1
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Weinig E, Rink G, Stürtzel A, Seyboth S, Grüger D, Schneeweiß C, Weinstock C, Scharberg EA, Bugert P. KNMB, a novel Knops blood group antigen located in LHR-C. Transfusion 2023; 63:E56-E58. [PMID: 37702281 DOI: 10.1111/trf.17541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Elke Weinig
- Institute of Transfusion Medicine and Gene Therapy, Medical Center-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabi Rink
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
- German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Annette Stürtzel
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hessen, Baden-Baden, Germany
| | - Susanne Seyboth
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hessen, Baden-Baden, Germany
| | | | | | - Christof Weinstock
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Service Baden-Württemberg - Hessen, Ulm, Germany
| | | | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
- German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
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2
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Gassner C, Castilho L, Chen Q, Clausen FB, Denomme GA, Flegel WA, Gleadall N, Hellberg Å, Ji Y, Keller MA, Lane WJ, Ligthart P, Lomas-Francis C, Nogues N, Olsson ML, Peyrard T, Storry JR, Tani Y, Thornton N, van der Schoot E, Veldhuisen B, Wagner F, Weinstock C, Wendel S, Westhoff C, Yahalom V, Hyland CA. International Society of Blood Transfusion Working Party on Red Cell Immunogenetics and Blood Group Terminology Report of Basel and three virtual business meetings: Update on blood group systems. Vox Sang 2022; 117:1332-1344. [PMID: 36121188 PMCID: PMC10680040 DOI: 10.1111/vox.13361] [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] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Under the ISBT, the Working Party (WP) for Red Cell Immunogenetics and Blood Group Terminology is charged with ratifying blood group systems, antigens and alleles. This report presents the outcomes from four WP business meetings, one located in Basel in 2019 and three held as virtual meetings during the COVID-19 pandemic in 2020 and 2021. MATERIALS AND METHODS As in previous meetings, matters pertaining to blood group antigen nomenclature were discussed. New blood group systems and antigens were approved and named according to the serologic, genetic, biochemical and cell biological evidence presented. RESULTS Seven new blood group systems, KANNO (defined numerically as ISBT 037), SID (038), CTL2 (039), PEL (040), MAM (041), EMM (042) and ABCC1 (043) were ratified. Two (039 and 043) were de novo discoveries, and the remainder comprised reported antigens where the causal genes were previously unknown. A further 15 blood group antigens were added to the existing blood group systems: MNS (002), RH (004), LU (005), DI (010), SC (013), GE (020), KN (022), JMH (026) and RHAG (030). CONCLUSION The ISBT now recognizes 378 antigens, of which 345 are clustered within 43 blood group systems while 33 still have an unknown genetic basis. The ongoing discovery of new blood group systems and antigens underscores the diverse and complex biology of the red cell membrane. The WP continues to update the blood group antigen tables and the allele nomenclature tables. These can be found on the ISBT website (http://www.isbtweb.org/working-parties/red-cell-immunogenetics-and-blood-group-terminology/).
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Affiliation(s)
- Christoph Gassner
- Institute of Translational Medicine, Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| | | | - Qing Chen
- Jiangsu Province Blood Center, Nanjing, Jiangsu, China
| | - Frederik Banch Clausen
- Department of Clinical Immunology, Laboratory of Blood Genetics, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Willy A. Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Nick Gleadall
- Department of Haematology, University of Cambridge and NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
| | - Åsa Hellberg
- Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Region Skåne, Sweden
| | - Yanli Ji
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People’s Republic of China
| | | | - William J. Lane
- Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Peter Ligthart
- Department of Diagnostic Immunohematology, Sanquin, Amsterdam, The Netherlands
| | - Christine Lomas-Francis
- Laboratory of Immunohematology and Genomics, New York Blood Center Enterprise, New York, New York, USA
| | | | - Martin L. Olsson
- Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Region Skåne, Sweden
- Department of Laboratory Medicine, Division of Hematology and Transfusion Medicine, Lund University, Lund, Sweden
| | - Thierry Peyrard
- Etablissement Français du Sang Ile-de-France, Centre National de Référence pour les Groupes sanguins, Ivry-sur-Seine, France
- UMR_S1134 Inserm Université Paris Cité, Paris, France
| | - Jill R. Storry
- Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Region Skåne, Sweden
- Department of Laboratory Medicine, Division of Hematology and Transfusion Medicine, Lund University, Lund, Sweden
| | | | - Nicole Thornton
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - Ellen van der Schoot
- Department of Experimental Immunohematology, Sanquin, Amsterdam, The Netherlands
| | - Barbera Veldhuisen
- Department of Diagnostic Immunohematology, Sanquin, Amsterdam, The Netherlands
- Department of Experimental Immunohematology, Sanquin, Amsterdam, The Netherlands
| | - Franz Wagner
- German Red Cross Blood Service NSTOB, Springe, Germany
- MVZ Clementinenkrankenhaus, Springe, Germany
| | - Christof Weinstock
- Department of Transfusion Medicine, Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Service, Ulm, Germany
| | | | - Connie Westhoff
- Laboratory of Immunohematology and Genomics, New York Blood Center Enterprise, New York, New York, USA
| | - Vered Yahalom
- Rabin Medical Center, Petach Tiqva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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3
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Weinstock C, Vogeser M. Die Verordnung (EU) 2017/746 des Europäischen
Parlaments über In-vitro-Diagnostika. Transfusionsmedizin 2022. [DOI: 10.1055/a-1720-8231] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
ZusammenfassungVon den klinisch tätigen medizinischen Akteuren nahezu unbemerkt trat am
26. Mai 2017 die vom Europaparlament verabschiedete Verordnung (EU)
2017/746 über In-vitro-Diagnostika in Kraft. Die Verordnung
löste die im Jahr 1998 von der Europäischen Gemeinschaft
verabschiedete Richtlinie 98/79/EG ab, in der damals
grundlegende Anforderungen an die Herstellung und Zulassung und an das
Inverkehrbringen von In-vitro-Diagnostika formuliert wurden. Dieser Beitrag
beschreibt die Neuerungen für industrielle Hersteller und für
Labore, die selbst In-vitro-Diagnostika herstellen (Eigenherstellung).
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Affiliation(s)
- Christof Weinstock
- DRK-Blutspendedienst Baden-Württemberg – Hessen,
Institut Ulm; Institut für Klinische Transfusionsmedizin und
Immungenetik, Ulm; Abteilung Transfusionsmedizin, Universität Ulm,
Ulm
| | - Michael Vogeser
- Institut für Laboratoriumsmedizin, Klinikum der
Universität München
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4
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Janda A, Engel C, Remppis J, Enkel S, Peter A, Hörber S, Ganzenmueller T, Schober S, Weinstock C, Jacobsen EM, Fabricius D, Zernickel M, Stamminger T, Dietz A, Groß HJ, Bode SFN, Haddad ADM, Elling R, Stich M, Tönshoff B, Henneke P, Debatin KM, Franz AR, Renk H. Role of ABO Blood Group in SARS-CoV-2 Infection in Households. Front Microbiol 2022; 13:857965. [PMID: 35602077 PMCID: PMC9120758 DOI: 10.3389/fmicb.2022.857965] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/19/2022] [Accepted: 02/28/2022] [Indexed: 12/30/2022] Open
Abstract
An association between certain ABO/Rh blood groups and susceptibility to SARS-CoV-2 infection has been proposed for adults, although this remains controversial. In children and adolescents, the relationship is unclear due to a lack of robust data. Here, we investigated the association of ABO/Rh blood groups and SARS-CoV-2 in a multi-center study comprising 163 households with 281 children and 355 adults and at least one SARS-CoV-2 seropositive individual as determined by three independent assays as a proxy for previous infection. In line with previous findings, we found a higher frequency of blood group A (+ 6%) and a lower frequency of blood group O (−6%) among the SARS-CoV-2 seropositive adults compared to the seronegative ones. This trend was not seen in children. In contrast, SARS-CoV-2 seropositive children had a significantly lower frequency of Rh-positive blood groups. ABO compatibility did not seem to play a role in SARS-CoV-2 transmission within the families. A correction for family clusters was performed and estimated fixed effects of the blood group on the risk of SARS-CoV-2 seropositivity and symptomatic infection were determined. Although we found a different distribution of blood groups in seropositive individuals compared to the reference population, the risk of SARS-CoV-2 seropositivity or symptomatic infection was not increased in children or in adults with blood group A or AB versus O or B. Increasing age was the only parameter positively correlating with the risk of SARS-CoV-2 infection. In conclusion, specific ABO/Rh blood groups and ABO compatibility appear not to predispose for SARS-CoV-2 susceptibility in children.
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Affiliation(s)
- Ales Janda
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Corinna Engel
- Center for Pediatric Clinical Studies, University Children's Hospital Tübingen, Tübingen, Germany
| | | | - Sigrid Enkel
- Center for Clinical Transfusion Medicine Tübingen, Tübingen, Germany
| | - Andreas Peter
- Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Tübingen, Germany
| | - Sebastian Hörber
- Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Tübingen, Germany
| | - Tina Ganzenmueller
- Institute for Medical Virology and Epidemiology of Viral Diseases, University Hospital Tübingen, Tübingen, Germany
| | - Sarah Schober
- University Children's Hospital Tübingen, Tübingen, Germany
| | - Christof Weinstock
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany.,Red Cross Blood Service Baden-Württemberg-Hessen, Ulm, Germany
| | - Eva-Maria Jacobsen
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Dorit Fabricius
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Maria Zernickel
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | | | - Andrea Dietz
- Institute of Virology, Ulm University Medical Center, Ulm, Germany
| | - Hans-Jürgen Groß
- Institute of Clinical Chemistry, Ulm University Medical Center, Ulm, Germany
| | - Sebastian F N Bode
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Anneke D M Haddad
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Roland Elling
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian Stich
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Philipp Henneke
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Klaus-Michael Debatin
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Axel R Franz
- Center for Pediatric Clinical Studies, University Children's Hospital Tübingen, Tübingen, Germany.,University Children's Hospital Tübingen, Tübingen, Germany
| | - Hanna Renk
- University Children's Hospital Tübingen, Tübingen, Germany
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5
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Wagner FF, Weinstock C. Terminologie der Blutgruppenantigene und -antikörper. Transfusionsmedizin 2022. [DOI: 10.1055/a-1623-9083] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungFür den Austausch von immunhämatologischen Befunden und für die Versorgung mit Blutpräparaten ist es erforderlich, dass alle Beteiligten das Gleiche meinen, wenn sie über
Blutgruppenantigene und Antikörper sprechen. Eine Arbeitsgruppe der International Society of Blood Transfusion (ISBT) erarbeitet die dafür erforderliche Terminologie und passt diese den
neuen Erkenntnissen regelmäßig an. Dieser Beitrag berichtet über den aktuellen Stand der international gebräuchlichen Terminologie der Blutgruppenantigene und die Empfehlungen der deutschen
Richtlinie.
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Affiliation(s)
- Franz F. Wagner
- Zentralinstitut Springe, DRK-Blutspendedienst NSTOB, Springe, Deutschland
- MVZ Clementinenkrankenhaus, Springe, Deutschland
| | - Christof Weinstock
- DRK-Blutspendedienst Baden-Württemberg – Hessen, Institut für Klinische Transfusionsmedizin und Immungenetik Ulm; Abteilung Transfusionsmedizin, Universität Ulm, Ulm,
Deutschland
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6
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Clausen FB, Hellberg Å, Bein G, Bugert P, Schwartz D, Drnovsek TD, Finning K, Guz K, Haimila K, Henny C, O’Brien H, Orzinska A, Sørensen K, Thorlacius S, Wikman A, Denomme GA, Flegel WA, Gassner C, de Haas M, Hyland C, Ji Y, Lane WJ, Nogués N, Olsson ML, Peyrard T, van der Schoot CE, Weinstock C, Legler T. Recommendation for validation and quality assurance of non-invasive prenatal testing for foetal blood groups and implications for IVD risk classification according to EU regulations. Vox Sang 2022; 117:157-165. [PMID: 34155647 PMCID: PMC10686716 DOI: 10.1111/vox.13172] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/20/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Non-invasive assays for predicting foetal blood group status in pregnancy serve as valuable clinical tools in the management of pregnancies at risk of detrimental consequences due to blood group antigen incompatibility. To secure clinical applicability, assays for non-invasive prenatal testing of foetal blood groups need to follow strict rules for validation and quality assurance. Here, we present a multi-national position paper with specific recommendations for validation and quality assurance for such assays and discuss their risk classification according to EU regulations. MATERIALS AND METHODS We reviewed the literature covering validation for in-vitro diagnostic (IVD) assays in general and for non-invasive foetal RHD genotyping in particular. Recommendations were based on the result of discussions between co-authors. RESULTS In relation to Annex VIII of the In-Vitro-Diagnostic Medical Device Regulation 2017/746 of the European Parliament and the Council, assays for non-invasive prenatal testing of foetal blood groups are risk class D devices. In our opinion, screening for targeted anti-D prophylaxis for non-immunized RhD negative women should be placed under risk class C. To ensure high quality of non-invasive foetal blood group assays within and beyond the European Union, we present specific recommendations for validation and quality assurance in terms of analytical detection limit, range and linearity, precision, robustness, pre-analytics and use of controls in routine testing. With respect to immunized women, different requirements for validation and IVD risk classification are discussed. CONCLUSION These recommendations should be followed to ensure appropriate assay performance and applicability for clinical use of both commercial and in-house assays.
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Affiliation(s)
- Frederik Banch Clausen
- Laboratory of Blood Genetics, Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
| | - Åsa Hellberg
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Region Skåne, Sweden
| | - Gregor Bein
- Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University, Giessen, Germany
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden Württemberg – Hessen, Mannheim, Germany
| | - Dieter Schwartz
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Kirstin Finning
- National Health Service Blood and Transplant, International Blood Group Reference Laboratory, UK
| | - Katarzyna Guz
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | | | - Helen O’Brien
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Australia
| | | | - Kirsten Sørensen
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Agneta Wikman
- Clinical Immunology and Transfusion Medicine Karolinska University Hospital and CLINTEC Karolinska Institutet, Stockholm, Sweden
| | - Gregory Andrew Denomme
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Versiti Blood Research Institute and Diagnostic Laboratories, Milwaukee, Wisconsin, USA
| | - Willy Albert Flegel
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Christoph Gassner
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Institute for Translational Medicine, Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Masja de Haas
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Department of Immunohaematology Diagnostic Services, Sanquin Diagnostic Services and Sanquin Research, Amsterdam, The Netherlands
- Department of Haematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Catherine Hyland
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Yanli Ji
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Guangzhou Blood Center, Institute of Clinical Blood Transfusion, Guangzhou, China
| | - William J. Lane
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Núria Nogués
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Immunohematology Laboratory, Blood and Tissue Bank, Barcelona, Spain
| | - Martin L. Olsson
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Region Skåne, Sweden
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Thierry Peyrard
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Institut National de la Transfusion Sanguine, Centre National de Référence pour les Groupes Sanguins, Paris, France
| | - C. Ellen van der Schoot
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands
| | - Christof Weinstock
- cfDNA subgroup from the International Society of Blood Transfusion (ISBT) Working Party on Red Cell Immunogenetics and Blood Group Terminology (RCIBGT), Amsterdam, The Netherlands
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg-Hessen, and Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Tobias Legler
- Department of Transfusion Medicine, University Medical Center Göttingen, Göttingen, Germany
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7
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Weinstock C, Flegel WA, Srivastava K, Kaiser S, Schrezenmeier H, Tsamadou C, Ludwig C, Jahrsdörfer B, Bovin NV, Henry SM. Erytra blood group analyser and kode technology testing of SARS-CoV-2 antibodies among convalescent patients and vaccinated individuals. EJHaem 2022; 3:72-79. [PMID: 35464155 PMCID: PMC9015314 DOI: 10.1002/jha2.352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 02/05/2023]
Abstract
Surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic requires tests to monitor antibody formation and prevalence. We detected SARS-CoV-2 antibodies using red cells coated by Kode technology with short peptides derived from the SARS-CoV-2 spike protein (SP). Such modified red cells, called C19-kodecytes, can be used as reagent cells in any manual or automated column agglutination assay. We investigated the presence of SARS-CoV-2 antibodies in 130 samples from COVID-19 convalescent plasma donors using standard manual technique, two FDA-authorized enzyme-linked immunosorbent assay (ELISA) assays and a virus neutralisation assay. The sensitivity of the C19-kodecyte assay was 88%, comparable to the anti-SP and anti-nucleocapsid protein (NCP) ELISAs (86% and 83%) and the virus neutralisation assay (88%). The specificity of the C19-kodecyte assay was 90% (anti-SP 100% and anti-NCP 97%). Likewise, 231 samples from 73 vaccinated individuals were tested with an automated analyser, and we monitored the appearance and persistence of SARS-CoV-2 antibodies. The C19-kodecyte assay is a robust tool for SARS-CoV-2 antibody detection. Automated blood group analyser use enables large-scale SARS-CoV-2 antibody testing for vaccination monitoring in population surveys.
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Affiliation(s)
- Christof Weinstock
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Willy A. Flegel
- Department of Transfusion MedicineNIH Clinical Center, National Institutes of HealthBethesdaMarylandUSA
| | - Kshitij Srivastava
- Department of Transfusion MedicineNIH Clinical Center, National Institutes of HealthBethesdaMarylandUSA
| | - Sabine Kaiser
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Chrysanthi Tsamadou
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Carolin Ludwig
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Bernd Jahrsdörfer
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Nicolai V. Bovin
- Centre for Kode Technology InnovationSchool of EngineeringComputer and Mathematical Sciences, Faculty of Design and Creative TechnologiesAuckland Stephen HenryAucklandNew Zealand
| | - Stephen M. Henry
- Centre for Kode Technology InnovationSchool of EngineeringComputer and Mathematical Sciences, Faculty of Design and Creative TechnologiesAuckland Stephen HenryAucklandNew Zealand
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Abstract
In 2014, the membrane-bound protein CD59 became a blood group antigen. CD59 has been known for decades as an inhibitor of the complement system, located on erythrocytes and on many other cell types. In paroxysmal nocturnal haemoglobinuria (PNH), a stem cell clone with acquired deficiency to express GPI-anchored molecules, including the complement inhibitor CD59, causes severe and life-threatening disease. The lack of CD59, which is the only membrane-bound inhibitor of the membrane attack complex, contributes a major part of the intravascular haemolysis observed in PNH patients. This crucial effect of CD59 in PNH disease prompted studies to investigate its role in other diseases. In this review, the role of CD59 in inflammation, rheumatic disease, and age-related macular degeneration is investigated. Further, the pivotal role of CD59 in PNH and congenital CD59 deficiency is reviewed.
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9
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Weinstock C, Flegel WA, Srivastava K, Kaiser S, Schrezenmeier H, Tsamadou C, Ludwig C, Jahrsdörfer B, Bovin NV, Henry SM. Erytra Blood Group Analyser and Kode Technology testing of SARS-CoV-2 antibodies among convalescent patients and vaccinated individuals. medRxiv 2021. [PMID: 34494027 DOI: 10.1101/2021.08.26.21262219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic requires tests to monitor antibody formation and prevalence. We detected SARS-CoV-2 antibodies using red cells coated by Kode technology with short peptides derived from the SARS-CoV-2 spike protein. Such modified red cells, called C19-kodecytes, can be used as reagent cells in any manual or automated column agglutination assay. We investigated the presence of SARS-CoV-2 antibodies in 130 samples from COVID-19 convalescent plasma donors using standard manual technique, two FDA authorized ELISA assays and a virus neutralisation assay. The sensitivity of the C19-kodecyte assay was 88%, comparable to the anti-SP and anti-NCP ELISAs (86% and 83%) and the virus neutralisation assay (88%). The specificity of the C19-kodecyte assay was 90% (anti-SP 100% and anti-NCP 97%). Likewise, 231 samples from 73 vaccinated individuals were tested with an automated analyser and we monitored the appearance and persistence of SARS-CoV-2 antibodies. The C19-kodecyte assay is a robust tool for SARS-CoV-2 antibody detection. Automated blood group analyser use enables large-scale SARS-CoV-2 antibody testing for vaccination monitoring in population surveys.
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10
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Hoffmüller P, Brüggemann M, Eggermann T, Ghoreschi K, Haase D, Hofmann J, Hunfeld KP, Koch K, Meisel C, Michl P, Müller J, Müller C, Rabenau HF, Reinhardt D, Riemenschneider MJ, Sachs UJ, Sack U, Stenzinger A, Streichert T, von Neuhoff N, Weichert W, Weinstock C, Zimmermann S, Spitzenberger F. Advisory opinion of the AWMF Ad hoc Commission In-vitro Diagnostic Medical Devices regarding in-vitro diagnostic medical devices manufactured and used only within health institutions established in the Union according to Regulation (EU) 2017/746 (IVDR). Ger Med Sci 2021; 19:Doc08. [PMID: 34194291 PMCID: PMC8204380 DOI: 10.3205/000295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Indexed: 11/30/2022]
Abstract
In view of the approaching application date of Regulation (EU) 2017/746 ("IVDR") and the resulting EU-wide, harmonized requirements for in-vitro diagnostic medical devices (IVD) manufactured and used within European health institutions, the Ad hoc Commission IVD of the German Association of the Scientific Medical Societies (AWMF) takes a national position on the details of the requirements and conditions related to the use of these IVD products. The Ad hoc Commission IVD emphasizes the relevance of examination procedures developed in medical laboratories, especially in the field of orphan diseases and new diagnostic markers. The IVDR sets an adequate regulatory framework for IVD manufactured and used within health institutions as long as these requirements are fulfilled with reliability and in accordance with the current state of the art in medical laboratory sciences. At the same time, the IVDR requirements have to be regarded under a pragmatic view and in accordance with the quality management systems approved within the different EU Member States. On the one hand, the mandatory requirements of the RiLiBÄK play an essential role in Germany. On the other hand, elements of voluntarily applicable international standards may support the fulfilment of product requirements for safety and performance according to Annex I of the IVDR. Both the complexity and possible solutions for the implementation of the IVDR requirements are discussed on the basis of examples such as the required documentation, performance evaluation and software validation. The Ad hoc Commission IVD recommends that, while aiming at a preferably EU-wide harmonized interpretation of the IVDR requirements, the flexibility in medical laboratory diagnostics necessary for patient care, including the use of IVD from in-house production, should be emphasized.
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Affiliation(s)
| | - Monika Brüggemann
- Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO)
| | | | | | - Detlef Haase
- Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO)
| | | | - Klaus-Peter Hunfeld
- Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM).,Gesellschaft zur Förderung der Qualitätssicherung in medizinischen Laboratorien (INSTAND e.V.)
| | - Katharina Koch
- Gesellschaft für Toxikologische und Forensische Chemie (GTFCh)
| | | | - Patrick Michl
- Deutsche Gesellschaft für Gastroenterologie, Verdauung und Stoffwechsel (DGVS)
| | - Jens Müller
- Gesellschaft für Thrombose- und Hämostaseforschung (GTH)
| | - Carsten Müller
- Deutsche Gesellschaft für Klinische Pharmakologie und Therapie (DGKliPa).,Deutsche Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL)
| | | | - Dirk Reinhardt
- Gesellschaft für pädiatrische Onkologie und Hämatologie (GPOH)
| | | | - Ulrich J Sachs
- Gesellschaft für Thrombose- und Hämostaseforschung (GTH)
| | - Ulrich Sack
- Deutsche Gesellschaft für Immunologie (DGfI)
| | | | - Thomas Streichert
- Deutsche Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL)
| | | | | | - Christof Weinstock
- Deutsche Gesellschaft für Transfusionsmedizin und Immunhämatologie (DGTI)
| | - Stefan Zimmermann
- Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM).,Paul-Ehrlich-Gesellschaft (PEG)
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11
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Jahrsdörfer B, Kroschel J, Ludwig C, Corman VM, Schwarz T, Körper S, Rojewski M, Lotfi R, Weinstock C, Drosten C, Seifried E, Stamminger T, Groß HJ, Schrezenmeier H. Independent Side-by-Side Validation and Comparison of 4 Serological Platforms for SARS-CoV-2 Antibody Testing. J Infect Dis 2021; 223:796-801. [PMID: 33064789 PMCID: PMC7665624 DOI: 10.1093/infdis/jiaa656] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/14/2020] [Indexed: 01/09/2023] Open
Abstract
Highly sensitive and specific platforms for the detection of anti-SARS-CoV-2 antibodies are becoming increasingly important for (1) evaluating potential SARS-CoV-2 convalescent plasma donors, (2) studying the spread of SARS-CoV-2 infections and (3) identifying individuals with seroconversion. This study provides a comparative validation of four anti-SARS-CoV-2 platforms. Unique feature of this study is the use of a representative cohort of COVID-19-convalescent patients with mild-to-moderate disease course. All platforms showed significant correlations with a SARS-CoV-2 plaque-reduction-neutralization test, with highest sensitivities for the Euroimmun and the Roche platforms, suggesting their preferential use for screening of persons at increased risk of SARS-CoV-2 infections.
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Affiliation(s)
- Bernd Jahrsdörfer
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Joris Kroschel
- Institute of Clinical Chemistry, Ulm University, Ulm, Germany
| | - Carolin Ludwig
- Department of Transfusion Medicine, Ulm University, Ulm, Germany
| | - Victor Max Corman
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tatjana Schwarz
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sixten Körper
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Markus Rojewski
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Ramin Lotfi
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Christof Weinstock
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Christian Drosten
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Erhard Seifried
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, Frankfurt, Germany
| | | | | | - Hubert Schrezenmeier
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
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12
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Fürst D, Tsamadou C, Neuchel C, Schrezenmeier H, Mytilineos J, Weinstock C. Next-Generation Sequencing Technologies in Blood Group Typing. Transfus Med Hemother 2019; 47:4-13. [PMID: 32110189 DOI: 10.1159/000504765] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 08/01/2019] [Accepted: 11/07/2019] [Indexed: 12/14/2022] Open
Abstract
Sequencing of the human genome has led to the definition of the genes for most of the relevant blood group systems, and the polymorphisms responsible for most of the clinically relevant blood group antigens are characterized. Molecular blood group typing is used in situations where erythrocytes are not available or where serological testing was inconclusive or not possible due to the lack of antisera. Also, molecular testing may be more cost-effective in certain situations. Molecular typing approaches are mostly based on either PCR with specific primers, DNA hybridization, or DNA sequencing. Particularly the transition of sequencing techniques from Sanger-based sequencing to next-generation sequencing (NGS) technologies has led to exciting new possibilities in blood group genotyping. We describe briefly the currently available NGS platforms and their specifications, depict the genetic background of blood group polymorphisms, and discuss applications for NGS approaches in immunohematology. As an example, we delineate a protocol for large-scale donor blood group screening established and in use at our institution. Furthermore, we discuss technical challenges and limitations as well as the prospect for future developments, including long-read sequencing technologies.
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Affiliation(s)
- Daniel Fürst
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg/Hessen, and University Hospital Ulm, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Chrysanthi Tsamadou
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg/Hessen, and University Hospital Ulm, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Christine Neuchel
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg/Hessen, and University Hospital Ulm, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg/Hessen, and University Hospital Ulm, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Joannis Mytilineos
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg/Hessen, and University Hospital Ulm, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Christof Weinstock
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg/Hessen, and University Hospital Ulm, Ulm, Germany.,Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
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13
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Weinstock C, Schnaidt M. Human Leucocyte Antigen Sensitisation and Its Impact on Transfusion Practice. Transfus Med Hemother 2019; 46:356-369. [PMID: 31832061 DOI: 10.1159/000502158] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 04/18/2019] [Accepted: 07/13/2019] [Indexed: 01/25/2023] Open
Abstract
Human leucocyte antigen (HLA) sensitisation, including the formation of antibodies against HLA, can cause serious effects in patients receiving blood. Under certain circumstances, donor HLA antibodies in the blood product can trigger the patient's granulocytes to release mediators that cause transfusion-associated lung injury (TRALI), a serious complication of transfusion. The HLA systems of both donor and patient are involved in transfusion-associated graft-versus-host disease, which is a rare disease with a high mortality. Patient HLA antibodies can destroy incompatible platelets and may cause refractoriness to platelet transfusion. Identification of a patient's HLA antibody specificities is necessary for issuing compatible platelets to overcome refractoriness. Many techniques for the detection and identification of HLA antibodies have been developed, including complement-dependent cytotoxicity assay, bead-based assays, the platelet adhesion immunofluorescence test, and the monoclonal antibody-specific immobilisation of platelet antigens assay. Different strategies for the selection of HLA-compatible platelets are applied. These strategies depend on the breadth of antibody reactivity and range from avoiding single HLA antigens in the platelet concentrates issued to apheresis of platelets from HLA-identical donors. The mechanisms of HLA sensitisation and the efforts made to provide compatible blood products to sensitised patients are reviewed in this article from the perspective of clinical transfusion medicine.
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Affiliation(s)
- Christof Weinstock
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Ulm, Institute of Transfusion Medicine, Ulm University, Ulm, Germany
| | - Martina Schnaidt
- Centre for Clinical Transfusion Medicine, Medical Faculty of Tübingen, University of Tübingen, Tübingen, Germany
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14
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Harder MJ, Höchsmann B, Dopler A, Anliker M, Weinstock C, Skerra A, Simmet T, Schrezenmeier H, Schmidt CQ. Different Levels of Incomplete Terminal Pathway Inhibition by Eculizumab and the Clinical Response of PNH Patients. Front Immunol 2019; 10:1639. [PMID: 31379839 PMCID: PMC6657537 DOI: 10.3389/fimmu.2019.01639] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 11/09/2018] [Accepted: 07/01/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Eculizumab blocks the lytic complement pathway by inhibiting C5 and has become the standard of care for certain complement-mediated diseases. Previously, we have shown that strong complement activation in vitro overrides the C5 inhibition by Eculizumab, which accounts for residual terminal pathway activity. Results: Here we show that the levels of residual hemolysis in ex vivo assays differ markedly (up to 3.4-fold) across sera collected from different paroxysmal nocturnal hemoglobinuria (PNH) patients on Eculizumab treatment. This large variability of residual activity was also found in sera of healthy donors, thus cross-validating the findings in patients. While PNH patients with residual lytic activities of 11–30% exhibited hemolysis levels around the upper limit of normal (i.e., plasma LDH of ~250 u/L), as expected for PNH patients on Eculizumab therapy, we found sustained and markedly increased LDH levels of around 400 u/L for the patient with the highest residual activity of 37%. Furthermore, the clinical history of nine out of 14 PNH patients showed intravascular breakthrough hemolysis at the time of documented infections despite ample amounts of administered Eculizumab and/or experimentally determined excess over C5. Conclusion: The occurrence of extraordinary high levels of residual terminal pathway activity in PNH patients receiving Eculizumab is rare, but can impair the suppression of hemolysis. The commonly observed low levels of residual terminal pathway activity seen for most PNH patients can exacerbate during severe infections and, thus, can cause pharmacodynamic breakthrough hemolysis in PNH patients treated with Eculizumab.
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Affiliation(s)
- Markus J Harder
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Britta Höchsmann
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Wurttemberg-Hessen and University Hospital, Ulm, Germany
| | - Arthur Dopler
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Markus Anliker
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Christof Weinstock
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Wurttemberg-Hessen and University Hospital, Ulm, Germany
| | - Arne Skerra
- Lehrstuhl für Biologische Chemie, Technische Universität München, Freising, Germany
| | - Thomas Simmet
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Hubert Schrezenmeier
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Wurttemberg-Hessen and University Hospital, Ulm, Germany
| | - Christoph Q Schmidt
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
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15
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Weinstock C, Mytilineos J, Bugert P, Sitzmann N, Pensel E, Schrezenmeier H, Fürst D. A novel allele of the atypical chemokine receptor 1 (ACKR1) gene containing the nucleotide change c.126 T>G (p.42Glu) encodes a third Duffy blood group protein sequence antithetical to that encoding Fy a and Fy b antigens. Transfusion 2019; 59:2158-2159. [PMID: 30848497 DOI: 10.1111/trf.15232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/21/2019] [Accepted: 02/03/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Christof Weinstock
- German Red Cross Blood Service Baden-Württemberg - Hessen, Institute Ulm, Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, and Institute of Transfusion Medicine, Ulm University, Ulm, Germany
| | - Joannis Mytilineos
- German Red Cross Blood Service Baden-Württemberg - Hessen, Institute Ulm, Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, and Institute of Transfusion Medicine, Ulm University, Ulm, Germany
| | - Peter Bugert
- German Red Cross Blood Service Baden-Württemberg - Hessen, Institute Mannheim and Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Nicole Sitzmann
- German Red Cross Blood Service Baden-Württemberg - Hessen, Institute Mannheim and Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Elke Pensel
- German Red Cross Blood Service Baden-Württemberg - Hessen, Institute Ulm, Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, and Institute of Transfusion Medicine, Ulm University, Ulm, Germany
| | - Hubert Schrezenmeier
- German Red Cross Blood Service Baden-Württemberg - Hessen, Institute Ulm, Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, and Institute of Transfusion Medicine, Ulm University, Ulm, Germany
| | - Daniel Fürst
- German Red Cross Blood Service Baden-Württemberg - Hessen, Institute Ulm, Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, and Institute of Transfusion Medicine, Ulm University, Ulm, Germany
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16
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Weinstock C, Anliker M, von Zabern I. An update on the CD59 blood group system. Immunohematology 2019; 35:7-8. [PMID: 30908070] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This update of the CD59 blood group system (Weinstock C, Anliker M, von Zabern I. CD59: a long-known complement inhibitor has advanced to a blood group system. Immunohematology 2015;31:145-51) increases the number of reported patients with CD59 deficiency from 10 to 14. All of these 14 patients suffered from severe illness. Recently, a new variant allele was found in heterozygosity. Flow cytometry data suggest that this variant was expressed on the red blood cells of the propositus. Although additional alleles have been found, the CD59 system (International Society of Blood Transfusion system 35) continues to have one antigen.
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Affiliation(s)
- Christof Weinstock
- Head of the Immunohematology Laboratory, Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Service
| | - Markus Anliker
- Deputy Head of the Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital Innsbruck, Innsbruck, Austria
| | - Inge von Zabern
- retired, previously at the Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Service
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17
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Anliker M, Schmidt CQ, Harder MJ, Ganchev G, von Zabern I, Höchsmann B, Schrezenmeier H, Weinstock C. Complement activation by human red blood cell antibodies: hemolytic potential of antibodies and efficacy of complement inhibitors assessed by a sensitive flow cytometric assay. Transfusion 2018; 58:2992-3002. [PMID: 30367826 DOI: 10.1111/trf.14893] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/09/2018] [Accepted: 05/13/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Therapeutic intervention strategies in complement-mediated hemolytic diseases are still inappropriate, and lethal events cannot be reliably prevented. As an in vitro model of intravascular hemolysis, a sensitive flow cytometric assay was designed using red blood cells (RBCs) of patients with paroxysmal nocturnal hemoglobinuria (PNH) as target cells. Complement activation by human allo- and autoantibodies directed against RBC antigens and the effect of different complement inhibitors were studied. STUDY DESIGN AND METHODS RBCs of patients with a PNH III RBC clone of more than 20% were coated with different human allo- or autoantibodies. Hemolysis was initiated with pooled normal human AB serum with or without the addition of complement inhibitors. Loss of PNH III RBCs was estimated by flow cytometry. RESULTS RBC antibodies of 174 different patients representing 37 different specificities were tested for their potency to activate complement. In correlation with blood group specificities roughly three different patterns were observed: 1) strong and regular, 2) sporadic, and 3) weak or absent complement activation. Remarkably strong complement activators were among antibodies directed against high-prevalence blood group antigens. The C5 inhibitor eculizumab abrogated mild but not strong complement activation, even in presence of excess inhibitor. However, this residual complement activity could be further depressed by combining eculizumab with other inhibitors. CONCLUSION The PNH hemolysis assay offers a sensitive tool for in vitro analyses of classical pathway-mediated complement activation. The recognition of additive effects of complement inhibitors may guide novel intervention strategies against unwanted complement damage.
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Affiliation(s)
- Markus Anliker
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany.,Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital Innsbruck, Innsbruck, Austria
| | - Christoph Q Schmidt
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Markus J Harder
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Georgi Ganchev
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
| | - Inge von Zabern
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
| | - Britta Höchsmann
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
| | - Hubert Schrezenmeier
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
| | - Christof Weinstock
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg - Hessen and University Hospital, Ulm, Germany
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18
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Mayer B, Müller J, Candela-García MJ, Manteau AC, Weinstock C, Pruß A. Evaluation of the New Lateral Flow Card MDmulticard® Basic Extended Phenotype in Routine Clinical Practice. Transfus Med Hemother 2018; 45:341-346. [PMID: 30498412 DOI: 10.1159/000486606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/12/2017] [Accepted: 01/03/2018] [Indexed: 11/19/2022] Open
Abstract
Background Transfusion emergencies and critical situations require specifically designed devices to simplify and optimize the standard procedures. In addition, matching antigens over and above ABO-Rh-K would be beneficial. Methods Routine blood samples were collected in four immunohematology centers and tested with the new MDmulticard Basic Extended Phenotype for the simultaneous detection of the Duffy, Kidd, and Ss antigens, according to the principle of the lateral flow. Results were compared with those obtained using routine serology methods. Discrepancies were analyzed by molecular techniques/genotyping. Results 310 samples were tested (167 donors; 75 patients; 28 subjects with positive direct antiglobulin test (DAT); 15 newborns; 25 previously transfused patients). The 285 samples with non-mixed-field reaction yielded 1,710 antigen results with 8 discrepancies (0.47%) six of which in DAT-positive subjects: three false-positive (Fya) for MDmulticard, and two false-positive (Fya) plus three false-negative (Fyb) for the reference methods (MDmulticard PPA for donors/patients/newborns: 99.82%; negative percent agreement: 100%; sensitivity: 100%; specificity: 99.39%, positive predictive value: 99.75%; negative predictive value: 100%). The MDmulticard detected mixed-field in 15 antigen reactions from 13 transfused patients, undetected by the comparative method, with the opposite result in 8 antigens (5 patients). Conclusion The MDmulticard Basic Extended Phenotype met the criteria prescribed for the testing of donor, patient, DAT-positive, and newborn samples in transfusion laboratory routine.
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Affiliation(s)
- Beate Mayer
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Müller
- German Red Cross Blood Service Baden-Württemberg - Hesse, Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany
| | | | | | - Christof Weinstock
- German Red Cross Blood Service Baden-Württemberg - Hesse, Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany
| | - Axel Pruß
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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19
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Geisen C, Weinstock C. Anmerkungen zu Kapitel 4 „Anwendung von Blutprodukten“ der Hämotherapie-Richtlinie. Transfusionsmedizin 2017. [DOI: 10.1055/s-0043-105038] [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: 10/18/2022]
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20
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Rauch S, Ritgen J, Wißkirchen M, Bauerfeind U, Kohne E, Weinstock C. A case of anti-Rd causing fetal anemia. Transfusion 2017; 57:1485-1487. [PMID: 28267201 DOI: 10.1111/trf.14078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/11/2017] [Accepted: 01/14/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rd (SC4) is a low-frequency antigen of the Scianna blood group system. Only very few reports on anti-Rd in pregnancy exist. Mild to moderate hemolytic disease of the newborn caused by anti-Rd has been reported. This report may add further information on the clinical significance of anti-Rd for the fetus. CASE REPORT In a case of severe fetal anemia (hemoglobin concentration, 3.0 g/dL) repeated intrauterine transfusions were required. The strongly positive direct antiglobulin test (DAT) of the fetal red blood cells led to the diagnosis of hemolytic disease. The routine antibody screen was negative, extended testing revealed a maternal anti-Rd with a titer of 256. Both the newborn and her father were confirmed to carry the SC*01.04 allele. CONCLUSION Anti-Rd can cause fetal anemia. Low-frequency antigens including Rd are normally not present on screening cells. Antibodies directed against low-frequency antigens will usually not be detected by routine antibody screening in pregnancy. Thus, in cases of fetal anemia the DAT should always be included in the diagnostic workup.
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Affiliation(s)
- Stefan Rauch
- Labor Prof. G. Enders & Kollegen MVZ GbR, Stuttgart, Germany
| | | | | | - Ursula Bauerfeind
- Institute of Transfusion Medicine, Blood Service, Cologne-Merheim Medical Center, Cologne, Germany; and
| | - Elisabeth Kohne
- Hemoglobin Laboratory, Department of Pediatrics, University Hospital Ulm
| | - Christof Weinstock
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg-Hessen, University of Ulm, Ulm, Germany
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21
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Harder MJ, Kuhn N, Schrezenmeier H, Höchsmann B, von Zabern I, Weinstock C, Simmet T, Ricklin D, Lambris JD, Skerra A, Anliker M, Schmidt CQ. Incomplete inhibition by eculizumab: mechanistic evidence for residual C5 activity during strong complement activation. Blood 2017; 129:970-980. [PMID: 28028023 PMCID: PMC5324716 DOI: 10.1182/blood-2016-08-732800] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/16/2016] [Indexed: 12/21/2022] Open
Abstract
Eculizumab inhibits the terminal, lytic pathway of complement by blocking the activation of the complement protein C5 and shows remarkable clinical benefits in certain complement-mediated diseases. However, several reports suggest that activation of C5 is not always completely suppressed in patients even under excess of eculizumab over C5, indicating that residual C5 activity may derogate the drug's therapeutic benefit under certain conditions. By using eculizumab and the tick-derived C5 inhibitor coversin, we determined conditions ex vivo in which C5 inhibition is incomplete. The degree of such residual lytic activity depended on the strength of the complement activator and the resulting surface density of the complement activation product C3b, which autoamplifies via the alternative pathway (AP) amplification loop. We show that at high C3b densities required for binding and activation of C5, both inhibitors reduce but do not abolish this interaction. The decrease of C5 binding to C3b clusters in the presence of C5 inhibitors correlated with the levels of residual hemolysis. However, by employing different C5 inhibitors simultaneously, residual hemolytic activity could be abolished. The importance of AP-produced C3b clusters for C5 activation in the presence of eculizumab was corroborated by the finding that residual hemolysis after forceful activation of the classical pathway could be reduced by blocking the AP. By providing insights into C5 activation and inhibition, our study delivers the rationale for the clinically observed phenomenon of residual terminal pathway activity under eculizumab treatment with important implications for anti-C5 therapy in general.
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Affiliation(s)
- Markus J Harder
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Nadine Kuhn
- Lehrstuhl für Biologische Chemie, Technische Universität München, Freising, Germany
| | - Hubert Schrezenmeier
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service and University Hospital of Ulm, Ulm, Germany; and
| | - Britta Höchsmann
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service and University Hospital of Ulm, Ulm, Germany; and
| | - Inge von Zabern
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service and University Hospital of Ulm, Ulm, Germany; and
| | - Christof Weinstock
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service and University Hospital of Ulm, Ulm, Germany; and
| | - Thomas Simmet
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Daniel Ricklin
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service and University Hospital of Ulm, Ulm, Germany; and
| | - John D Lambris
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - Arne Skerra
- Lehrstuhl für Biologische Chemie, Technische Universität München, Freising, Germany
| | - Markus Anliker
- Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service and University Hospital of Ulm, Ulm, Germany; and
| | - Christoph Q Schmidt
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Ulm, Germany
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22
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Hustinx H, Lejon Crottet S, Scharberg EA, Weinstock C. Rare donor programs in Switzerland, Germany, and Austria. Immunohematology 2016; 32:63-66. [PMID: 27901571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Hein Hustinx
- Interregional Blood Service Swiss Red Cross, Bern, Switzerland
| | | | - Erwin A Scharberg
- German Red Cross Blood Service Baden-Wüerttemberg, Baden-Baden, Germany
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23
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Leo A, Laier S, Weinstock C, Stürtzel A, Albrecht B, Scharberg E. Anti-D, Anti-C und Anti-G in der Schwangerschaft: diagnostische Strategien. Transfusionsmedizin 2016. [DOI: 10.1055/s-0042-104484] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- A. Leo
- Institut für Klinische Transfusionsmedizin und Zelltherapie Heidelberg gGmbH, ein Gemeinschaftsunternehmen des DRK-Blutspendedienstes Baden-Württemberg – Hessen gGmbH und des Universitätsklinikums Heidelberg AöR, Heidelberg
| | - S. Laier
- Institut für Klinische Transfusionsmedizin und Zelltherapie Heidelberg gGmbH, ein Gemeinschaftsunternehmen des DRK-Blutspendedienstes Baden-Württemberg – Hessen gGmbH und des Universitätsklinikums Heidelberg AöR, Heidelberg
| | - C. Weinstock
- Institut für Klinische Transfusionsmedizin und Immungenetik Ulm gGmbH, ein Gemeinschaftsunternehmen des DRK-Blutspendedienstes Baden-Württemberg – Hessen gGmbH und des Universitätsklinikums Ulm, Ulm
| | - A. Stürtzel
- Institut für Transfusionsmedizin und Immunhämatologie, DRK-Blutspendedienst Baden-Württemberg – Hessen gGmbH, Institut Baden-Baden, Baden-Baden
| | - B. Albrecht
- Institut für Klinische Transfusionsmedizin und Zelltherapie Heidelberg gGmbH, ein Gemeinschaftsunternehmen des DRK-Blutspendedienstes Baden-Württemberg – Hessen gGmbH und des Universitätsklinikums Heidelberg AöR, Heidelberg
| | - E. Scharberg
- Institut für Transfusionsmedizin und Immunhämatologie, DRK-Blutspendedienst Baden-Württemberg – Hessen gGmbH, Institut Baden-Baden, Baden-Baden
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24
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Braun N, Rosenfeld S, Giolai M, Banzhaf W, Fretschner R, Warth H, Weinstock C, Deppisch R, Erley CM, Müller GA. Effect of continuous hemodiafiltration on IL-6, TNF-alpha, C3a, and TCC in patients with SIRS/septic shock using two different membranes. Contrib Nephrol 2015; 116:89-98. [PMID: 8529388 DOI: 10.1159/000424619] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- N Braun
- Department of Internal Medicine III, University of Tübingen, FRG
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25
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Weinstock C, Anliker M, von Zabern I. CD59: A long-known complement inhibitor has advanced to a blood group system. Immunohematology 2015; 31:145-151. [PMID: 27187193] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The blood group system number 35 is based on CD59, a 20-kDa membrane glycoprotein present on a large number of different cells, including erythrocytes. The major function of CD59 is to protect cells from complement attack. CD59 binds to complement components CS and C9 and prevents the polymerization of C9, which is required for the formation of the membrane attack complex (MAC). Other functions of CD59 in cellular immunity are less well defined. CD59 is inserted into the membrane by a glycosylphosphatidylinositol (GPI) anchor. A defect of this anchor causes lack of this protein from the cell membrane, which leads to an enhanced sensitivity towards complement attack. Patients with paroxysmal nocturnal hemoglobinuria (PNH) harbor a varying percentage of red blood cell clones with a defect in GPI-anchored proteins, including CD59. The most characteristic symptoms of this disease are episodes of hemolysis and thromboses. Although CD59 has been classified as a membrane protein for more than 25 years, an alloantibody directed against CD59 was found only recently. So far, the first and sole alloantibody described was detected in a CD59-deficient child. In 2014, CD59 received the status of a blood group system by the International Society for Blood Transfusion Red Cell Immunogenetics and Blood Group Terminology Working Party. Among a variety of almost 20 synonyms, the designation CD59 was chosen for the blood group system and CD59.l for the wild-type protein. The only three alleles published to date are null alleles. All CD59-deficient individuals recognized so far were severely ill, two of whom have died. Most of the reported cases present with a typical clinical picture within the first year of life that includes neuropathy, strokes, and mild Coombs-negative hemolysis. In one published case, the application of the complement inhibitor eculizumab caused a pronounced improvement of the clinical situation.
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Affiliation(s)
- Christof Weinstock
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Service Baden-Württemberg-Hessen, and University of Ulm, Germany, Helmholtzstr. 10, 89081 Ulm, Germany
| | - Markus Anliker
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Service Baden-Württemberg-Hessen, and University of Ulm, Germany
| | - Inge von Zabern
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Service Baden-Württemberg-Hessen, and University of Ulm, Germany
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26
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Weinstock C, Möhle R, Dorn C, Weisel K, Höchsmann B, Schrezenmeier H, Kanz L. Successful use of eculizumab for treatment of an acute hemolytic reaction after ABO-incompatible red blood cell transfusion. Transfusion 2014; 55:605-10. [DOI: 10.1111/trf.12882] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 07/24/2014] [Accepted: 08/05/2014] [Indexed: 12/29/2022]
Affiliation(s)
- Christof Weinstock
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Institute of Transfusion Medicine; University of Ulm; Ulm Germany
| | - Robert Möhle
- Department of Medicine; University Hospital of Tuebingen; Tuebingen Germany
| | - Christiane Dorn
- Department of Medicine; University Hospital of Tuebingen; Tuebingen Germany
| | - Katja Weisel
- Department of Medicine; University Hospital of Tuebingen; Tuebingen Germany
| | - Britta Höchsmann
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Institute of Transfusion Medicine; University of Ulm; Ulm Germany
| | - Hubert Schrezenmeier
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Service Baden-Württemberg-Hessen; Institute of Transfusion Medicine; University of Ulm; Ulm Germany
| | - Lothar Kanz
- Department of Medicine; University Hospital of Tuebingen; Tuebingen Germany
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27
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Anliker M, von Zabern I, Höchsmann B, Kyrieleis H, Dohna-Schwake C, Flegel WA, Schrezenmeier H, Weinstock C. A new blood group antigen is defined by anti-CD59, detected in a CD59-deficient patient. Transfusion 2014; 54:1817-22. [PMID: 24383981 DOI: 10.1111/trf.12531] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/10/2013] [Accepted: 10/31/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND CD59 is a cell surface glycoprotein of approximately 20 kDa limiting the lytic activity of the terminal complement complex C5b-9. Although CD59 is known as a red blood cell (RBC) antigen defined by monoclonal antibodies, it so far has not been identified as a blood group antigen, since the description of a human alloantibody was missing. In this study we show the presence of an anti-CD59 in a patient affected by a homozygous CD59 deficiency. STUDY DESIGN AND METHODS RBC CD59 and CD55 were determined by flow cytometry or by the column agglutination technique using monoclonal antisera. Commercially available His-tagged recombinant soluble CD59 protein was used to inhibit anti-CD59. RESULTS Seven cases of an isolated CD59 deficiency due to three distinct null alleles of the CD59 gene have been published so far. Recently we described the CD59-null allele c.146delA in a young child of heterozygous parents. Her plasma contained an alloantibody directed against the high-prevalence RBC antigen CD59. The antibody specificity was identified using soluble recombinant human CD59 protein, which blocked the reactivity of the patient's antibody and of monoclonal anti-CD59 but not of monoclonal anti-CD55. In addition, RBC alloantibodies such as anti-K, anti-C, anti-c, or anti-Fy(a) remained unaffected. Therefore, inhibition by recombinant CD59 is a useful diagnostic tool to detect alloantibodies in the presence of anti-CD59. CONCLUSION This is the first demonstration of a human anti-CD59 alloantibody, which defines CD59 as an RBC blood group antigen. CD59 represents a candidate for a new blood group system.
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Affiliation(s)
- Markus Anliker
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, Ulm, Germany; Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
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28
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Affiliation(s)
- Christof Weinstock
- Correspondence: Christof Weinstock, Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Württemberg-Hessen, Helmholtzstraße 10, 89081 Ulm, Germany, e-mail:
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29
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Flesch BK, Matheis N, Alt T, Weinstock C, Bux J, Kahaly GJ. HLA class II haplotypes differentiate between the adult autoimmune polyglandular syndrome types II and III. J Clin Endocrinol Metab 2014; 99:E177-82. [PMID: 24187405 DOI: 10.1210/jc.2013-2852] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND Genetics of the adult autoimmune polyglandular syndrome (APS) is poorly understood. AIM The aim of this study was to gain further insight into the genetics of the adult APS types. SITE: The study was conducted at a university referral center. METHODS The human leukocyte antigen (HLA) class II alleles, haplotypes, and genotypes were determined in a large cohort of patients with APS, autoimmune thyroid disease (AITD), and type 1 diabetes and in healthy controls by the consistent application of high-resolution typing at a four-digit level. RESULTS Comparison of the allele and haplotype frequencies significantly discriminated patients with APS vs AITD and controls. The HLA class II alleles DRB1*03:01 *04:01, DQA1*03:01, *05:01, DQB1*02:01, and *03:02 were observed more frequently (P<.001) in APS than in AITD and controls, whereas the alleles DRB1*15:01, DQB1*03:01, and *06:02 were underrepresented in APS vs AITD (Pc<.001) and controls (Pc<.01), respectively. The DRB1*03:01-DQA1*05:01-DQB1*02:01 (DR3-DQ2) and DRB1*04:01-DQA1*03:01:DQB1*03:02 (DRB1*04:01-DQ8) haplotypes were overrepresented in APS (Pc<.001). Combination of both haplotypes to a genotype was highly prevalent in APS vs AITD and controls (Pc<.001). Dividing the APS collective into those with Addison's disease (APS type II) and those without Addison's disease but including type 1 diabetes and AITD (APS type III) demonstrated DR3-DQ2/DRB1*04:01-DQ8 as a susceptibility genotype in APS III (Pc<.001), whereas the DR3-DQ2/DRB1*04:04-DQ8 genotype correlated with APS II (Pc<.001). The haplotypes DRB1*11:01-DQA1*05:05-DQB1*03:01 and DRB1*15:01-DQA1*01:02-DQB1*06:02 are protective in APS III but not in type II (Pc<.01). CONCLUSIONS HLA class II haplotypes differentiate between the adult APS types II and III. Susceptible haplotypes favor the development of polyglandular autoimmunity in patients with AITD.
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Affiliation(s)
- B K Flesch
- Laboratory of Immunogenetics/HLA (B.K.F., C.W.), German Red Cross Blood Service West, Bad Kreuznach 55543, Germany; Molecular Thyroid Research Laboratory (N.M., G.J.K.), Johannes Gutenberg University Medical Center, Mainz 55101, Germany; Bioinformatics Unit (T.A.) and Center for Transfusion Medicine (J.B.), German Red Cross Blood Service West, Hagen 58097, Germany
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30
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Anliker M, von Zabern I, Höchsmann B, Dohna-Schwake C, Kyrieleis H, Schrezenmeier H, Weinstock C. CD59 is a blood group antigen. Mol Immunol 2013. [DOI: 10.1016/j.molimm.2013.05.114] [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: 11/16/2022]
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31
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Cario H, Weinstock C, Mayer B, Lobitz S. Grundlagen und Besonderheiten der Transfusionstherapie bei Hämoglobinopathien. Transfusionsmedizin 2013. [DOI: 10.1055/s-0032-1324992] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- H. Cario
- Kinder-Hämatologie und ‑Onkologie, Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm
| | - C. Weinstock
- Institut für Klinische Transfusionsmedizin und Immungenetik Ulm, DRK-Blutspendedienst Baden-Württemberg - Hessen und Institut für Transfusionsmedizin, Universität Ulm
| | - B. Mayer
- Institut für Transfusionsmedizin, Charité-Universitätsmedizin Berlin
| | - S. Lobitz
- Klinik für Pädiatrie mit Schwerpunkt Onkologie/Hämatologie/KMT, Charité-Universitätsmedizin Berlin
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32
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Weinstock C, Schnaidt M. The complement-mediated prozone effect in the Luminex single-antigen bead assay and its impact on HLA antibody determination in patient sera. Int J Immunogenet 2012; 40:171-7. [PMID: 22913810 DOI: 10.1111/j.1744-313x.2012.01147.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 06/29/2012] [Accepted: 07/04/2012] [Indexed: 11/29/2022]
Abstract
The Luminex xMAP system has become an important tool for HLA antibody screening and identification in sera of transplant patients. Recently, the Luminex single antigen bead assay was shown to be prone to an artefact, the so called prozone phenomenon: Sera with high titer HLA antibodies gave negative results when tested neat, but reacted strongly positive after 1:10 dilution. We also observed such a phenomenon and found that it was most likely caused by the complement component 1 (C1) by competitively displacing the detection antibodies. In this article we review the complement-mediated prozone effect and other mechanisms of interference with solid phase assays, and we discuss possible consequences for HLA antibody testing with the Luminex SAB assay.
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Affiliation(s)
- C Weinstock
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Ulm, Ulm, Germany.
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33
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Weinstock C, Bigenwald R, Hochman T, Sun P, Narod S, Warner E. Outcomes of surveillance for contralateral breast cancer in patients less than age 60 at the time of initial diagnosis. Curr Oncol 2012; 19:e160-4. [PMID: 22670105 PMCID: PMC3364776 DOI: 10.3747/co.19.890] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND After an initial diagnosis of breast cancer, the risk of contralateral breast cancer is approximately 0.5% per year. Annual mammography is recommended to identify local recurrences and contralateral new primaries. Because the sensitivity of mammography tends to be lower in younger women, we conducted a retrospective review of the method of detection and pathologic stage of metachronous contralateral primary breast cancers according to age at diagnosis in a cohort of breast cancer patients. METHODS The Henrietta Banting Database contains information on cases of breast cancer diagnosed at Women's College Hospital from 1987 to 2004. From among 1992 women in the database, 71 patients were identified who were initially diagnosed before age 60 and who subsequently developed a contralateral breast cancer. Medical records were obtained for 53 of the 71 patients. RESULTS Of the 53 contralateral cancers, 33 (62%) were detected by mammography, including 4 in 16 patients (25%) diagnosed before age 50 and 29 in 37 patients (78%) diagnosed at age 50 or older (p ≤ 0.001). CONCLUSIONS Mammography has poor sensitivity for the surveillance of contralateral breast cancer in early-onset breast cancer patients. Other imaging modalities should be evaluated in this setting.
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Affiliation(s)
- C. Weinstock
- Division of Medical Oncology, Sunnybrook Health Sciences Center, Toronto, ON
- Current affiliation: Department of Hematology and Oncology, University of Maryland Greenbaum Cancer Center, Baltimore, MD, U.S.A
| | - R. Bigenwald
- Division of Medical Oncology, Sunnybrook Health Sciences Center, Toronto, ON
| | - T. Hochman
- Women’s College Research Institute, Women’s College Hospital and University of Toronto, Toronto, ON
| | - P. Sun
- Department of Biostatistics, NYU Cancer Center, New York, NY, U.S.A
| | - S.A. Narod
- Department of Biostatistics, NYU Cancer Center, New York, NY, U.S.A
| | - E. Warner
- Division of Medical Oncology, Sunnybrook Health Sciences Center, Toronto, ON
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34
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Weinstock C, Hochgeladen E. Was tun bei einem positiven direkten Antiglobulintest? Transfusionsmedizin 2011. [DOI: 10.1055/s-0031-1283703] [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: 10/17/2022]
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35
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Weinstock C, Matheis N, Barkia S, Haager MC, Janson A, Marković A, Bux J, Kahaly GJ. Autoimmune polyglandular syndrome type 2 shows the same HLA class II pattern as type 1 diabetes. ACTA ACUST UNITED AC 2011; 77:317-24. [PMID: 21388354 DOI: 10.1111/j.1399-0039.2011.01634.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Autoimmune polyglandular syndrome (APS) type 2 is defined by the manifestation of at least two autoimmune endocrine diseases. Only few data exist on genetic associations of APS type 2. In this controlled study, 98 patients with APS type 2, 96 patients with type 1 diabetes (T1D), and 92 patients with autoimmune thyroid disease, both as a single autoimmune endocrinopathy, were tested for association with alleles of the human leukocyte antigen (HLA) class II loci DRB1, DQA1, and DQB1. Patients with APS type 2 had significantly more often the alleles DRB1*03 (P(c) < 0.0001), DRB1*04 (P(c) < 0.000005), DQA1*03 (P(c) < 0.0001), and DQB1*02 (P(c) < 0.05), when compared with controls. Less frequent in APS were DRB1*15 (P(c) < 0.05), DQA1*01 (P(c) < 0.0005), and DQB1*05 (P(c) < 0.005). With regard to frequency and linkage of these alleles, the susceptible haplotypes DRB1*0301-DQA1*0501-DQB1*0201 and DRB1*0401/04-DQA1*0301-DQB1*0302 were deduced. Protective haplotypes in this study were DRB1*1501-DQA1*0102-DQB1*0602 and DRB1*0101-DQA1*0101-DQB1*0501. Comparing APS patients with vs without AD, no significant differences regarding HLA class II alleles were noted in our collective. Patients with T1D as a singular disease had the same susceptible and protective HLA alleles and haplotypes. The prevalence of DRB1*03 and DRB1*04 in APS patients was not because of the presence of diabetes, as the APS type 2 patients without diabetes had the same allele distribution. In conclusion, these data suggest a common immunogenetic pathomechanism for T1D and APS type 2, which might be different from the immunogenetic pathomechanism of other autoimmune endocrine disease.
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Affiliation(s)
- C Weinstock
- German Red Cross Blood Service West, Hagen, Germany.
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Weinstock C, Zhu Y, Bao T, Buras RR, Hanna NN, Tkaczuk K, Chumsri S. Abstract P6-06-01: Relationship between Vitamin D Deficiency and Breast Cancer Histology: A Retrospective Database Review. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p6-06-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Vitamin D deficiency has recently been shown to be correlated with high rates of developing breast cancer (Chen P et al, Breast Cancer Res Treat; Oct 2009). However, the association between the degree of vitamin D deficiency and specific histological subtypes of breast cancer remains unclear. Preclinical data has suggested that vitamin D plays an essential role in the terminal differentiation of breast cancer cells, and thus vitamin D deficiency would be associated with the pathogenesis of estrogen receptor negative tumors (Welsh J et al, Journal of Steroid Biochem Mol Biol; Feb 2003), in particular triple-negative tumors, which are associated with a particularly aggressive clinical course. Methods: Beginning in July 2008, the majority of newly diagnosed breast cancer patients at University of Maryland Greenebaum Cancer Center had Vitamin D 25-OH levels testedon initial presentation to the clinic. We conducted a retrospective chart review to obtain information about tumor histology and vitamin D levels in these patients. Results: We include data on 71 patients who presented with newly-diagnosed breast carcinoma or DCIS between June 2008 and December 2009. Average age at diagnosis was 57 (range 36-87), and 58% of patients were African American. Stage distribution of the cohort included; DCIS-3%, stage I-15%, stage II-41%, stage III-28%, and stage IV-10%. Overall, 80% of the patients were vitamin D deficient at diagnosis, with vitamin D levels under 30 ng/ml, and 57% had levels under 20 ng/ml. Patients with triple-negative tumors were the most likely to be vitamin D deficient at diagnosis (90%) compared to hormone receptor-positive patients (75%), and they had the lowest mean and median vitamin D levels compared to all other patients.
Percentage of patients with Vitamin D deficiency
Vitamin D level by histological subtype
Hormone receptor-positive patients were significantly more likely to have normal vitamin D levels at diagnosis and significantly less likely to have severe deficiency (level <10 ng/ml) than those with hormone receptor-negative tumors (p=0.037). African-American women in this cohort were also more likely to be severely vitamin D deficient, with levels <10 ng/ml, than were Caucasian women (34% vs. 7%, p=0.048). Conclusion: Vitamin D deficiency is common among patients with newly-diagnosed breast cancer. Patients with triple-negative tumors may have a higher likelihood of being vitamin D deficient than patients with other histological subtypes.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-06-01.
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Affiliation(s)
- C Weinstock
- University of Maryland Medical Center, Baltimore
| | - Y Zhu
- University of Maryland Medical Center, Baltimore
| | - T Bao
- University of Maryland Medical Center, Baltimore
| | - RR Buras
- University of Maryland Medical Center, Baltimore
| | - NN Hanna
- University of Maryland Medical Center, Baltimore
| | - K Tkaczuk
- University of Maryland Medical Center, Baltimore
| | - S. Chumsri
- University of Maryland Medical Center, Baltimore
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Roth S, Weinstock C, van Ahlen H, Semjonow A, Leusmann D, Hertle L. Risk of Uretero-Intestinal Anastomotic Stricture in Orthotopic Bladder Substitution. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1055657] [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: 10/21/2022]
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38
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Weinstock C, Bigenwald R, Narod S, Sun P, Hochman T, Warner E. Sensitivity of surveillance mammography for contralateral breast cancers and ipsilateral recurrences in survivors under 50. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11009] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11009 Background: Annual mammography is currently the gold standard for surveillance of breast cancer survivors for both ipsilateral recurrence and contralateral new primaries. The risk of either of these events occurring has been found to be inversely proportional to age and is at least 1% per year if breast cancer was diagnosed before age 50. (Chen et al 1999) (Komoike et al 2006). However, the sensitivity of screening mammography is significantly lower in young women. We therefore sought to determine the effectiveness of surveillance mammography according to age of diagnosis using a prospective database. Methods: The Henrietta Banting Database prospectively follows all new cases of operable breast cancer diagnosed from 1987 - 2004 at Women’s College Hospital. From the 1992 women in the database, we selected all patients diagnosed before age 60 who subsequently developed non-metastatic contralateral cancers (n=71 ) or ipsilateral recurrences (n=11 ). Records were obtainable for 59 of these 82 patients. Results: Method of detection and stage of diagnosis are listed in table below for the 59 patients according to age of diagnosis of second cancers. Overall, mammography was less effective at detecting contralateral and recurrent breast cancers in younger women, detecting only 24% of these cancers in women under 50 compared to 74% in patients 50 and older (Chi-Square, p<0.001). In addition, 77% of patients under 50 whose second cancers were detected by methods other than mammography had negative surveillance mammograms in the 15 months prior to diagnosis. Conclusion: Since mammography detected only 24% of second primary breast cancers/ recurrences in survivors < age 50 and almost one third of all detected cancers were locally advanced, more sensitive imaging modalities such as breast MRI should be considered for surveillance of young survivors. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- C. Weinstock
- Beth Israel Medical Center, New York, NY; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada; Women’s College Research Institute, Toronto, ON, Canada; New York University School of Medicine, New York, NY
| | - R. Bigenwald
- Beth Israel Medical Center, New York, NY; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada; Women’s College Research Institute, Toronto, ON, Canada; New York University School of Medicine, New York, NY
| | - S. Narod
- Beth Israel Medical Center, New York, NY; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada; Women’s College Research Institute, Toronto, ON, Canada; New York University School of Medicine, New York, NY
| | - P. Sun
- Beth Israel Medical Center, New York, NY; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada; Women’s College Research Institute, Toronto, ON, Canada; New York University School of Medicine, New York, NY
| | - T. Hochman
- Beth Israel Medical Center, New York, NY; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada; Women’s College Research Institute, Toronto, ON, Canada; New York University School of Medicine, New York, NY
| | - E. Warner
- Beth Israel Medical Center, New York, NY; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada; Women’s College Research Institute, Toronto, ON, Canada; New York University School of Medicine, New York, NY
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39
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Sinzger C, Mangin M, Weinstock C, Topp MS, Hebart H, Einsele H, Jahn G. Effect of serum and CTL on focal growth of human cytomegalovirus. J Clin Virol 2007; 38:112-9. [PMID: 17204454 DOI: 10.1016/j.jcv.2006.11.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [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: 06/16/2006] [Revised: 11/17/2006] [Accepted: 11/17/2006] [Indexed: 11/29/2022]
Abstract
BACKGROUND In immunocompromised patients only cytotoxic T-lymphocytes (CTL) but not antiviral antibodies appear to be efficient in control of human cytomegalovirus (HCMV) infection. This is contrasted by the well-documented neutralising activity of patient sera against standard HCMV strains. OBJECTIVE We tested the hypothesis that a cell-culture model based on a recent clinical HCMV isolate would more accurately approximate the clinical situation and provide an explanation for the failure of neutralising antibodies in efficient restriction of HCMV infection. METHODS Sera from five bone marrow transplant recipients with or without prolonged HCMV replication were analysed by an enzyme-linked immunoassay for their capacity to neutralise cell-free HCMV preparations. The inhibitory effect of these sera on viral cell-to-cell-spread was then quantified by focus expansion assays using a recent clinical HCMV-isolate and was finally compared to the inhibitory effect of HCMV-specific CTL lines. RESULTS Prolonged HCMV replication occurred in three patients despite high titres of neutralising antibodies. In contrast to the strong inhibitory effect on cell-free HCMV, their sera could not inhibit the focal growth of a recent cell-associated HCMV isolate, whereas CTL clones directed against pUL123 or pUL83 of HCMV effectively limited focal expansion of the clinical isolate in fibroblast culture. CONCLUSIONS Focus expansion assays based on a cell-associated clinical HCMV isolate provide a model for the in vivo effectiveness of virus-specific CTL and neutralising antibodies. Our data support the assumption that due to their strict cell-association clinical HCMV strains are withdrawn from neutralising antibodies.
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Affiliation(s)
- Christian Sinzger
- Institute of Medical Virology, University of Tuebingen, Tuebingen, Germany.
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40
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Sinzger C, Eberhardt K, Cavignac Y, Weinstock C, Kessler T, Jahn G, Davignon JL. Macrophage cultures are susceptible to lytic productive infection by endothelial-cell-propagated human cytomegalovirus strains and present viral IE1 protein to CD4+ T cells despite late downregulation of MHC class II molecules. J Gen Virol 2006; 87:1853-1862. [PMID: 16760387 DOI: 10.1099/vir.0.81595-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The contribution of CD4(+) T cells to control of human cytomegalovirus (HCMV) has been shown and infected tissue macrophages might contribute to this response by antigen presentation. As shown previously, CD4(+) T cells recognize HCMV immediate-early antigen IE1 on glioblastoma cells manipulated to express MHC class II molecules. Here, the possible interference of virus-induced MHC class II downmodulation with the presentation of IE1 by natural target cells was analysed. The capacity of IE1-specific CD4(+) T-cell clones to recognize HCMV-infected monocyte-derived macrophages was tested. Various HCMV strains were used to achieve efficient infection of macrophages. Activation of CD4(+) T cells by infected macrophages was evaluated at different time points after infection. Endothelial-cell-adapted HCMV strains efficiently infected cultured human macrophages. However, the immediate-early and early phases of replication were prolonged. Infected cells entered the late replication phase only after 3 days of infection, which was associated with downmodulation of MHC class II molecules at the surface of infected cells. Strong stimulation of IE1-specific CD4(+) T cells resulted from endogenous de novo antigen production and presentation by infected macrophages during the first 3 days of virus replication, despite MHC class II downmodulation in the late replication phase. Therefore, infected macrophages are assumed to contribute to the antiviral immune response in infected organs.
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Affiliation(s)
- Christian Sinzger
- Institut für Medizinische Virologie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Kathrin Eberhardt
- Institut für Medizinische Virologie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Yolaine Cavignac
- Institut für Medizinische Virologie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Christof Weinstock
- Institut für Medizinische Virologie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Tobias Kessler
- Institut für Medizinische Virologie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Gerhard Jahn
- Institut für Medizinische Virologie, Universitätsklinikum Tübingen, Tübingen, Germany
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41
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Lang PA, Kaiser S, Myssina S, Birka C, Weinstock C, Northoff H, Wieder T, Lang F, Huber SM. Effect of Vibrio parahaemolyticus haemolysin on human erythrocytes. Cell Microbiol 2004; 6:391-400. [PMID: 15009030 DOI: 10.1111/j.1462-5822.2004.00369.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Haemolysin Kanagawa, a toxin from Vibrio parahaemolyticus, is known to trigger haemolysis. Flux studies indicated that haemolysin forms a cation channel. In the present study, channel properties were elucidated by patch clamp and functional significance of ion fluxes by fluorescence-activated cell sorting (FACS) analysis. Treatment of human erythrocytes with 1 U ml-1 haemolysin within minutes induces a non-selective cation permeability. Moreover, haemolysin activates clotrimazole-sensitive K+ channels, pointing to stimulation of Ca2+-sensitive Gardos channels. Haemolysin (1 U ml-1) leads within 5 min to slight cell shrinkage, which is reversed in Ca2+-free saline. Erythrocytes treated with haemolysin (0.1 U ml-1) do not undergo significant haemolysis within the first 60 min. Replacement of extracellular Na+ with NMDG+ leads to slight cell shrinkage, which is potentiated by 0.1 U ml-1 haemolysin. According to annexin binding, treatment of erythrocytes with 0.1 U ml-1 haemolysin leads within 30 min to breakdown of phosphatidylserine asymmetry of the cell membrane, a typical feature of erythrocyte apoptosis. The annexin binding is significantly blunted at increased extracellular K+ concentrations and by K+ channel blocker clotrimazole. In conclusion, haemolysin Kanagawa induces cation permeability and activates endogenous Gardos K+ channels. Consequences include breakdown of phosphatidylserine asymmetry, which depends at least partially on cellular loss of K+.
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Affiliation(s)
- Philipp A Lang
- Department of Physiology and Universitätsklinik für Anaesthesiologie und Transfusionsmedizin, University of Tübingen, Gmelinstrasse 5, D-72076 Tübingen, Germany
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42
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Lang P, Bader P, Schumm M, Feuchtinger T, Einsele H, Führer M, Weinstock C, Handgretinger R, Kuci S, Martin D, Niethammer D, Greil J. Transplantation of a combination of CD133+ and CD34+ selected progenitor cells from alternative donors. Br J Haematol 2004; 124:72-9. [PMID: 14675410 DOI: 10.1046/j.1365-2141.2003.04747.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Positive selected haematopoietic stem cells are increasingly used for allogeneic transplantation with the CD34 antigen employed in most separation techniques. However, the recently described pentaspan molecule CD133 appears to be a marker of more primitive haematopoietic progenitors. Here we report our experience with a new CD133-based selection method in 10 paediatric patients with matched unrelated (n = 2) or mismatched-related donors (n = 8). These patients received a combination of stem cells (median = 29.3 x 10(6)/kg), selected with either anti-CD34 or anti-CD133 coated microbeads. The proportion of CD133+ selected cells was gradually increased from patient to patient from 10% to 100%. Comparison of CD133+ and CD34+ separation procedures revealed similar purity and recovery of target populations but a lower depletion of T cells by CD133+ selection (3.7 log vs. 4.1 log, P < 0.001). Both separation procedures produced >90% CD34+/CD133+ double positive target cells. Engraftment occurred in all patients (sustained primary, n = 8; after reconditioning, n = 2). No primary acute graft versus host disease (GvHD) >/= grade II or chronic GvHD was observed. The patients showed a rapid platelet recovery (median time to independence from substitution = 13.5 d), whereas T cell regeneration was variable. Five patients are alive with a median follow-up of 10 months. Our data demonstrates the feasibility of CD133+ selection for transplantation from alternative donors and encourages further trials with total CD133+ separated grafts.
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Affiliation(s)
- Peter Lang
- Children's University Hospital, University of Tuebingen, Tuebingen, Germany.
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43
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König D, Grathwohl D, Weinstock C, Northoff H, Berg A. Upper respiratory tract infection in athletes: influence of lifestyle, type of sport, training effort, and immunostimulant intake. Exerc Immunol Rev 2001; 6:102-20. [PMID: 10919064] [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: 02/17/2023]
Abstract
Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes, while moderate exercise is believed to be protective. During the past years, many groups have investigated the association between changes within the immune system and exercise at different intensity levels. Although following strenuous exercise, some immunologic alterations were quite consistent and reproducible, e.g. neutrophilia, lymphopenia, and depression of natural killer cell activity, some findings were divergent or strongly dependent on the study design and athletes investigated. Lately, interesting results in the field of psychoneuroimmunolgy as well as new insights in the relationship between macro- and micronutrient and the immune system have brought up new fields of research interest. There is growing evidence that e.g. lifestyle factors, the coping with daily stress, and dietary behavior are important cofactors in the immune response to exercise. The present work gives a short review on the literature dealing with URTI in athletes with special reference to the above mentioned cofactors. In addition, the results of a recent investigation concerning training and associated lifestyle patterns in German athletes are presented.
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Affiliation(s)
- D König
- Medizinische Klinik, Abt. Rehabilitation, Prävention und Sportmedizin, Freiburg im Breisgau, Germany
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Fehrenbach E, Passek F, Niess AM, Pohla H, Weinstock C, Dickhuth HH, Northoff H. HSP expression in human leukocytes is modulated by endurance exercise. Med Sci Sports Exerc 2000; 32:592-600. [PMID: 10731000 DOI: 10.1097/00005768-200003000-00007] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Temperature increase, oxidative stress, and inflammatory reactions after endurance exercise were expected to stimulate the synthesis of heat shock proteins (HSP) in peripheral blood leukocytes. Furthermore, it was of interest whether regular endurance training influences HSP expression. METHODS The expression of HSP27, HSP60, HSP70, constitutive HSC70, and HSP90 in the cytoplasma and surface of lymphocytes, monocytes, and granulocytes of 12 trained athletes was analyzed by flow cytometry before and after (0, 3, and 24 h) a half marathon. Twelve untrained persons at rest were included as control. RESULTS After the race, there was a significantly greater percentage of leukocytes expressing cytoplasmic HSP27, HSP60, and HSP70 (P < 0.01), whereas HSC70 and HSP90 remained unchanged. The fluorescence intensity increased significantly in monocytes for HSP27 (0 and 3 h) and HSP70 (0, 3, and 24 h) and in granulocytes, only 24 h postexercise for HSP70. The percent values of trained athletes at rest were significantly lower compared with untrained persons (P < 0,01). CONCLUSIONS Strenuous exercise increased HSP expression in blood immediately after the run, indicating a protective function of HSP in leukocytes of athletes to maintain function after heavy exercise. The downregulation of HSP-positive cells in trained athletes at rest seems to be a result of adaptation mechanisms to regular endurance training.
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Affiliation(s)
- E Fehrenbach
- Department of Transfusion Medicine, University of Tuebingen, Germany.
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45
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Khalighi K, Weinstock C, Handgretinger R, Ziemer G. Induction of interleukin-10 during extracorporeal circulation. Crit Care 1999. [PMCID: PMC3300196 DOI: 10.1186/cc324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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46
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König D, Weinstock C, Keul J, Northoff H, Berg A. Zinc, iron, and magnesium status in athletes--influence on the regulation of exercise-induced stress and immune function. Exerc Immunol Rev 1998; 4:2-21. [PMID: 9644092] [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: 02/07/2023]
Abstract
Intense physical exercise has been shown to be associated with immunosuppression and increased rate of infection. The immunosuppressive effect of exhaustive exercise has been attributed to a reduced helper/suppressor T-cell ratio, low salivary levels of immunoglobulin-A, decreased lymphocyte proliferative response and natural killer cell activity, and elevation of stress hormones. Yet some athletes can withstand intense training periods without health problems while others are prone to infections. Thus it has been postulated that other factors may interfere with immunoregulation. The notion that macro- and micronutrients are involved in the regulation of immunological processes and the ability to cope with muscular and systemic exercise stress has been gaining attention. Particularly trace elements have been shown to be related to cell mediated and humoral immunity such as NK-cell activity, T- and B-cell functions, and cytokine release. Many investigations have reported decreased concentrations of trace elements in blood and tissues after training and competition. However, the magnitude of losses is highly dependent on the type and intensity of exercise, the individual regulatory state, and most important, nutrition. This paper reviews the data on zinc, iron, and magnesium status in athletes and summarizes the consequences of deficiencies in these trace elements regarding exercise tolerance and immune function. These elements were chosen since there is evidence they are related to exercise-induced stress and immune function.
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Affiliation(s)
- D König
- Dept. of Rehabilitation, Prevention and Sports Medicine, Freiburg University Hospital, Germany
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47
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Northoff H, Berg A, Weinstock C. Similarities and differences of the immune response to exercise and trauma: the IFN-gamma concept. Can J Physiol Pharmacol 1998; 76:497-504. [PMID: 9839075 DOI: 10.1139/cjpp-76-5-497] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Similar to physical fitness, fitness of the immune system requires training. Animals that have been raised under sterile conditions have a poor immune system and fail to thrive. "Immune training" is normally provided by contact with live microorganisms or immunizations. Increasing evidence has suggested that moderate sports can decrease the frequency of infections while excessive, exhausting exercise can lead to the opposite, a situation that has been described by a J-curve. Following prolonged exhausting exercise, a transient partial suppression of several immune functions can be shown, and it has been suggested that this period provides a window for invasion of microbes. On the basis of data showing that endotoxin-inducible interferon-gamma (IFN-gamma) production is virtually abrogated for a short period following excessive exercise, we present the hypothesis that the rigorous regulatory blockade of one of the ways of IFN-gamma induction may be critically involved in causing the transient immunosuppression following exhaustive exercise stress.
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Affiliation(s)
- H Northoff
- Department of Transfusion Medicine, University of Tuebingen, Germany
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48
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Northoff H, Berg A, Weinstock C. Similarities and differences of the immune response to exercise and trauma: the IFN-γ concept. Can J Physiol Pharmacol 1998. [DOI: 10.1139/y98-052] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Similar to physical fitness, fitness of the immune system requires training. Animals that have been raised under sterile conditions have a poor immune system and fail to thrive. "Immune training" is normally provided by contact with live microorganisms or immunizations. Increasing evidence has suggested that moderate sports can decrease the frequency of infections while excessive, exhausting exercise can lead to the opposite, a situation that has been described by a J-curve. Following prolonged exhausting exercise, a transient partial suppression of several immune functions can be shown, and it has been suggested that this period provides a window for invasion of microbes. On the basis of data showing that endotoxin-inducible interferon-gamma (IFN-gamma) production is virtually abrogated for a short period following excessive exercise, we present the hypothesis that the rigorous regulatory blockade of one of the ways of IFN-gamma induction may be critically involved in causing the transient immunosuppression following exhaustive exercise stress.Key words: exhaustive exercise, immune functions, immunosuppression, interferon-gamma, cytokines.
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Abstract
A patient presented with the unique clinical picture of diffuse cutaneous and mucosal leishmaniasis caused by Leishmania tropica. Elevated serum levels of several cytokines including interleukin (IL) 2, interferon gamma (IFN-gamma), and tumor necrosis factor alpha were found. All cytokine levels returned to normal during therapy. No IL-10 or IL-4 levels were detectable. In whole blood cultures, induction of IFN-gamma by lipopolysaccharide (LPS) was completely negative, even after therapy. Concanavalin A (Con A)-induced release of IFN-gamma, like Con A-induced release of the other cytokines, was only initially impaired but returned to normal during therapy. Induction of the other cytokines by LPS was never impaired. The low expression of human leukocyte antigen DR on monocytes increased during IFN-gamma therapy but dropped when IFN-gamma treatment was ceased. We conclude that in this patient one or more of the routes of IFN-gamma production was impaired, thus resulting in insufficient IFN-gamma production in the infected lesions (although IFN-gamma was systemically present).
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Affiliation(s)
- C Weinstock
- Department of Transfusion Medicine, Eberhard Karls University, Tuebingen, Germany
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50
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Brenner B, Koppenhoefer U, Weinstock C, Linderkamp O, Lang F, Gulbins E. Fas- or ceramide-induced apoptosis is mediated by a Rac1-regulated activation of Jun N-terminal kinase/p38 kinases and GADD153. J Biol Chem 1997; 272:22173-81. [PMID: 9268362 DOI: 10.1074/jbc.272.35.22173] [Citation(s) in RCA: 257] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In the present study, we show that Fas receptor ligation or cellular treatment with synthetic C6-ceramide results in activation or phosphorylation, respectively, of the small G-protein Rac1, Jun N-terminal kinase (JNK)/p38 kinases (p38-K), and the transcription factor GADD153. A signaling cascade from the Fas receptor via ceramide, Ras, Rac1, and JNK/p38-K to GADD153 is demonstrated employing transfection of transdominant inhibitory N17Ras, N17Rac1, c-Jun, or treatment with a specific p38-K inhibitor. The critical function of this signaling cascade is indicated by prevention of Fas- or C6-ceramide-induced apoptosis after inhibition of Ras, Rac1, or JNK/p38-K.
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Affiliation(s)
- B Brenner
- Department of Pediatrics, University of Heidelberg, INF 150, 69120 Heidelberg, Germany
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