vaughan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Ian Tomlinson
- Edinburgh Cancer Research Centre, IGMM, University of Edinburgh, Edinburgh, UK
| | - David C Whiteman
- Cancer Control, Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Rebecca Claire Fitzgerald
- Medical Research Council (MRC) Cancer Unit, Hutchison-MRC Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Janusz Jankowski
- Comprehensive Clinical Trials Unit, University College London, London, UK
| | - Michael Vieth
- Institute of Pathology, Friedrich-Alexander-Universiät Erlangen-Nürnberg, Klinikum Bayreuth, Bayreuth, Germany
| | - Andreas Mayr
- Institute of Medical Biometrics, Informatics and Epidemiology (IMBIE), Medical Faculty, University of Bonn, Bonn, Germany
| | - Puya Gharahkhani
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Claire Palles
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
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Torres GG, Dose J, Hasenbein TP, Nygaard M, Krause-Kyora B, Mengel-From J, Christensen K, Andersen-Ranberg K, Kolbe D, Lieb W, Laudes M, Görg S, Schreiber S, Franke A, Caliebe A, Kuhlenbäumer G, Nebel A. Long-Lived Individuals Show a Lower Burden of Variants Predisposing to Age-Related Diseases and a Higher Polygenic Longevity Score. Int J Mol Sci 2022; 23:10949. [PMID: 36142858 PMCID: PMC9504529 DOI: 10.3390/ijms231810949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/22/2022] Open
Abstract
Longevity is a complex phenotype influenced by both environmental and genetic factors. The genetic contribution is estimated at about 25%. Despite extensive research efforts, only a few longevity genes have been validated across populations. Long-lived individuals (LLI) reach extreme ages with a relative low prevalence of chronic disability and major age-related diseases (ARDs). We tested whether the protection from ARDs in LLI can partly be attributed to genetic factors by calculating polygenic risk scores (PRSs) for seven common late-life diseases (Alzheimer's disease (AD), atrial fibrillation (AF), coronary artery disease (CAD), colorectal cancer (CRC), ischemic stroke (ISS), Parkinson's disease (PD) and type 2 diabetes (T2D)). The examined sample comprised 1351 German LLI (≥94 years, including 643 centenarians) and 4680 German younger controls. For all ARD-PRSs tested, the LLI had significantly lower scores than the younger control individuals (areas under the curve (AUCs): ISS = 0.59, p = 2.84 × 10-35; AD = 0.59, p = 3.16 × 10-25; AF = 0.57, p = 1.07 × 10-16; CAD = 0.56, p = 1.88 × 10-12; CRC = 0.52, p = 5.85 × 10-3; PD = 0.52, p = 1.91 × 10-3; T2D = 0.51, p = 2.61 × 10-3). We combined the individual ARD-PRSs into a meta-PRS (AUC = 0.64, p = 6.45 × 10-15). We also generated two genome-wide polygenic scores for longevity, one with and one without the TOMM40/APOE/APOC1 gene region (AUC (incl. TOMM40/APOE/APOC1) = 0.56, p = 1.45 × 10-5, seven variants; AUC (excl. TOMM40/APOE/APOC1) = 0.55, p = 9.85 × 10-3, 10,361 variants). Furthermore, the inclusion of nine markers from the excluded region (not in LD with each other) plus the APOE haplotype into the model raised the AUC from 0.55 to 0.61. Thus, our results highlight the importance of TOMM40/APOE/APOC1 as a longevity hub.
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Affiliation(s)
- Guillermo G. Torres
- Institute of Clinical Molecular Biology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 12, 24105 Kiel, Germany
| | - Janina Dose
- Institute of Clinical Molecular Biology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 12, 24105 Kiel, Germany
| | - Tim P. Hasenbein
- Institute of Clinical Molecular Biology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 12, 24105 Kiel, Germany
- Department of Neurology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany
- Institute of Pharmacology and Toxicology, Technical University Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Marianne Nygaard
- Department of Public Health, Epidemiology, Biostatistics and Biodemography, University of Southern, Denmark, J.B. Winsloews Vej 9B, 5000 Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, J.B. Winsloews Vej 4, 5000 Odense, Denmark
| | - Ben Krause-Kyora
- Institute of Clinical Molecular Biology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 12, 24105 Kiel, Germany
| | - Jonas Mengel-From
- Department of Public Health, Epidemiology, Biostatistics and Biodemography, University of Southern, Denmark, J.B. Winsloews Vej 9B, 5000 Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, J.B. Winsloews Vej 4, 5000 Odense, Denmark
| | - Kaare Christensen
- Department of Public Health, Epidemiology, Biostatistics and Biodemography, University of Southern, Denmark, J.B. Winsloews Vej 9B, 5000 Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, J.B. Winsloews Vej 4, 5000 Odense, Denmark
- Department of Clinical Biochemistry, Odense University Hospital, Kløvervænget 47, 5000 Odense, Denmark
| | - Karen Andersen-Ranberg
- Department of Public Health, Epidemiology, Biostatistics and Biodemography, University of Southern, Denmark, J.B. Winsloews Vej 9B, 5000 Odense, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Kløvervænget 23, 5000 Odense, Denmark
| | - Daniel Kolbe
- Institute of Clinical Molecular Biology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 12, 24105 Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology and Biobank Popgen, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Niemannsweg 11, 24105 Kiel, Germany
| | - Matthias Laudes
- Clinic for Internal Medicine I, Division of Endocrinology, Diabetes and Clinical Nutrition, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 12, 24105 Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 12, 24105 Kiel, Germany
| | - Amke Caliebe
- Institute of Medical Informatics and Statistics, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Brunswiker Str. 10, 24105 Kiel, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany
| | - Almut Nebel
- Institute of Clinical Molecular Biology, Kiel University, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 12, 24105 Kiel, Germany
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5
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Neugebauer J, Hagen C, Brockmann C, Juhl D, Schuster SO, Steppat D, Görg S, Ziemann M. Completing the Donor History Questionnaire before the Donation Visit Can Improve Blood Safety. Transfus Med Hemother 2022; 49:306-314. [PMID: 37969867 PMCID: PMC10642529 DOI: 10.1159/000522101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/20/2022] [Indexed: 11/17/2023] Open
Abstract
Background and Objectives In Germany, the donor history questionnaire (DHQ) is traditionally filled in at the donation center to avoid any influence of others. Since March 2020, it has been suggested to donors to answer the DHQ already at home and to call if they have any concerns to reduce the number of ineligible donors on-site during the COVID-19 pandemic. Materials and Methods We evaluated the rate of ineligible donors before and after March 2020. Additionally, an anonymous online survey asking for the donors' attitude towards the DHQ was performed. It included questions on whether and for what reason the DHQ had been answered incorrectly in the past. Results The rate of ineligible donors decreased by 27% (from 7.1% to 5.2%). In total, 5,556 of 10,252 invited donors completed the survey (54.2%). 88.6% reported either going through the DHQ at home or knowing all questions from their previous donations. 444 donors (8.0%) had at least once postponed a donation after reading the DHQ at home. 68 donors (1.2%) admitted having intentionally provided false answers in the past (9 at home, 43 on-site, 14 both, 2 unknown). Not wanting to be rejected once arriving at the donation center was an important motivation for 42% of donors answering incorrectly on-site. Details on 46 incorrect answers were provided: only 17 had no influence on donor eligibility or product quality. In 5 cases, some blood products might have had impaired quality. Truthful answers to 17 questions would have led to deferral, mostly due to increased risk for unrecognized viral infections transmitted by sexual contacts. For a further 7 questions, there was insufficient information available to determine possible consequences. Asked about their general opinion, 753 (13.6%) of all donors estimated the risk of incorrect answers being greater on-site, while 239 (4.3%) presumed an increased risk at home. Conclusion Answering the DHQ prior to a donation visit prevented ineligible donors from visiting the donation center. Furthermore, it might improve honesty, as the discomfort of being deferred after arriving at the donation center was an important reason to answer incorrectly. Overall, there was no increased risk of donor or product safety, and potentially even a benefit.
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Affiliation(s)
| | | | | | | | | | | | | | - Malte Ziemann
- Institute for Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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6
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Steiert TA, Fuß J, Juzenas S, Wittig M, Hoeppner M, Vollstedt M, Varkalaite G, ElAbd H, Brockmann C, Görg S, Gassner C, Forster M, Franke A. High-throughput method for the hybridisation-based targeted enrichment of long genomic fragments for PacBio third-generation sequencing. NAR Genom Bioinform 2022; 4:lqac051. [PMID: 35855323 PMCID: PMC9278042 DOI: 10.1093/nargab/lqac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/08/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022] Open
Abstract
Hybridisation-based targeted enrichment is a widely used and well-established technique in high-throughput second-generation short-read sequencing. Despite the high potential to genetically resolve highly repetitive and variable genomic sequences by, for example PacBio third-generation sequencing, targeted enrichment for long fragments has not yet established the same high-throughput due to currently existing complex workflows and technological dependencies. We here describe a scalable targeted enrichment protocol for fragment sizes of >7 kb. For demonstration purposes we developed a custom blood group panel of challenging loci. Test results achieved > 65% on-target rate, good coverage (142.7×) and sufficient coverage evenness for both non-paralogous and paralogous targets, and sufficient non-duplicate read counts (83.5%) per sample for a highly multiplexed enrichment pool of 16 samples. We genotyped the blood groups of nine patients employing highly accurate phased assemblies at an allelic resolution that match reference blood group allele calls determined by SNP array and NGS genotyping. Seven Genome-in-a-Bottle reference samples achieved high recall (96%) and precision (99%) rates. Mendelian error rates were 0.04% and 0.13% for the included Ashkenazim and Han Chinese trios, respectively. In summary, we provide a protocol and first example for accurate targeted long-read sequencing that can be used in a high-throughput fashion.
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Affiliation(s)
- Tim Alexander Steiert
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
| | - Janina Fuß
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
| | - Simonas Juzenas
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
- Institute of Biotechnology, Life Science Centre, Vilnius University, Vilnius 02241, Lithuania
| | - Michael Wittig
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
| | - Marc Patrick Hoeppner
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
| | - Melanie Vollstedt
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
| | - Greta Varkalaite
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas 44307, Lithuania
| | - Hesham ElAbd
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
| | - Christian Brockmann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Kiel 24105, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Kiel 24105, Germany
| | - Christoph Gassner
- Institute of Translational Medicine, Private University in the Principality of Liechtenstein, Triesen 9495, Liechtenstein
| | - Michael Forster
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
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Markewitz R, Pauli D, Dargvainiene J, Steinhagen K, Engel S, Herbst V, Zapf D, Krüger C, Sharifzadeh S, Schomburg B, Leypoldt F, Rupp J, Görg S, Junker R, Wandinger KP. The temporal course of T- and B-cell responses to vaccination with BNT162b2 and mRNA-1273. Clin Microbiol Infect 2022; 28:701-709. [PMID: 34547457 PMCID: PMC8450229 DOI: 10.1016/j.cmi.2021.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/31/2021] [Accepted: 09/05/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the response of the immune system (and its influencing factors) to vaccination with BNT162b2 or mRNA-1273. METHODS 531 vaccinees, recruited from healthcare professionals, donated samples before, in between, and after the administration of the two doses of the vaccine. T- and B-cell responses were examined via interferon-γ (IFN-γ) release assay, and antibodies against different epitopes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (S1 and NCP) were detected via ELISA and surrogate neutralization assay. Results were correlated with influencing factors such as age, sex, prior infection, vaccine received (BNT162b2 or mRNA-1273), and immunosuppression. Furthermore, antinuclear antibodies (ANAs) were measured to screen for autoimmune responses following vaccination with an mRNA vaccine. RESULTS No markers of immunity against SARS-CoV-2 were found before the first vaccination. Two weeks after it, specific responses against SARS-CoV-2 were already measurable (median ± median absolute deviation (MAD): anti-S1 IgG 195.5 ± 172.7 BAU/mL; IgA 6.7 ± 4.9 OD; surrogate neutralization 39 ± 23.7%), and were significantly increased two weeks after the second dose (anti-S1 IgG 3744 ± 2571.4 BAU/mL; IgA 12 ± 0 OD; surrogate neutralization 100 ± 0%, IFN-γ 1897.2 ± 886.7 mIU/mL). Responses were stronger for younger participants (this difference decreasing after the second dose). Further influences were previous infection with SARS-CoV-2 (causing significantly stronger responses after the first dose compared to unexposed individuals (p ≤ 0.0001)) and the vaccine received (significantly stronger reactions for recipients of mRNA-1273 after both doses, p < 0.05-0.0001). Some forms of immunosuppression significantly impeded the immune response to the vaccination (with no observable immune response in three immunosuppressed participants). There was no significant induction of ANAs by the vaccination (no change in qualitative ANA results (p 0.2592) nor ANA titres (p 0.08) from pre-to post-vaccination. CONCLUSIONS Both vaccines elicit strong and specific immune responses against SARS-CoV-2 which become detectable one week (T-cell response) or two weeks (B-cell response) after the first dose.
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Affiliation(s)
- Robert Markewitz
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany.
| | - Daniela Pauli
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Justina Dargvainiene
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Katja Steinhagen
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Sarah Engel
- Department of Anesthesiology and Intensive Care, University Hospital of Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Victor Herbst
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Dorinja Zapf
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Christina Krüger
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Shahpour Sharifzadeh
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Benjamin Schomburg
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Frank Leypoldt
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany; Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Lübeck, Lübeck, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Ralf Junker
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Klaus-Peter Wandinger
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
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8
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Markewitz RDH, Juhl D, Pauli D, Görg S, Junker R, Rupp J, Engel S, Steinhagen K, Herbst V, Zapf D, Krüger C, Brockmann C, Leypoldt F, Dargvainiene J, Schomburg B, Sharifzadeh SR, Salek Nejad L, Wandinger KP, Ziemann M. Differences in Immunogenicity of Three Different Homo- and Heterologous Vaccination Regimens against SARS-CoV-2. Vaccines (Basel) 2022; 10:vaccines10050649. [PMID: 35632405 PMCID: PMC9145236 DOI: 10.3390/vaccines10050649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Due to findings on adverse reactions and clinical efficacy of different vaccinations against SARS-CoV-2, the administration of vaccination regimens containing both adenoviral vector vaccines and mRNA-based vaccines has become common. Data are still needed on the direct comparison of immunogenicity for these different regimens. Methods: We compared markers for immunogenicity (anti-S1 IgG/IgA, neutralizing antibodies, and T-cell response) with three different vaccination regimens (homologous ChAdOx1 nCoV-19 (n = 103), or mixture of ChAdOx1 nCoV-19 with mRNA-1273 (n = 116) or BNT162b2 (n = 105)) at two time points: the day of the second vaccination as a baseline and 14 days later. Results: All examined vaccination regimens elicited measurable immune responses that were significantly enhanced after the second dose. Homologous ChAdOx1 nCoV-19 was markedly inferior in immunogenicity to all other examined regimens after administration of the second dose. Between the heterologous regimens, mRNA-1273 as second dose induced greater antibody responses than BNT162b2, with no difference found for neutralizing antibodies and T-cell response. Discussion: While these findings allow no prediction about clinical protection, from an immunological point of view, vaccination against SARS-CoV-2 with an mRNA-based vaccine at one or both time points appears preferable to homologous vaccination with ChAdOx1 nCoV-19. Whether or not the demonstrated differences between the heterologous regimens are of clinical significance will be subject to further research.
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Affiliation(s)
- Robert Daniel Heinrich Markewitz
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
- Correspondence: ; Tel.: +49-451-00-16315
| | - David Juhl
- Institute for Transfusion Medicine, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany; (D.J.); (S.G.); (C.B.); (M.Z.)
| | - Daniela Pauli
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
| | - Siegfried Görg
- Institute for Transfusion Medicine, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany; (D.J.); (S.G.); (C.B.); (M.Z.)
| | - Ralf Junker
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Lübeck, 23538 Lübeck, Germany;
| | - Sarah Engel
- Department of Anesthesiology and Intensive Care, University Hospital of Schleswig-Holstein Campus Lübeck, 23562 Lübeck, Germany;
| | - Katja Steinhagen
- Institute for Experimental Immunology, EUROIMMUN AG, 23560 Lübeck, Germany; (K.S.); (V.H.); (D.Z.); (C.K.)
| | - Victor Herbst
- Institute for Experimental Immunology, EUROIMMUN AG, 23560 Lübeck, Germany; (K.S.); (V.H.); (D.Z.); (C.K.)
| | - Dorinja Zapf
- Institute for Experimental Immunology, EUROIMMUN AG, 23560 Lübeck, Germany; (K.S.); (V.H.); (D.Z.); (C.K.)
| | - Christina Krüger
- Institute for Experimental Immunology, EUROIMMUN AG, 23560 Lübeck, Germany; (K.S.); (V.H.); (D.Z.); (C.K.)
| | - Christian Brockmann
- Institute for Transfusion Medicine, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany; (D.J.); (S.G.); (C.B.); (M.Z.)
| | - Frank Leypoldt
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
| | - Justina Dargvainiene
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
| | - Benjamin Schomburg
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
| | - Shahpour Reza Sharifzadeh
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
| | - Lukas Salek Nejad
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
| | - Klaus-Peter Wandinger
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany; (D.P.); (R.J.); (F.L.); (J.D.); (B.S.); (S.R.S.); (L.S.N.); (K.-P.W.)
| | - Malte Ziemann
- Institute for Transfusion Medicine, University Hospital of Schleswig-Holstein, 23538 Lübeck, Germany; (D.J.); (S.G.); (C.B.); (M.Z.)
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Markewitz R, Pauli D, Dargvainiene J, Steinhagen K, Engel S, Herbst V, Zapf D, Krüger C, Sharifzadeh S, Schomburg B, Leypoldt F, Rupp J, Görg S, Junker R, Wandinger KP. B-cell-responses to vaccination with BNT162b2 and mRNA-1273 six months after second dose. Clin Microbiol Infect 2022; 28:1024.e1-1024.e6. [PMID: 35259531 PMCID: PMC8897957 DOI: 10.1016/j.cmi.2022.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/02/2022] [Accepted: 02/27/2022] [Indexed: 12/19/2022]
Abstract
Objectives To examine the state of B-cell immunity 6 months after the second vaccination against SARS-CoV-2 in comparison to the state observed 2 weeks after vaccination. Methods Sera of 439 participants, whose immune responses to two doses of an mRNA-based vaccine (BNT162b2 or mRNA-1273) were previously characterized, was examined for anti-S1 IgG and IgA, anti-NCP IgG and neutralizing antibodies (nAb), and antinuclear antibodies (ANA). Results Levels of all examined markers decreased significantly from 2 weeks to 6 months after second vaccination (anti-S1 IgG: 3744 ± 2571.4 vs. 253 ± 144 binding antibody units (BAU)/mL; anti-S1 IgA: 12 ± 0 vs. 1.98 ± 1.75 optical density (OD) ratio; nAb: 100% ± 0% vs. 82% ± 19.3%), the vast majority of participants retaining reactive levels of anti-S1 IgG (436/439) and anti-S1 IgA (334/439) at 6 months. Immune responses were stronger for mRNA-1273 compared with BNT162b2 (anti-S1 IgG: 429 ± 289 vs. 243 ± 143 BAU/mL; anti-S1 IgA: 5.38 ± 3.91 vs. 1.89 ± 1.53 OD ratio; nAb: 90.5% ± 12.6% vs. 81% ± 19.3%). There was no meaningful influence of sex and age on the examined markers. There was a strong correlation between anti-S1 IgG and the surrogate neutralization assay (rho = 0.91, p <0.0001), but not for for IgA and the surrogate neutralization assay (rho = 0.52, p <0.0001). There was a ceiling effect for the association between anti-S1 IgG titres and the inhibition of binding between S1 and ACE2. ANA prevalence was unchanged from 2 weeks to 6 months after the second vaccination (87/498 vs. 77/435), as were the median ANA titres (1:160 vs. 1:160). Discussion Although the clinical consequences of decreasing anti-SARS-CoV-2 antibody titres cannot be estimated with certainty, a lowered degree of clinical protection against SARS-CoV-2 is possible. Persistently stronger responses to mRNA-1273 suggest that it might confer greater protection than BNT162b2, even 6 months after the second vaccination. Neither examined vaccinations induced ANA within the examined time frame.
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Markewitz R, Juhl D, Pauli D, Görg S, Junker R, Rupp J, Engel S, Steinhagen K, Herbst V, Zapf D, Krüger C, Brockmann C, Leypoldt F, Dargvainiene J, Schomburg B, Sharifzadeh S, Nejad LS, Wandinger KP, Ziemann M. Kinetics of the Antibody Response to Boostering With Three Different Vaccines Against SARS-CoV-2. Front Immunol 2022; 13:811020. [PMID: 35126395 PMCID: PMC8807650 DOI: 10.3389/fimmu.2022.811020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/03/2022] [Indexed: 12/14/2022] Open
Abstract
BackgroundHeterologous vaccinations against SARS-CoV-2 with ChAdOx1 nCoV-19 and a second dose of an mRNA-based vaccine have been shown to be more immunogenic than homologous ChAdOx1 nCoV-19. In the current study, we examined the kinetics of the antibody response to the second dose of three different vaccination regimens (homologous ChAdOx1 nCoV-19 vs. ChAdOx1 nCoV-19 + BNT162b2 or mRNA-1273) against SARS-CoV-2 in a longitudinal manner; whether there are differences in latency or amplitude of the early response and which markers are most suitable to detect these responses.MethodsWe performed assays for anti-S1 IgG and IgA, anti-NCP IgG and a surrogate neutralization assay on serum samples collected from 57 participants on the day of the second vaccination as well as the following seven days.ResultsAll examined vaccination regimens induced detectable antibody responses within the examined time frame. Both heterologous regimens induced responses earlier and with a higher amplitude than homologous ChAdOx1 nCoV-19. Between the heterologous regimens, amplitudes were somewhat higher for ChAdOx1 nCoV-19 + mRNA-1273. There was no difference in latency between the IgG and IgA responses. Increases in the surrogate neutralization assay were the first changes to be detectable for all regimens and the only significant change seen for homologous ChAdOx1 nCoV-19.DiscussionBoth examined heterologous vaccination regimens are superior in immunogenicity, including the latency of the response, to homologous ChAdOx1 nCoV-19. While the IgA response has a shorter latency than the IgG response after the first dose, no such difference was found after the second dose, implying that both responses are driven by separate plasma cell populations. Early and steep increases in surrogate neutralization levels suggest that this might be a more sensitive marker for antibody responses after vaccination against SARS-CoV-2 than absolute levels of anti-S1 IgG.
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Affiliation(s)
- Robert Markewitz
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
- *Correspondence: Robert Markewitz,
| | - David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Daniela Pauli
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Ralf Junker
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Lübeck, Lübeck, Germany
| | - Sarah Engel
- Department of Anesthesiology and Intensive Care, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Katja Steinhagen
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Victor Herbst
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Dorinja Zapf
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Christina Krüger
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Christian Brockmann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Frank Leypoldt
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Justina Dargvainiene
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Benjamin Schomburg
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Shahpour Sharifzadeh
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Lukas Salek Nejad
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Klaus-Peter Wandinger
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Malte Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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Göbel CH, Heinze A, Karstedt S, Morscheck M, Tashiro L, Cirkel A, Hamid Q, Halwani R, Temsah MH, Ziemann M, Görg S, Münte T, Göbel H. Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study. Pain Ther 2021; 10:1309-1330. [PMID: 34313952 PMCID: PMC8314854 DOI: 10.1007/s40122-021-00296-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/15/2021] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The most frequently reported neurological adverse event of ChAdOx1 nCoV-19 (AZD1222) vaccine is headache in 57.5%. Several cases of cerebral venous thrombosis (CVT) have developed after vaccination. Headache is the leading symptom of CVT. For the differential diagnosis of headaches attributed to this vaccine and headaches attributed to CVT, it is of central clinical importance whether and, if so, how the phenotypes and course of these headaches can be differentiated. The study aims to examine in detail the phenotype of headache attributed to this vaccine. METHODS Data on the clinical features and corresponding variables were recorded using a standardized online questionnaire in this multicenter observational cohort study. The primary outcomes of this study are the clinical features of headaches after vaccination. FINDINGS A total of 2464 participants reported headaches after vaccination with the ChAdOx1 nCoV-19 (AZD1222) vaccine. On average, headaches occurred 14.5 ± 21.6 h after vaccination and lasted 16.3 ± 30.4 h. A bilateral location was described by 75.8% of participants. This is most often found on the forehead (40.0%) and temples (31.4%); 50.4% reported a pressing and 37.7% a dull pain character. Headache intensity was most often severe (38.7%), moderate (35.2%), or very severe (15.5%). Accompanying symptoms were most commonly fatigue (44.8%), chills (36.1%), exhaustion (34.9%), and fever (30.4%). CONCLUSION Headaches attributed to COVID-19 vaccination with the ChAdOx1 nCoV-19 (AZD1222) vaccine demonstrate an extensive and characteristic complex of symptoms. The findings have several important clinical implications for the differentiation of post-vaccinal headache and other primary as well as secondary headaches.
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Affiliation(s)
- Carl H. Göbel
- grid.412468.d0000 0004 0646 2097Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany ,Kiel Migraine and Headache Centre, Kiel, Germany
| | - Axel Heinze
- Kiel Migraine and Headache Centre, Kiel, Germany
| | | | | | | | - Anna Cirkel
- grid.412468.d0000 0004 0646 2097Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany ,Kiel Migraine and Headache Centre, Kiel, Germany
| | - Qutyaba Hamid
- grid.412789.10000 0004 4686 5317Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates ,grid.412789.10000 0004 4686 5317Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rabih Halwani
- grid.412789.10000 0004 4686 5317Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates ,grid.412789.10000 0004 4686 5317Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamad-Hani Temsah
- grid.56302.320000 0004 1773 5396College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Malte Ziemann
- grid.412468.d0000 0004 0646 2097Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Campus, Lübeck, Germany
| | - Siegfried Görg
- grid.412468.d0000 0004 0646 2097Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Campus, Lübeck, Germany
| | - Thomas Münte
- grid.412468.d0000 0004 0646 2097Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
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Ziemann M, Görg S. In Reply. Dtsch Arztebl Int 2021; 118:722. [PMID: 35020588 PMCID: PMC8767151 DOI: 10.3238/arztebl.m2021.0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Malte Ziemann
- Institut für Transfusionsmedizin Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - Siegfried Görg
- Institut für Transfusionsmedizin Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
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13
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Günther V, Alkatout I, Meyerholz L, Maass N, Görg S, von Otte S, Ziemann M. Live Birth Rates after Active Immunization with Partner Lymphocytes. Biomedicines 2021; 9:biomedicines9101350. [PMID: 34680467 PMCID: PMC8533392 DOI: 10.3390/biomedicines9101350] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 12/30/2022] Open
Abstract
Although many potential causes have been established for recurrent implantation failure (RIF) and recurrent miscarriage (RM), about 50% of these remain idiopathic. Scientific research is focused on immunological risk factors. In the present study, we aim to evaluate live birth rates after immunization with paternal lymphocytes (lymphocyte immunotherapy (LIT)). This retrospective study consisted of 148 couples with a history of RM and/or RIF. The women underwent immunization with lymphocytes of their respective partners from November 2017 to August 2019. Fifty-five patients (43%) had live births. Stratified by indication (RM, RIF, combined), live birth rates in the RM and the combined group were significantly higher than that in the RIF group (53%, 59% and 33%, respectively, p = 0.02). The difference was especially noticeable during the first 90 days after immunization (conception rate leading to live births: 31%, 23% and 8% for RM, the combined group and RIF, respectively; p = 0.005), while there was no difference between groups during the later follow-up. LIT was associated with high live birth rates, especially in women with recurrent miscarriage. In view of the limited data from randomized studies, LIT cannot be recommended as routine therapy. However, it may be considered in individual cases.
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Affiliation(s)
- Veronika Günther
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House C), 24105 Kiel, Germany; (I.A.); (L.M.); (N.M.)
- University Fertility Center, Ambulanzzentrum gGmbH, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House C), 24105 Kiel, Germany;
- Institute for Transfusion Medicine and Transplant Center, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House 17), 24105 Kiel, Germany; (S.G.); (M.Z.)
- Institute for Transfusion Medicine and Transplant Center, University Hospitals Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160 (House 31), 23538 Lübeck, Germany
- Correspondence: ; Tel.: +49-(0)431-500-21401
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House C), 24105 Kiel, Germany; (I.A.); (L.M.); (N.M.)
| | - Lisa Meyerholz
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House C), 24105 Kiel, Germany; (I.A.); (L.M.); (N.M.)
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House C), 24105 Kiel, Germany; (I.A.); (L.M.); (N.M.)
| | - Siegfried Görg
- Institute for Transfusion Medicine and Transplant Center, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House 17), 24105 Kiel, Germany; (S.G.); (M.Z.)
- Institute for Transfusion Medicine and Transplant Center, University Hospitals Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160 (House 31), 23538 Lübeck, Germany
| | - Sören von Otte
- University Fertility Center, Ambulanzzentrum gGmbH, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House C), 24105 Kiel, Germany;
| | - Malte Ziemann
- Institute for Transfusion Medicine and Transplant Center, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3 (House 17), 24105 Kiel, Germany; (S.G.); (M.Z.)
- Institute for Transfusion Medicine and Transplant Center, University Hospitals Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160 (House 31), 23538 Lübeck, Germany
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14
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Lin JR, Sin-Chan P, Napolioni V, Torres GG, Mitra J, Zhang Q, Jabalameli MR, Wang Z, Nguyen N, Gao T, Laudes M, Görg S, Franke A, Nebel A, Greicius MD, Atzmon G, Ye K, Gorbunova V, Ladiges WC, Shuldiner AR, Niedernhofer LJ, Robbins PD, Milman S, Suh Y, Vijg J, Barzilai N, Zhang ZD. Rare genetic coding variants associated with human longevity and protection against age-related diseases. Nat Aging 2021; 1:783-794. [PMID: 37117627 DOI: 10.1038/s43587-021-00108-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 08/05/2021] [Indexed: 12/18/2022]
Abstract
Extreme longevity in humans has a strong genetic component, but whether this involves genetic variation in the same longevity pathways as found in model organisms is unclear. Using whole-exome sequences of a large cohort of Ashkenazi Jewish centenarians to examine enrichment for rare coding variants, we found most longevity-associated rare coding variants converge upon conserved insulin/insulin-like growth factor 1 signaling and AMP-activating protein kinase signaling pathways. Centenarians have a number of pathogenic rare coding variants similar to control individuals, suggesting that rare variants detected in the conserved longevity pathways are protective against age-related pathology. Indeed, we detected a pro-longevity effect of rare coding variants in the Wnt signaling pathway on individuals harboring the known common risk allele APOE4. The genetic component of extreme human longevity constitutes, at least in part, rare coding variants in pathways that protect against aging, including those that control longevity in model organisms.
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Göbel CH, Heinze A, Karstedt S, Morscheck M, Tashiro L, Cirkel A, Hamid Q, Halwani R, Temsah MH, Ziemann M, Görg S, Münte T, Göbel H. Clinical characteristics of headache after vaccination against COVID-19 (coronavirus SARS-CoV-2) with the BNT162b2 mRNA vaccine: a multicentre observational cohort study. Brain Commun 2021; 3:fcab169. [PMID: 34405142 PMCID: PMC8344581 DOI: 10.1093/braincomms/fcab169] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 05/30/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023] Open
Abstract
The novel coronavirus SARS-CoV-2 causes the infectious disease COVID-19. Newly developed mRNA vaccines can prevent the spread of the virus. Headache is the most common neurological symptom in over 50% of those vaccinated. Detailed information about the clinical characteristics of this form of headache has not yet been described. The aim of the study is to examine in detail the clinical characteristics of headaches occurring after vaccination against COVID-19 with the BNT162b2 mRNA COVID-19 vaccine for the first time. In a multicentre observational cohort study, data on the clinical features and corresponding variables were recorded using a standardized online questionnaire. The questionnaire was circulated to 12 000 residential care homes of the elderly as well as tertiary university hospitals in Germany and the United Arab Emirates. The primary outcomes of this study are the clinical features of headache after vaccination. Comorbidities, treatment with medication and sociodemographic variables are also analysed. A total of 2349 participants reported headaches after vaccination with the BNT162b2 mRNA COVID-19 vaccine. Headaches occur an average of 18.0 ± 27.0 h after vaccination and last an average duration of 14.2 ± 21.3 h. Only 9.7% of those affected also report headaches resulting from previous vaccinations. In 66.6% of the participants, headache occurs as a single episode. A bilateral location is indicated by 73.1% of the participants. This is most often found on the forehead (38.0%) and temples (32.1%). A pressing pain character is indicated by 49.2% and 40.7% report a dull pain character. The pain intensity is most often moderate (46.2%), severe (32.1%) or very severe (8.2%). The most common accompanying symptoms are fatigue (38.8%), exhaustion (25.7%) and muscle pain (23.4%). Headaches after COVID-19 vaccination show an extensive complex of symptoms. The constellation of accompanying symptoms together with the temporal and spatial headache characteristics delimit a distinctive headache phenotype.
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Affiliation(s)
- Carl H Göbel
- Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany.,Kiel Migraine and Headache Centre, Kiel, Germany
| | - Axel Heinze
- Kiel Migraine and Headache Centre, Kiel, Germany
| | - Sarah Karstedt
- Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany.,Kiel Migraine and Headache Centre, Kiel, Germany
| | | | | | - Anna Cirkel
- Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany.,Kiel Migraine and Headache Centre, Kiel, Germany
| | - Qutayba Hamid
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rabih Halwani
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Malte Ziemann
- Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Thomas Münte
- Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany
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16
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Pfaff EM, Derad I, Feldkamp T, Nitschke M, Görg S, Ziemann M. Appearance of new CDC-reactive antibodies in patients waiting for kidney transplantation. Transpl Immunol 2021; 69:101449. [PMID: 34391884 DOI: 10.1016/j.trim.2021.101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients awaiting kidney transplantation are regularly screened for HLA-antibodies, but there is scarce data about the optimal interval. METHODS Results from Complement-dependent cytotoxicity testing (CDC) for waitlisted patients were reviewed for increases in panel reactive antibodies (PRA) by at least 10%-points. Clinical records were screened for historic immunizing events and possible trigger factors preceding the PRA-increase. Additionally, non-pretransplanted men tested negative for HLA antibodies by solid-phase assays (SPA) out of their first two samples on the waiting list ("non-immunized men") were evaluated for detection of HLA antibodies by SPA during their further stay on the waiting list. RESULTS 15,360 samples from 1928 patients tested by CDC were analyzed for changes in PRA. PRA-increases occurred most frequently in patients waitlisted recently for retransplantation (annual incidence 6%). Removal of previous transplants, severe infections and/or reduced immunosuppression triggered 65% of PRA-increases during the first year after waitlisting. Transfusions accounted for 55% of PRA-increases in later years. Leucocyte-reduced red blood cell units not only boosted historic antibodies, but even induced primary immunization. In the second part of the study, 6780 samples tested by SPA from 703 non-immunized men were evaluated for development of HLA-antibodies. Only 9 men (1.3%) turned HLA antibody-positive (annual incidence 0.4%). CONCLUSION A uniform screening interval does not fit all: Frequencies should be highest in patients newly waitlisted for re-transplant and lowest in non-immunized men. Transfused patients should be monitored closely for development of HLA-antibodies even if leukoreduced products are used.
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Affiliation(s)
- Eva-Marie Pfaff
- Institute for Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Inge Derad
- Transplant center, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Thorsten Feldkamp
- Transplant center, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Martin Nitschke
- Transplant center, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Siegfried Görg
- Institute for Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Malte Ziemann
- Institute for Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany.
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17
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Ziemann M, Görg S. Inability to Work After Corona Vaccination in Medical Staff. Dtsch Arztebl Int 2021; 118:298-299. [PMID: 34180800 DOI: 10.3238/arztebl.m2021.0205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/17/2021] [Accepted: 04/07/2021] [Indexed: 11/27/2022]
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18
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Juhl D, Chudy M, Görg S, Hennig H. Prevalence of antibodies against Hepatitis D virus (HDV) in blood donors in Northern Germany. Transfus Apher Sci 2020; 59:102721. [DOI: 10.1016/j.transci.2020.102721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/05/2019] [Accepted: 12/23/2019] [Indexed: 12/31/2022]
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Ziemann M, Altermann W, Angert K, Arns W, Bachmann A, Bakchoul T, Banas B, von Borstel A, Budde K, Ditt V, Einecke G, Eisenberger U, Feldkamp T, Görg S, Guthoff M, Habicht A, Hallensleben M, Heinemann FM, Hessler N, Hugo C, Kaufmann M, Kauke T, Koch M, König IR, Kurschat C, Lehmann C, Marget M, Mühlfeld A, Nitschke M, Pego da Silva L, Quick C, Rahmel A, Rath T, Reinke P, Renders L, Sommer F, Spriewald B, Staeck O, Stippel D, Süsal C, Thiele B, Zecher D, Lachmann N. Preformed Donor-Specific HLA Antibodies in Living and Deceased Donor Transplantation: A Multicenter Study. Clin J Am Soc Nephrol 2019; 14:1056-1066. [PMID: 31213508 PMCID: PMC6625630 DOI: 10.2215/cjn.13401118] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/23/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES The prognostic value of preformed donor-specific HLA antibodies (DSA), which are only detectable by sensitive methods, remains controversial for kidney transplantation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The outcome of 4233 consecutive kidney transplants performed between 2012 and 2015 in 18 German transplant centers was evaluated. Most centers used a stepwise pretransplant antibody screening with bead array tests and differentiation of positive samples by single antigen assays. Using these screening results, DSA against HLA-A, -B, -C, -DRB1 and -DQB1 were determined. Data on clinical outcome and possible covariates were collected retrospectively. RESULTS Pretransplant DSA were associated with lower overall graft survival, with a hazard ratio of 2.53 for living donation (95% confidence interval [95% CI], 1.49 to 4.29; P<0.001) and 1.59 for deceased donation (95% CI, 1.21 to 2.11; P=0.001). ABO-incompatible transplantation was associated with worse graft survival (hazard ratio, 2.09; 95% CI, 1.33 to 3.27; P=0.001) independent from DSA. There was no difference between DSA against class 1, class 2, or both. Stratification into DSA <3000 medium fluorescence intensity (MFI) and DSA ≥3000 MFI resulted in overlapping survival curves. Therefore, separate analyses were performed for 3-month and long-term graft survival. Although DSA <3000 MFI tended to be associated with both lower 3-month and long-term transplant survival in deceased donation, DSA ≥3000 MFI were only associated with worse long-term transplant survival in deceased donation. In living donation, only strong DSA were associated with reduced graft survival in the first 3 months, but both weak and strong DSA were associated with reduced long-term graft survival. A higher incidence of antibody-mediated rejection within 6 months was only associated with DSA ≥3000 MFI. CONCLUSIONS Preformed DSA were associated with an increased risk for graft loss in kidney transplantation, which was greater in living than in deceased donation. Even weak DSA <3000 MFI were associated with worse graft survival. This association was stronger in living than deceased donation.
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Affiliation(s)
| | - Wolfgang Altermann
- Institute for Transfusion Medicine, University Hospital Halle, Halle, Germany
| | | | - Wolfgang Arns
- Clinic for Internal Medicine I, Kliniken der Stadt Köln, Cologne, Germany
| | - Anette Bachmann
- Medical Department III - Endocrinology, Nephrology, Rheumatology and
| | | | - Bernhard Banas
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Annette von Borstel
- Institute for Transfusion Medicine, Kliniken der Stadt Köln, Cologne, Germany
| | - Klemens Budde
- Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Vanessa Ditt
- Institute for Transfusion Medicine, Kliniken der Stadt Köln, Cologne, Germany
| | | | | | - Thorsten Feldkamp
- Transplant Center, University Hospital of Schleswig-Holstein, Kiel, Germany
| | | | - Martina Guthoff
- Section for Renal and Hypertensive Disorders, Clinic for Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
| | | | - Michael Hallensleben
- Institute for Transfusion Medicine, Medizinische Hochschule Hannover, Hannover, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Nicole Hessler
- Institute of Medical Biometry and Statistics, University Medical Center Schleswig-Holstein Lübeck, Germany
| | - Christian Hugo
- Clinic for Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Matthias Kaufmann
- Regional Office North, German Organ Transplantation Foundation, Hannover, Germany
| | - Teresa Kauke
- Department of General, Visceral, Vascular, and Transplant Surgery and.,Department for Transfusion Medicine, Hospital of the Ludwig-Maximilians-University München München, Germany.,Department for Transfusion Medicine, Hospital of the Ludwigs-Maximilians-University München, München, Germany
| | | | - Inke R König
- Institute of Medical Biometry and Statistics, University Medical Center Schleswig-Holstein Lübeck, Germany
| | | | - Claudia Lehmann
- Institute for Transfusion Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Matthias Marget
- Institute for Transfusion Medicine, University Hospital Hamburg, Hamburg, Germany
| | - Anja Mühlfeld
- Clinic for Renal and Hypertensive Disorders, Rheumatological and Immunological Diseases, University Hospital Aachen, Aachen, Germany
| | - Martin Nitschke
- Transplant center, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | | | - Carmen Quick
- Clinic for Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Axel Rahmel
- German Organ Transplantation Foundation, Frankfurt, Germany
| | - Thomas Rath
- Department for Nephrology and Transplantation, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Petra Reinke
- Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lutz Renders
- Department for Nephrology, Klinikum Rechts der Isar der Technischen Universität München, Munich, Germany
| | - Florian Sommer
- Department of General, Visceral, and Transplant Surgery, Klinikum Augsburg, Augsburg, Germany
| | - Bernd Spriewald
- Department of Medicine 5 - Hematology and Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Oliver Staeck
- Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Dirk Stippel
- Department of General, Visceral Surgery and Surgical Oncology, University Hospital Cologne, Cologne, Germany
| | - Caner Süsal
- Institute of Immunology and Transplant Immunology, University Hospital, Heidelberg, Heidelberg, Germany
| | - Bernhard Thiele
- Institut für Immunologie und Genetik Kaiserslautern, Kaiserslautern, Germany; and
| | - Daniel Zecher
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Nils Lachmann
- HLA Laboratory, Institute of Transfusion Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Günther V, Alkatout I, Junkers W, Maass N, Ziemann M, Görg S, von Otte S. Active Immunisation with Partner Lymphocytes in Female Patients Who Want to Become Pregnant - Current Status. Geburtshilfe Frauenheilkd 2018; 78:260-273. [PMID: 29576631 PMCID: PMC5862550 DOI: 10.1055/s-0044-101609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/30/2017] [Accepted: 01/24/2018] [Indexed: 12/15/2022] Open
Abstract
Around 1 – 3% of all couples who try to have a child are affected by recurrent miscarriage. According to the WHO, recurrent miscarriage is defined as the occurrence of three or more consecutive miscarriages up to the 20th week of pregnancy. There are various causes of recurrent miscarriage; in many cases, the causes remain unclear, with the result that immunological factors are one of the possible causes discussed. For the motherʼs immune system, the embryo represents a semi-allogeneic transplant, as half of the embryoʼs genes are of paternal origin. In place of a conventional immune response, the embryo induces a secondary protection mechanism, which contributes to the successful implantation. When performing immunisation with partner lymphocytes, the patient receives an intradermal injection of her partnerʼs prepared lymphocytes into the volar side of the forearm in order to induce immunomodulation with a consequently increased rate of pregnancy and live birth. A prerequisite for this procedure is that all other possible causes of sterility have been ruled out in advance. Due to the highly heterogeneous nature of the data, a significant benefit as a result of the immunisation cannot yet be clearly proven. However, there are signs that the therapy may be effective when using lymphocytes that have been extracted as short a time beforehand as possible. Overall, the treatment represents a safe, low-risk procedure. Following a detailed informative discussion with the couple regarding the chances of success and following a detailed review of the indication and contraindications, immunisation with partner lymphocytes can be discussed with the couple on a case-by-case basis – provided that all other possible causes of sterility have been ruled out in advance.
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Affiliation(s)
- Veronika Günther
- Klinik für Gynäkologie und Geburtshilfe, UKSH Campus Kiel, Kiel, Germany
| | - Ibrahim Alkatout
- Klinik für Gynäkologie und Geburtshilfe, UKSH Campus Kiel, Kiel, Germany
| | - Wiebe Junkers
- Universitäres Kinderwunschzentrum, MVZ, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nicolai Maass
- Klinik für Gynäkologie und Geburtshilfe, UKSH Campus Kiel, Kiel, Germany
| | - Malte Ziemann
- Institut für Transfusionsmedizin, UKSH Campus Kiel, Kiel, Germany.,Institut für Transfusionsmedizin, UKSH Campus Lübeck, Lübeck, Germany
| | - Siegfried Görg
- Institut für Transfusionsmedizin, UKSH Campus Kiel, Kiel, Germany.,Institut für Transfusionsmedizin, UKSH Campus Lübeck, Lübeck, Germany
| | - Sören von Otte
- Universitäres Kinderwunschzentrum, MVZ, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
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21
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Juhl D, Nowak‐Göttl U, Blümel J, Görg S, Hennig H. Lack of evidence for the transmission of hepatitis E virus by coagulation factor concentrates based on seroprevalence data. Transfus Med 2017; 28:427-432. [DOI: 10.1111/tme.12498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 12/01/2017] [Accepted: 12/04/2017] [Indexed: 01/18/2023]
Affiliation(s)
- D. Juhl
- Institute of Transfusion MedicineUniversity Hospital of Schleswig‐Holstein Lübeck Germany
| | - U. Nowak‐Göttl
- Institute of Clinical ChemistryUniversity Hospital of Schleswig‐Holstein Kiel Germany
| | - J. Blümel
- Paul‐Ehrlich‐InstitutFederal Institute for Vaccines and Biomedicines Langen Germany
| | - S. Görg
- Institute of Transfusion MedicineUniversity Hospital of Schleswig‐Holstein Lübeck Germany
| | - H. Hennig
- Institute of Transfusion MedicineUniversity Hospital of Schleswig‐Holstein Lübeck Germany
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22
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Ziemann M, Juhl D, Brockmann C, Görg S, Hennig H. Infectivity of blood products containing cytomegalovirus DNA: results of a lookback study in nonimmunocompromised patients. Transfusion 2017; 57:1691-1698. [DOI: 10.1111/trf.14105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/08/2017] [Accepted: 02/16/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Malte Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein; Lübeck Germany
| | - David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein; Lübeck Germany
| | - Christian Brockmann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein; Lübeck Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein; Lübeck Germany
| | - Holger Hennig
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein; Lübeck Germany
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Ziemann M, Heßler N, König IR, Lachmann N, Dick A, Ditt V, Budde K, Reinke P, Eisenberger U, Suwelack B, Klein T, Westhoff TH, Arns W, Ivens K, Habicht A, Renders L, Stippel D, Bös D, Sommer F, Görg S, Nitschke M, Feldkamp T, Heinemann FM, Kelsch R. Unacceptable human leucocyte antigens for organ offers in the era of organ shortage: influence on waiting time before kidney transplantation. Nephrol Dial Transplant 2017; 32:880-889. [DOI: 10.1093/ndt/gfw462] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/29/2016] [Indexed: 11/12/2022] Open
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Juhl D, Marget M, Hallensleben M, Görg S, Ziemann M. Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs. Transpl Immunol 2017; 41:17-21. [DOI: 10.1016/j.trim.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 12/30/2016] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
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Juhl D, Knobloch JKM, Görg S, Hennig H. Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors. Transfus Med Hemother 2015; 43:37-43. [PMID: 27022321 DOI: 10.1159/000441676] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/13/2015] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Testing for antibodies against hepatitis B core antigen (anti-HBc) was introduced to detect blood donors suffering from occult hepatitis B infection. Confirmation of specification of reactive results in the anti-HBc screening assay is still a challenge for blood donation services. METHODS Two different test strategies for confirmation of specification of reactive anti-HBc tests, one performed in our institute and one suggested by the German authority (Paul-Ehrlich-Institut (PEI)), were compared. The first strategy is based on one supplemental anti-HBc test, the other requires two supplemental anti-HBc tests. RESULTS 389 samples from 242 donors were considered. Both test strategies yielded concordant results in 117 reactive samples termed 'true-positive' or 'specificity confirmed', in 156 reactive samples termed 'false-positive' or 'specificity not confirmed', and in 99 negative samples. In 17 samples obtained from 11 donors, both test strategies gave discrepant results ('false-positive' but 'specificity confirmed'). In 10 of 11 donors, a real HBV infection was very unlikely, one remained unclear. 30 donors considered 'false-positive' became negative in all anti-HBc tests after follow-up testing and thus eligible for donor re-entry. CONCLUSIONS The test strategy suggested by the PEI yielded no additional information but induced an overestimation of HBV infections and unnecessary look-back procedures. Many anti-HBc-reactive donors can be regained after follow-up testing.
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Affiliation(s)
- David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Johannes K-M Knobloch
- Institute of Medical Microbiology and Hygiene, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Holger Hennig
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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Juhl D, Özdemir M, Dreier J, Görg S, Hennig H. Look-back study on recipients of Parvovirus B19 (B19V) DNA-positive blood components. Vox Sang 2015; 109:305-11. [PMID: 26053938 DOI: 10.1111/vox.12295] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/01/2015] [Accepted: 04/08/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES To assess the relevance of Parvovirus B19 (B19V) DNA at low to intermediate concentrations in blood donors for the recipients of their blood components. MATERIAL AND METHODS We studied recipients of B19V DNA-positive blood components [red blood cell concentrates (RBCs), pooled platelet concentrates and fresh frozen plasma]. This included archived pretransfusion samples as well as follow-up samples investigated by ELISA or NAT and genome sequence analysis. RESULTS In 132 out of 424 recipients, we could detect no anti-B19V IgG before transfusion. In 67 out of 132 sero-negative recipients, a follow-up sample was available. Sixty-five of these received blood components from donors with <10(4) IU B19V DNA/ml plasma and had no evidence of transfusion-transmitted (TT)-B19V infection. Homology in genome sequences in donor and recipient provided evidence for a TT-B19V infection in two recipients. Both patients received RBC containing 3.4 × 10(6) and 1.8 × 10(4) IU B19V DNA/ml plasma, respectively. The anti-B19V IgG titres in the donors were 2 and 76 IU/ml plasma, respectively. The antibodies in the second donor were directed against capsid proteins and are thus considered as potential neutralizing antibodies. CONCLUSIONS TT-B19V infections through blood components with low (<10(4) IU/ml plasma) B19V DNA concentrations did not occur in our study. One of the TT-B19V infections occurred from RBC with intermediate B19V DNA concentration despite the presence of potential neutralizing antibodies in the donor, but its clinical significance was low.
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Affiliation(s)
- D Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - M Özdemir
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - J Dreier
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany
| | - S Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - H Hennig
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
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Prüßmann W, Prüßmann J, Koga H, Recke A, Iwata H, Juhl D, Görg S, Henschler R, Hashimoto T, Schmidt E, Zillikens D, Ibrahim SM, Ludwig RJ. Prevalence of pemphigus and pemphigoid autoantibodies in the general population. Orphanet J Rare Dis 2015; 10:63. [PMID: 25971981 PMCID: PMC4436865 DOI: 10.1186/s13023-015-0278-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 04/29/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Mucocutaneous blistering is characteristic of autoimmune bullous dermatoses (AIBD). Blisters are caused by autoantibodies directed against structural components of the skin. Hence, detection of specific autoantibodies has become a hallmark for AIBD diagnosis. Studies on prevalence of AIBD autoantibodies in healthy individuals yielded contradictory results. METHODS To clarify this, samples from 7063 blood donors were tested for presence of anti-BP180-NC16A, anti-BP230 and anti-Dsg1/3 IgG by indirect immunofluorescence (IF) microscopy using a biochip. RESULTS Cumulative prevalence of these autoantibodies was 0.9 % (CI: 0.7-1.1 %), with anti-BP180-NC16A IgG being most prevalent. Validation of IF findings using ELISA confirmed presence of autoantibodies in 7/15 (anti-Dsg1), 6/7 (anti-Dsg3), 35/37 (anti-BP180-NC16A) and 2/3 (anti-BP230) cases. Moreover, in 16 samples, anti-BP180-NC16A autoantibody concentrations exceeded the cut-off for the diagnosis of bullous pemphigoid. Interestingly, these anti-BP180-NC16A autoantibodies from healthy individuals formed immune complexes with recombinant antigen and dose-dependently activated neutrophils in vitro. However, fine-epitope mapping within NC16A showed a different binding pattern of anti-BP180-NC16A autoantibodies from healthy individuals compared to bullous pemphigoid patients, while IgG subclasses were identical. CONCLUSIONS Collectively, we here report a low prevalence of AIBD autoantibodies in a large cohort of healthy individuals. Furthermore, functional analysis shows differences between autoantibodies from healthy donors and AIBD patients.
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Affiliation(s)
- Wiebke Prüßmann
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.
| | - Jasper Prüßmann
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.
| | - Hiroshi Koga
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.
| | - Andreas Recke
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.
| | - Hiroaki Iwata
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
| | - David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck and Kiel, Germany.
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck and Kiel, Germany.
| | - Reinhard Henschler
- Transfusion Medicine, Cellular Therapeutics and Hemostaseology, Clinics of the Ludwigs-Maximilians-University Munich, Munich, Germany.
| | - Takashi Hashimoto
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan.
| | - Enno Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
| | - Detlef Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.
| | - Saleh M Ibrahim
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.
| | - Ralf J Ludwig
- Department of Dermatology, University of Lübeck, Lübeck, Germany.
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.
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Wittig M, Anmarkrud JA, Kässens JC, Koch S, Forster M, Ellinghaus E, Hov JR, Sauer S, Schimmler M, Ziemann M, Görg S, Jacob F, Karlsen TH, Franke A. Development of a high-resolution NGS-based HLA-typing and analysis pipeline. Nucleic Acids Res 2015; 43:e70. [PMID: 25753671 PMCID: PMC4477639 DOI: 10.1093/nar/gkv184] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 02/23/2015] [Indexed: 01/06/2023] Open
Abstract
The human leukocyte antigen (HLA) complex contains the most polymorphic genes in the human genome. The classical HLA class I and II genes define the specificity of adaptive immune responses. Genetic variation at the HLA genes is associated with susceptibility to autoimmune and infectious diseases and plays a major role in transplantation medicine and immunology. Currently, the HLA genes are characterized using Sanger- or next-generation sequencing (NGS) of a limited amplicon repertoire or labeled oligonucleotides for allele-specific sequences. High-quality NGS-based methods are in proprietary use and not publicly available. Here, we introduce the first highly automated open-kit/open-source HLA-typing method for NGS. The method employs in-solution targeted capturing of the classical class I (HLA-A, HLA-B, HLA-C) and class II HLA genes (HLA-DRB1, HLA-DQA1, HLA-DQB1, HLA-DPA1, HLA-DPB1). The calling algorithm allows for highly confident allele-calling to three-field resolution (cDNA nucleotide variants). The method was validated on 357 commercially available DNA samples with known HLA alleles obtained by classical typing. Our results showed on average an accurate allele call rate of 0.99 in a fully automated manner, identifying also errors in the reference data. Finally, our method provides the flexibility to add further enrichment target regions.
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Affiliation(s)
- Michael Wittig
- Christian-Albrechts-University of Kiel, Institute of Clinical Molecular Biology, Kiel, Germany
| | - Jarl A Anmarkrud
- Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway K.G. Jebsen Inflammation Research Center, Institute of Clinical Medicine, University of Oslo, Oslo, Norway Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Jan C Kässens
- Christian-Albrechts-University of Kiel, Department of Computer Science, Kiel, Germany
| | - Simon Koch
- Muthesius Academy of Fine Arts and Design, Kiel, Germany
| | - Michael Forster
- Christian-Albrechts-University of Kiel, Institute of Clinical Molecular Biology, Kiel, Germany
| | - Eva Ellinghaus
- Christian-Albrechts-University of Kiel, Institute of Clinical Molecular Biology, Kiel, Germany
| | - Johannes R Hov
- Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway K.G. Jebsen Inflammation Research Center, Institute of Clinical Medicine, University of Oslo, Oslo, Norway Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway Section of Gastroenterology, Department of Transplantation Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Sascha Sauer
- Max-Planck Institute for Molecular Genetics, Berlin, Germany
| | - Manfred Schimmler
- Christian-Albrechts-University of Kiel, Department of Computer Science, Kiel, Germany
| | - Malte Ziemann
- University of Lübeck, Institute of Transfusion Medicine, Lübeck, Germany
| | - Siegfried Görg
- University of Lübeck, Institute of Transfusion Medicine, Lübeck, Germany
| | - Frank Jacob
- Muthesius Academy of Fine Arts and Design, Kiel, Germany
| | - Tom H Karlsen
- Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway K.G. Jebsen Inflammation Research Center, Institute of Clinical Medicine, University of Oslo, Oslo, Norway Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway Section of Gastroenterology, Department of Transplantation Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Andre Franke
- Christian-Albrechts-University of Kiel, Institute of Clinical Molecular Biology, Kiel, Germany
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Prüßmann J, Prüßmann W, Recke A, Rentzsch K, Juhl D, Henschler R, Müller S, Lamprecht P, Schmidt E, Csernok E, Görg S, Stöcker W, Zillikens D, Ibrahim SM, Ludwig RJ. Co-occurrence of autoantibodies in healthy blood donors. Exp Dermatol 2014; 23:519-21. [DOI: 10.1111/exd.12445] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Jasper Prüßmann
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | - Wiebke Prüßmann
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | - Andreas Recke
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | | | - David Juhl
- Institute of Transfusion Medicine; University Hospital of Schleswig-Holstein; Lübeck and Kiel Germany
| | - Reinhard Henschler
- Institute of Transfusion Medicine and Immune Hematology; German Red Cross Blood Donor Service Baden-Württemberg - Hessen; Clinics of the Goethe University; Frankfurt Germany
- Transfusion Medicine, Cellular Therapeutics and Hemostaseology; Clinics of the Ludwigs-Maximilians-University Munich; München Germany
| | - Susen Müller
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | - Peter Lamprecht
- Department of Rheumatology and Vasculitis Center; Clinical Center Bad Bramstedt; University of Lübeck; Lübeck Germany
| | - Enno Schmidt
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | - Elena Csernok
- Department of Rheumatology and Vasculitis Center; Clinical Center Bad Bramstedt; University of Lübeck; Lübeck Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine; University Hospital of Schleswig-Holstein; Lübeck and Kiel Germany
| | | | | | | | - Ralf J. Ludwig
- Department of Dermatology; University of Lübeck; Lübeck Germany
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Juhl D, Görg S, Hennig H. Persistence of Parvovirus B19 (B19V) DNA and humoral immune response in B19V-infected blood donors. Vox Sang 2014; 107:226-32. [PMID: 24916600 DOI: 10.1111/vox.12162] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/30/2014] [Accepted: 05/07/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Parvovirus B19 (B19V) DNA seems to persist in the plasma of B19V-infected blood donors. The relevance of this for recipients of single-donor blood components is yet unclear. MATERIAL AND METHODS We studied serial archive and follow-up samples from 75 B19V-infected blood donors to obtain more data about the duration and degree of viraemia and the presence of IgG and IgM anti-B19V. IgG antibodies were further characterized by Western blot analysis in 29 donors. RESULTS In 411 B19V DNA-positive samples collected, we found high concentrations (>10(6) IU B19V DNA/ml plasma) in five. B19V DNA persisted for a mean of 21·5 months (range: 2·3-52·4; 95% confidence interval, 19·1-23·9 months) in all donors. Only 15 such samples had either no or low-titre IgG anti-B19V. IgG antibodies were predominantly directed against epitopes on the minor capsid protein VP1, thus probably of neutralizing type with high avidity. IgM anti-B19V was detectable in 9/13 samples with high DNA concentrations. CONCLUSIONS The vast majority of single-donor blood components with detectable B19V DNA are probably not infectious for their recipients because DNA is at only low levels and the donors also have potentially neutralizing antibodies with high avidity. Anti-B19V IgM testing does not identify every donation with high B19V DNA concentrations, but, in addition to B19V NAT testing, donors with persistent IgG anti-B19V might be considered 'B19V-safe' for single-donor blood components.
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Affiliation(s)
- D Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
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Juhl D, Steppat D, Görg S, Hennig H. Parvovirus b19 infections and blood counts in blood donors. ACTA ACUST UNITED AC 2013; 41:52-9. [PMID: 24659948 DOI: 10.1159/000357650] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 11/22/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Parvovirus B19 (B19V) is a transfusion-transmissible virus. To obtain data about the prevalence, incidence, the course of B19V infection in blood donors and whether B19V might impair their blood counts, samples from blood donors with B19V infection were investigated. METHODS Blood donations were screened for B19V DNA using the Cobas TaqScreen DPX Test® in mini-pools. B19V DNA concentration, anti-B19V IgG antibody titer and blood counts were determined in positive donors. RESULTS 157/23,889 (0.66%) donors provided 347 B19V DNA-positive samples. Prevalence of B19V infection was 0.45%, incidence 0.20%. B19V DNA concentrations were predominantly low; only in 8 samples were viral loads of ≥10(5) IU B19V DNA/ml plasma detectable. Besides a slight decrease in hemoglobin, hematocrit, mean corpuscular volume, mean cellular hemoglobin and mean hemoglobin concentration, no major differences in blood counts occurred in B19V DNA-positive samples. In samples with a low B19V DNA concentration, anti-B19V IgG titers were rather high. 98 donors provided at least 1 B19V DNA-positive follow-up sample, indicating a prolonged viremia. CONCLUSIONS B19V infection induced no major impairment in the blood counts. In donors with low-level viremia, infectivity through their donations is probably reduced by high antibody titers. Low-level viremia is prolonged, probably exceeding 1 year in many cases.
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Affiliation(s)
- David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Dagmar Steppat
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Holger Hennig
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
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Jung W, Prüßmann J, Recke A, Rentzsch K, Juhl D, Henschler R, Müller S, Lamprecht P, Schmidt E, Csernok E, Görg S, Stöcker W, Zillikens D, Ibrahim S, Ludwig R. AB0734 Prevalence and co-occurrence of autoantibodies in blood donors. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ziemann M, Juhl D, Görg S, Hennig H. The impact of donor cytomegalovirus DNA on transfusion strategies for at-risk patients. Transfusion 2013; 53:2183-9. [PMID: 23581526 DOI: 10.1111/trf.12199] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/11/2013] [Accepted: 02/28/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) DNA is frequently detected in plasma of newly seropositive donors. Selection of leukoreduced blood products from donors with remote CMV infection could avoid transfusion-transmitted CMV infections (TT-CMV) due to primarily infected donors. However, there are no data about the prevalence of reactivations in long-term seropositive donors compared to the incidence of window period donations in seronegative donors. Therefore, the optimal transfusion strategy for at-risk patients is unclear. STUDY DESIGN AND METHODS Whole blood samples from 22,904 donations were tested for CMV DNA, and CMV DNA-positive donations were categorized as donations from 1) seronegative donors, 2) newly seropositive donors, and 3) long-term seropositive donors. RESULTS Twenty-one donors were reproducibly CMV DNA-positive (0.09%). Frequency of detection and concentration of CMV DNA in whole blood were comparable for seronegative and long-term seropositive donors. Nonreproducibly positive results for CMV DNA in whole blood were more frequent in long-term seropositive donors (0.16% vs. 0.01%, p<0.01). Only low concentrations of CMV DNA in plasma were detectable in two seronegative donors and one long-term seropositive donor. Highest concentrations of CMV DNA in both whole blood and plasma, however, were found in newly seropositive donors. CONCLUSION Prevalences of window period donations among seronegative donors and reactivations among long-term seropositive donors, as well as the CMV DNA concentration in whole blood and plasma samples from these donors, are comparable. Therefore, blood products from both groups could be used for patients at risk for TT-CMV, while those of newly seropositive donors seem to bear an increased risk.
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Affiliation(s)
- Malte Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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Juhl D, Vockel A, Luhm J, Ziemann M, Hennig H, Görg S. Comparison of the two fully automated anti-HCMV IgG assays: Abbott Architect CMV IgG assay and Biotest anti-HCMV recombinant IgG ELISA. Transfus Med 2013; 23:187-94. [DOI: 10.1111/tme.12036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 03/08/2013] [Accepted: 03/12/2013] [Indexed: 11/27/2022]
Affiliation(s)
- D. Juhl
- Institute of Transfusion Medicine; University Hospital of Schleswig-Holstein; Lübeck/Kiel; Germany
| | - A. Vockel
- Abbott GmbH & Co. KG; Wiesbaden; Germany
| | - J. Luhm
- Institute of Transfusion Medicine; University Hospital of Schleswig-Holstein; Lübeck/Kiel; Germany
| | - M. Ziemann
- Institute of Transfusion Medicine; University Hospital of Schleswig-Holstein; Lübeck/Kiel; Germany
| | - H. Hennig
- Institute of Transfusion Medicine; University Hospital of Schleswig-Holstein; Lübeck/Kiel; Germany
| | - S. Görg
- Institute of Transfusion Medicine; University Hospital of Schleswig-Holstein; Lübeck/Kiel; Germany
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35
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Juhl D, Baylis SA, Blümel J, Görg S, Hennig H. Seroprevalence and incidence of hepatitis E virus infection in German blood donors. Transfusion 2013; 54:49-56. [PMID: 23441647 DOI: 10.1111/trf.12121] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 11/29/2012] [Accepted: 12/15/2012] [Indexed: 01/10/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) is transmissible by transfusion. More data are needed about seroprevalence, incidence, and viremia in blood donors for the assessment of risk of transfusion-transmitted (TT)-HEV infections. STUDY DESIGN AND METHODS Samples from 1019 whole blood donors were tested for anti-HEV immunoglobulin (Ig)G by enzyme-linked immunosorbent assay and Western blot. The incidence of HEV and presence of HEV RNA in donors who seroconverted were determined by testing archive samples and recipients of viremic donations were traced. Anti-HEV IgM and alanine transaminase (ALT) testing were also performed to assess the value of such measures in the prevention of TT-HEV infections. RESULTS A total of 69 of 1019 donors tested positive for anti-HEV IgG (6.8% seroprevalence), and seroconversion for anti-HEV IgG occurred in seven of 69 donors within 2 years (incidence, 0.35%/year). Three of seven (42.8%) seroconverting donors provided an archive sample in which HEV RNA was detectable. One recipient of these donations was traceable; anti-HEV IgG, IgM, and HEV RNA testing were negative 41 days after transfusion. Neither ALT levels nor anti-HEV IgM detection correlated with the presence of HEV RNA. CONCLUSIONS The seroprevalence of HEV was 6.8%, and the annual incidence 0.35%. HEV RNA was detectable in several seroconverting donors, without evidence for HEV transmission in the only traceable recipient. Since neither ALT nor anti-HEV IgM testing correlate with the presence of HEV RNA, HEV nucleic acid testing currently provides the only method for the prevention of TT-HEV infection. However, before implementation, more data about clinical relevance of TT-HEV infections and infectious dose of HEV are required.
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Affiliation(s)
- David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany; Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
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Ziemann M, Heuft HG, Frank K, Kraas S, Görg S, Hennig H. Window period donations during primary cytomegalovirus infection and risk of transfusion-transmitted infections. Transfusion 2013; 53:1088-94. [DOI: 10.1111/trf.12074] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 07/20/2012] [Accepted: 07/23/2012] [Indexed: 11/30/2022]
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Bünger S, Barow M, Thorns C, Freitag-Wolf S, Danner S, Tiede S, Pries R, Görg S, Bruch HP, Roblick U, Kruse C, Habermann J. Pancreatic Carcinoma Cell Lines Reflect Frequency and Variability of Cancer Stem Cell Markers in Clinical Tissue. Eur Surg Res 2012; 49:88-98. [DOI: 10.1159/000341669] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 07/05/2012] [Indexed: 12/20/2022]
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Ziemann M, Schönemann C, Bern C, Lachmann N, Nitschke M, Fricke L, Görg S. Prognostic value and cost-effectiveness of different screening strategies for HLA antibodies prior to kidney transplantation. Clin Transplant 2012; 26:644-56. [DOI: 10.1111/j.1399-0012.2012.01615.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Malte Ziemann
- Institute of Transfusion Medicine; University Hospital Schleswig-Holstein; Lübeck; Germany
| | - Constanze Schönemann
- Institute of Transfusion Medicine; Charité; Campus Virchow Hospital; Berlin; Germany
| | - Christina Bern
- Institute of Transfusion Medicine; University Hospital Schleswig-Holstein; Lübeck; Germany
| | - Nils Lachmann
- Institute of Transfusion Medicine; Charité; Campus Virchow Hospital; Berlin; Germany
| | - Martin Nitschke
- Transplantation Center; University Hospital Schleswig-Holstein; Lübeck; Germany
| | - Lutz Fricke
- Transplantation Center; University Hospital Schleswig-Holstein; Lübeck; Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine; University Hospital Schleswig-Holstein; Lübeck; Germany
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Juhl D, Luhm J, Görg S, Ziemann M, Hennig H. Evaluation of algorithms for the diagnostic assessment and the reentry of blood donors who tested reactive for antibodies against hepatitis B core antigen. Transfusion 2011; 51:1477-85. [DOI: 10.1111/j.1537-2995.2010.03031.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Schulze TJ, Weiß C, Luhm J, Brockmann C, Görg S, Hennig H. Preanalytical stability of HIV-1 and HCV RNA: impact of storage and plasma separation from cells on blood donation testing by NAT. Transfus Med 2010; 21:99-106. [DOI: 10.1111/j.1365-3148.2010.01051.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
BACKGROUND AND OBJECTIVES As cytomegalovirus (CMV) DNA is frequently detectable in the plasma of recently infected sero-positive blood donors, information concerning primary CMV infection is important for the identification of possibly infectious donors. MATERIALS AND METHODS Monitoring of 17 982 donors for CMV antibodies and DNA in plasma identified 14 subjects with ongoing primary CMV infection. Thirteen donors were interrogated for possible sources of infection and CMV-related symptoms, and monitored for CMV antigens, CMV DNA in plasma, leucocytes and urine, course of IgG and IgM antibodies as well as markers of systemic infection and parameters of organ function. RESULTS CMV antigens and DNA were detectable in peripheral blood for up to 54 and 269 days respectively. Clearance of CMV DNA from blood correlated with clearance of IgM antibodies, development of IgG antibodies against the membrane glycoprotein gB and development of high avidity IgG antibodies. Eighty-five percent of subjects with primary CMV infection, but even 69% of matched controls reported possibly CMV-related symptoms. Sixty-two and 23%, respectively, had contact with possible sources of infection. One donor developed a febrile illness accompanied by increased levels of CMV DNA in peripheral blood 2 to 3 weeks after seroconversion. In other donors, neither markers of systemic infection nor parameters of organ function correlated with the course of CMV DNA and antigens. CONCLUSION Potentially infectious donors can be identified by measuring CMV DNA, IgM antibodies or avidity of IgG antibodies. Alternatively, blood products donated during the first year after seroconversion should not be used for immunocompromised patients.
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Affiliation(s)
- M Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany.
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Machens HG, Pabst A, Dreyer M, Gliemroth J, Görg S, Bahlmann L, Klaus S, Kaun M, Krü Ger S, Mailänder P. C3a levels and occurrence of subdermal vascular thrombosis are age-related in deep second-degree burn wounds. Surgery 2006; 139:550-5. [PMID: 16627066 DOI: 10.1016/j.surg.2005.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2005] [Revised: 07/28/2005] [Accepted: 09/10/2005] [Indexed: 11/17/2022]
Abstract
BACKGROUND After second-degree burns, thrombosis of the subdermal vascular plexus may occur, necessitating epifascial necrectomy instead of tangential excision to ensure split skin graft healing. Until now, no parameter has been obtained to explain this phenomenon. METHODS Thirty-four patients with deep second-degree burn wounds were divided into 2 groups. In group 1, patients' age was < 60 years, in group 2, > 60 years. In each patient, 2 microdialysis catheters were introduced into subdermal tissue of deep second-degree thermal wounds immediately after admission. Another 2 catheters were introduced in control tissue. We measured biochemical parameters (lactate, glycerol and glucose) and complement 3a (C3a) until surgery was performed. The surgically removed tissue was examined histologically. RESULTS In thermal wounds of both groups, glucose levels fell, but lactate and glycerol levels rose compared to healthy tissue. Within the first 24 hours after trauma, C3a levels were significant higher in both groups, compared with controls (P < .01). After 24 hours the levels in group 1 had fallen to nonsignificant values, while in group 2 these levels remained high until surgery was performed (P < .001). We found significantly more thrombotic blood vessels in deep dermal tissue of group 2 (P < .005). Abbreviated burn severity index score was comparable in both groups. CONCLUSIONS C3a is continuously elevated in deep second-degree burned wounds in patients > 60 years. This finding may be related to the occurrence of significantly more thrombotic blood vessels in deep dermal tissue of elderly patients. Microdialysis therapy is a useful tool to measure metabolic and immunologic parameters in thermally damaged tissue.
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Abstract
BACKGROUND In some situations, the administration of D+ RBCs to D- patients is necessary. The probability of a subsequent anti-D formation is assumed to be around 80 percent, a figure based primarily on studies in healthy volunteers. It was hypothesized that patients requiring blood transfusion have a much lower probability of developing antibodies. STUDY DESIGN AND METHODS A retrospective analysis was performed whereby 78 D- patients were evaluated for the development of RBC antibodies after administration of D+ RBCs. For the analysis of the cross-sectional observations, parametric models were used for interval-censored data. RESULTS Anti-D was detected in 16 of 78 patients. Considering the individual patient's inspection times, the calculated probability of developing antibody following D+ RBC supply was shown to be below 41.7 percent (upper 95% confidence bound) and estimated as 30.4 percent. The data hinted toward an inverse correlation between the number of transfused units and the probability of antibody formation. Interestingly, 6 of these 16 patients developed additional IgG autoantibody. In 3 of those cases, evidence for prolonged hemolysis was found. CONCLUSION The actual frequency of antibody formation in our patients is much lower than assumed. On the other hand, prolonged hemolysis probably induced by additional autoreactive antibodies might occur. This possible complication has not yet been addressed. Further studies might reveal whether a less restricted transfusion policy with respect to D matching is justified in selected patients.
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Affiliation(s)
- Christoph Frohn
- Institute of Immunology and Transfusion Medicine, University of Lübeck, Lübeck, Germany.
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Wilhelm D, Fiebelkorn A, Görg S, Klouche M, Klüter H, Kirchner H. Immediate-type hypersensitivity reactions after platelet transfusion. Beitr Infusionsther Transfusionsmed 1998; 32:448-52. [PMID: 9422125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Non-febrile non-haemolytic transfusion reactions (NHTR) after platelet substitution vary from severe (anaphylactic shock) to mild (urticaria) forms. Although the symptoms of these immediate-type hypersensitivity reactions are well documented, little is known about their pathophysiology. We therefore examined sera from patients suffering from different forms of NHTR regarding total serum IgE, specific IgE antibodies and complement activity. Our results show that specific IgE antibodies in the recipients' sera were clearly associated with immediate-type hypersensitivity NHTR and conclude that atopic patients have a higher risk of suffering from these forms of transfusion reactions than non-atopic patients. Allergy diagnostic for patients who require platelet transfusions should be considered in case of multiple platelet substitution.
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Affiliation(s)
- D Wilhelm
- Institute of Immunology and Transfusion Medicine, University of Lübeck, Germany
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Görg S, Niederstadt C, Klouche M, Rob PM, Steinhoff J, Kirchner H, Sack K. [Intestinal vasculitis and glomerulonephritis in hepatitis C- associated cryoglobulinemia]. Immun Infekt 1995; 23:29-31. [PMID: 7698812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In a 53-year-old female patient with recurrent, sometimes bloody diarrhea, the long standing diagnosis of an ANA-negative lupus erythematosus with membranoproliferative glomerulonephritis, leucocytoclastic vasculitis and chronic hepatitis was ruled out and the diagnosis of a hepatitis C associated cryoglobulinaemia was established. The origin of the diarrhea was due to intestinal vasculitis as a result of cold food or beverages.
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Affiliation(s)
- S Görg
- Klinik für Innere Medizin, Medizinischen Universität zu Lübeck
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Abstract
Although structure, biologic activities, and expression of the low-affinity IgE receptor (FceRII, CD23) have been investigated, the diagnostic value for allergies of this molecule and its soluble circulating fragment (sCD23) remains unclear. Therefore, serum sCD23 levels were measured in 203 blood donors. They were divided into atopic and nonatopic subjects by allergy history, physical findings of allergic symptoms, and corresponding specific circulating IgE antibodies. The group consisting of nonatopic subjects was divided into four age categories in order to exclude age-dependent variations in the expression of the low-affinity IgE receptor. In our study population, sCD23 serum levels were not influenced by age. Furthermore, no significant differences, especially no decrease in serum sCD23 levels, between the four nonatopic age groups were detected. There was no significant increase of sCD23 serum levels in atopic subjects in comparison with nonatopic blood donors. In addition, no correlation between total IgE levels and sCD23 serum levels could be detected, in either the group of atopic donors or the group of nonatopics. Our data suggest that the circulating low-affinity IgE receptor does not appear to be an additional general marker for the diagnosis of allergies, as previously suggested.
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Affiliation(s)
- D Wilhelm
- Institute of Immunology and Transfusion Medicine, University of Lübeck, School of Medicine, Germany
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Abstract
To test tetanus immunity, tetanus antitoxin titres were measured in the serum of 692 subjects (354 males, 338 females), aged one day (newborns) to 92 years (mean age 29 years). Those aged 18 to 65 years were first-time blood donors, the remainder were healthy newborns, while the children and those over 65 years were patients without immune-compromising disease. An inadequate protection (titre < 0.1 IU/ml) was found in 107 (15.5%), of whom 75 (70%) were females. Women aged 20 years and above also had significantly lower average antitoxin titres than men (1.7 vs. 3.5 IU/ml); P < 0.0001). The inadequate immunization protection of many young women is reflected in the lack of protective antibodies in 10 of the 49 examined newborns. In addition, 18% of children aged between 1 and 15 years had inadequate immunity against tetanus. In the whole group the titre level decreased with age, while the proportion of unprotected persons increased. Apart from the obvious age and sex dependency of the demonstrated inadequacy of immunological protection against tetanus, attention should also be paid to the lack of protective antibodies in newborns and the marked gaps of immunity among children.
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Affiliation(s)
- M Klouche
- Institut für Immunologie und Transfusionsmedizin, Medizinischen Universität Lübeck
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Görg S, Klouche M, Wilhelm D, Kirchner H. [Interferon alpha antibodies show no cross reactions with typical autoantibodies]. Immun Infekt 1993; 21 Suppl 1:54-6. [PMID: 8344695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Patients treated with natural human interferon alpha develop anti-interferon antibodies (IFN-AB) only in very rare cases. By contrast, patients with autoimmune disorders are able to generate high-titered IFN-AB against endogenous interferon alpha. One explanation for the development of auto-IFN-AB could be cross-reactivity with typical autoimmune antigens. We investigated the cross-reactivity of 3 high-titered IgG IFN-AB of female autoimmune patients (aged 32, 36, 74 years; two severe cases of SLE, one case of autoimmune thyroiditis) as well as 25 low-titered natural IgM IFN-AB of healthy blood donors (aged 19-48 years). Typical autoimmune antigens including dsDNA, ENA, as well as natural interferon beta and recombinant interferon gamma are not able to inhibit binding of IFN-AB to interferon alpha in an ELISA test system. Preincubation of sera containing either dsDNA antibodies (dsDNA-AB) (24 patients), thyroid peroxidase (TPO-AB) (9 patients) or thyroglobulin (TG-AB) (12 patients) with interferon alpha resulted in no change in the respective autoantibody titer. These data suggest that there is no cross-reactivity between IFN-alpha-AB and dsDNA-AB, TPO-AB or TG-AB. Thus, an explanation for the occurrence of IFN-AB in autoimmune disorders cannot be found in a cross-reaction between interferon alpha with typical autoimmune antigens.
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Affiliation(s)
- S Görg
- Institut für Immunologie und Transfusionsmedizin, Medizinische Universität zu Lübeck
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Frohn H, Görg S, Priwitzer A. New pentafluorophenyliodine(III) and (V) compounds. J Fluor Chem 1992. [DOI: 10.1016/s0022-1139(00)80782-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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