1
|
Lipman T, Bienz MN, Pendergrast J, Cserti-Gazdewich C, Branch DR. Unexpected difficulty in performance of a monocyte monolayer assay when using RBCs from a patient with sickle cell disease. Transfusion 2024; 64:4-5. [PMID: 37971163 DOI: 10.1111/trf.17605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Tatiana Lipman
- Centre for Innovation, Canadian Blood Services, Keenan Research Centre, Toronto, Ontario, Canada
| | - Marc Nicolas Bienz
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jacob Pendergrast
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | | | - Donald R Branch
- Centre for Innovation, Canadian Blood Services, Keenan Research Centre, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Sandhu G, Lipman T, Bodnar M, Bienz MN, Branch DR. Significant rosettes observed in monocyte monolayer assay due to complement-binding antibodies. Transfusion 2023. [PMID: 37114749 DOI: 10.1111/trf.17384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023]
Affiliation(s)
- Gurleen Sandhu
- Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | - Tatiana Lipman
- Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | - Melanie Bodnar
- Medical Laboratory and Stem Cell Services, Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Marc Nicolas Bienz
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Donald R Branch
- Centre for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
3
|
Antigen density dictates RBC clearance, but not antigen modulation, following incompatible RBC transfusion in mice. Blood Adv 2021; 5:527-538. [PMID: 33496748 DOI: 10.1182/bloodadvances.2020002695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/17/2020] [Indexed: 12/17/2022] Open
Abstract
Incompatible red blood cell (RBC) transfusion can result in life-threatening transfusion complications that can be challenging to manage in patients with transfusion-dependent anemia. However, not all incompatible RBC transfusions result in significant RBC removal. One factor that may regulate the outcome of incompatible RBC transfusion is the density of the incompatible antigen. Despite the potential influence of target antigen levels during incompatible RBC transfusion, a model system capable of defining the role of antigen density in this process has not been developed. In this study, we describe a novel model system of incompatible transfusion using donor mice that express different levels of the KEL antigen and recipients with varying anti-KEL antibody concentrations. Transfusion of KEL+ RBCs that express high or moderate KEL antigen levels results in rapid antibody-mediated RBC clearance. In contrast, relatively little RBC clearance was observed following the transfusion of KEL RBCs that express low KEL antigen levels. Intriguingly, unlike RBC clearance, loss of the KEL antigen from the transfused RBCs occurred at a similar rate regardless of the KEL antigen density following an incompatible transfusion. In addition to antigen density, anti-KEL antibody levels also regulated RBC removal and KEL antigen loss, suggesting that antigen density and antibody levels dictate incompatible RBC transfusion outcomes. These results demonstrate that antibody-induced antigen loss and RBC clearance can occur at distinct antigen density thresholds, providing important insight into factors that may dictate the outcome of an incompatible RBC transfusion.
Collapse
|
4
|
El-Sayed HAN, Abdollah MRA, Raafat SN, Ragab D. Monocyte monolayer assay in pre-transfusion testing: A magic key in transfusing patients with recurrent bad cross-match due to alloimmunization. J Immunol Methods 2021; 492:112968. [PMID: 33465386 DOI: 10.1016/j.jim.2021.112968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The monocyte monolayer assay (MMA) is an in-vitro assay that can predict the outcome of blood transfusion of antigen positive units when serologically compatible blood is not available. MATERIALS AND METHODS Fifty-four patients testing positive by the antibody screening test using gel agglutination were further examined by the alloantibody identification panel to determine alloantibody specificity. After determining and categorizing the antibodies, patients' samples were examined using the MMA to determine the clinical significance of the detected alloantibodies. We also tested 2 seeding methods (24-well cell culture plates versus 8-well chamber-slides) and 3 visualization/staining techniques (unstained phase contrast, Leishman and Giemsa staining). RESULTS 35 out of the 54 cases (64.8%) had a monocyte index of >5% which is predictive of occurrence of hemolytic reaction after transfusion; 23 cases with antibodies known to be clinically significant [anti-C, anti-E, anti-c, anti-K, anti-Fy(a), anti Fy(b), anti-JK(b)], 2 with Anti-M specificity, 7 cases with autoantibodies and 3 cases with multiple antibodies. On the other hand, 19 out of the 54 (35.2%) cases included in the study showed a monocyte index of <5% which is predictive of absence of hemolytic reaction after transfusion. The 8-well chamber-slides were better than the 24-well culture plates, as the latter showed a lot of un-phagocytosed RBCs in the background. Also, Leishman staining was better than Giemsa staining with better and clearer differentiation between the RBCs, monocytes and phagocytic vacuoles. CONCLUSION MMA can be used as a surrogate cross-match test for the selection of blood units in cases where antigen-negative blood units are not available.
Collapse
Affiliation(s)
| | - Maha R A Abdollah
- Pharmacology and Biochemistry, Faculty of Pharmacy, The British University in Egypt (BUE), Egypt; The Center for Drug Research and Development (CDRD), Faculty of Pharmacy, The British University in Egypt (BUE), Egypt
| | - Shereen N Raafat
- Pharmacology, Faculty of Dentistry, The British University in Egypt (BUE), Egypt; Dentistry Research Center (DRC), Faculty of Dentistery, The British University in Egypt (BUE), Egypt
| | - Dina Ragab
- Clinical Pathology, Faculty of Medicine, Ain Shams University, Egypt.
| |
Collapse
|
5
|
Cen SY, Branch DR. Isoagglutinin-reduced immunoglobulin retains efficacy in mouse models of immune thrombocytopenia and rheumatoid arthritis and is less likely to cause intravenous immunoglobulin-associated hemolysis. Transfusion 2019; 60:250-255. [PMID: 31837028 PMCID: PMC7496430 DOI: 10.1111/trf.15622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/11/2019] [Accepted: 11/15/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Immunoglobulin therapy including intravenous immunoglobulin (IVIg) has been used as an effective treatment for autoimmune/inflammatory conditions with few side effects. However, high‐dose IVIg (1‐2 g/kg) has been recognized as a cause of hemolytic anemia in non–blood group O patients. Hemolysis when observed has been due to anti‐A/anti‐B isoagglutinins contained in the IVIg. Recently, an isoagglutinin‐reduced IVIg, whereby the anti‐A and anti‐B titers have been reduced by immunoaffinity chromatography, has been introduced; however, whether this new product is as efficacious as nonreduced immunoglobulin (Ig) or will result in less IVIg‐associated hemolysis has not been resolved. STUDY DESIGN AND METHODS We used in vitro phagocytosis by monocytes and proinflammatory/anti‐inflammatory macrophages, with isoagglutinin‐reduced and ‐nonreduced Ig opsonized group A1, B, and A1B red blood cells, to estimate clinical significance of the IgG isoagglutinins. We also used immune thrombocytopenia (ITP) and rheumatoid arthritis (RA) mouse models to examine the in vivo efficacy of isoagglutinin‐reduced versus ‐nonreduced Ig on the amelioration of the diseases. RESULTS In contrast to nonreduced Ig, phagocytosis was largely absent when isoagglutinin‐reduced Ig was used at a concentration equivalent to a patient receiving 2 g/kg. The in vivo efficacy of isoagglutinin‐reduced versus nonreduced Ig on the amelioration of experimental ITP and RA was similar, indicating no loss of efficacy due to the chromatographic removal of isoagglutinins. CONCLUSION Isoagglutinin‐reduced Ig should have efficacy similar to nonreduced Ig and result in less IVIg‐associated hemolysis.
Collapse
Affiliation(s)
- Selena Y Cen
- Center for Innovation, Canadian Blood Services, Toronto, Ontario, Canada
| | - Donald R Branch
- Center for Innovation, Canadian Blood Services, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Almizraq RJ, Kipkeu BJ, Acker JP. Platelet vesicles are potent inflammatory mediators in red blood cell products and washing reduces the inflammatory phenotype. Transfusion 2019; 60:378-390. [PMID: 31756004 DOI: 10.1111/trf.15590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Studies suggest that washing red cell concentrates (RCCs) to remove soluble mediators and/or inflammatory components, such as extracellular vesicles (EVs), may lead to better clinical outcomes. This study tested the hypothesis that non-red blood cell (RBC) generated vesicles in RCC are potent inflammatory mediators in vitro and washing RCCs can reduce these vesicles and subsequently decrease the inflammatory activity of RCCs. STUDY DESIGN AND METHODS Sixteen RCCs were pooled and split into four groups based on pre-wash storage time (Day 2 or 14; n = 4/group). Each group was tested 24 hours and 7 days post-wash. Characteristics of RBCs and EVs, cytokines released by monocytes, and expression of human umbilical vein endothelial cells (HUVECs) adhesion molecules were assessed. RESULTS All RCCs meet quality standards for hemolysis, hematocrit, and hemoglobin. Washing did not remove residual platelets from RCCs but led to a significant reduction in platelet-EV count regardless of the group. Supernatant of RCCs washed on Day 14 and stored for 24 hours had significantly lower concentrations of RBC-EVs and white blood cell EVs compared to unwashed controls. Supernatant of unwashed RCCs showed higher production of inflammatory cytokines/chemokines MCP-1, IL-8, and TNF-α, and heightened expression of HUVEC VCAM-1, which were significantly reduced by washing. Spiking washed RCC supernatants with platelet-EVs showed significant increase in IL-8, MCP-1, VCAM-1, and E-selection in groups washed on Day 14. CONCLUSIONS Platelet-EVs in RCCs are associated with pro-inflammatory activity. As washing significantly reduced RCC immunomodulatory activity, implementation of this process may improve transfusion outcomes.
Collapse
Affiliation(s)
- Ruqayyah J Almizraq
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Betty J Kipkeu
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Jason P Acker
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.,Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada
| |
Collapse
|
7
|
Arthur CM, Chonat S, Fasano R, Yee MEM, Josephson CD, Roback JD, Stowell SR. Examining the Role of Complement in Predicting, Preventing, and Treating Hemolytic Transfusion Reactions. Transfus Med Rev 2019; 33:217-224. [PMID: 31679762 PMCID: PMC7147990 DOI: 10.1016/j.tmrv.2019.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 12/24/2022]
Abstract
Red blood cell (RBC) transfusion is a critical component of optimal management for a broad range of conditions. Regardless of the indication, pretransfusion testing is required to appropriately match RBC donors and recipients to provide immunologically compatible blood. Although this approach is effective in the vast majority of situations, occasionally, patients will inadvertently receive an incompatible RBC transfusion, which can result in a hemolytic transfusion reaction (HTR). In addition, patients with life-threatening anemia and a complex alloantibody profile, which precludes rapid procurement of compatible RBCs, may also receive incompatible RBCs, placing them at risk for an HTR. Despite the rarity of these clinical situations, when incompatible blood transfusion results in an HTR, the consequences can be devastating. In this review, we will explore the challenges associated with actively preventing and treating acute HTRs following incompatible RBC transfusion. In doing so, we will focus primarily on the role of complement, not only as a key player in HTRs, but also as a potential target for the prevention and treatment of HTRs.
Collapse
Affiliation(s)
- Connie M Arthur
- Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Satheesh Chonat
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA
| | - Ross Fasano
- Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA
| | - Marianne E M Yee
- Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA
| | - Cassandra D Josephson
- Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA
| | - John D Roback
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA
| | - Sean R Stowell
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, Atlanta, GA.
| |
Collapse
|
8
|
Chonat S, Arthur CM, Zerra PE, Maier CL, Jajosky RP, Yee MEM, Miller MJ, Josephson CD, Roback JD, Fasano R, Stowell SR. Challenges in preventing and treating hemolytic complications associated with red blood cell transfusion. Transfus Clin Biol 2019; 26:130-134. [PMID: 30979566 DOI: 10.1016/j.tracli.2019.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Red blood cell (RBC) transfusion support represents a critical component of sickle cell disease (SCD) management. However, as with any therapeutic intervention, RBC transfusion is not without risk. Repeat exposure to allogeneic RBCs can result in the development of RBC alloantibodies that can make it difficult to find compatible RBCs for future transfusions and can directly increase the risk of developing acute or delayed hemolytic transfusion reactions, which can be further complicated by hyperhemolysis. Several prophylactic and treatment strategies have been employed in an effort to reduce or prevent hemolytic transfusion reactions. However, conflicting data exist regarding the efficacy of many of these approaches. We will explore the challenges associated with predicting, preventing and treating different types of hemolytic transfusion reactions in patients with SCD in addition to describing future strategies that may aid in the management of the complex transfusion requirements of SCD patients.
Collapse
Affiliation(s)
- Satheesh Chonat
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Connie M Arthur
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA
| | - Patricia E Zerra
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA
| | - Cheryl L Maier
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA
| | - Ryan P Jajosky
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA
| | - Marianne E M Yee
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Maureen J Miller
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA
| | - Cassandra D Josephson
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA
| | - John D Roback
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA
| | - Ross Fasano
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, and Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA.
| | - Sean R Stowell
- Center for Transfusion Medicine and Cellular Therapies, Department of Laboratory Medicine and Pathology, Emory University School of Medicine, 101, Woodruff Circle, 30322 Atlanta, GA, USA.
| |
Collapse
|
9
|
Tong TN, Cen S, Branch DR. The Monocyte Monolayer Assay: Past, Present and Future. Transfus Med Rev 2019; 33:24-28. [DOI: 10.1016/j.tmrv.2018.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/19/2018] [Accepted: 07/24/2018] [Indexed: 11/24/2022]
|
10
|
Lemay AS, Tong TN, Branch DR, Huang M, Sumner C, Oldfield L, Hawes J, Cserti-Gazdewich CM, Lau W. The first case of severe acute hemolytic transfusion reaction caused by anti-Sc2. Transfusion 2018; 58:2506-2512. [PMID: 30299537 DOI: 10.1111/trf.14867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/28/2018] [Accepted: 05/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Alloantibodies to the low-frequency antigen Scianna-2 (Sc2) have been implicated in cases of hemolytic disease of the fetus and newborn but never in hemolytic transfusion reactions (HTRs); thus, the clinical significance of anti-Sc2 has yet to be fully addressed. STUDY DESIGN AND METHODS A 26-year-old woman with thalassemia presented rigors, fever, nausea, abdominal pain, and hemolytic biochemistry after exposure to 75 mL of plasma-reduced red blood cells (RBCs). The RBC unit was issued by electronic crossmatch but was 3+ incompatible on recrossmatch by gel indirect antiglobulin test (IAT). The patient had anti-Sc2 previously identified, but considered to be clinically insignificant. The transfusion history was reviewed and a monocyte monolayer assay (MMA) was performed. RESULTS The patient was investigated for a RBC reaction 9 years prior, when she developed symptoms of HTR. The RBC unit was crossmatched by immediate spin due to consistent screen negativity. Full crossmatch found the RBC 1+ incompatible by gel IAT with both pre/post samples, while direct antiglobulin test was negative (pre) and 1+ immunoglobulin G positive (post). The antibody remained unidentified and she was committed to gel IAT crossmatch. Two-years later, the specificity to Sc2 was deduced when one RBC unit was found 3+ incompatible. Finally, the transfusion reaction reported herein occurred when she received by happenstance RBCs from the same donor who was associated with the remote reaction 9 years earlier. MMA yielded highly positive phagocytic indices only for Sc2+ RBCs, including the donor's RBCs that triggered the severe HTR. CONCLUSION This is the first case of HTR caused by anti-Sc2 confirmed by clinical findings and MMA.
Collapse
Affiliation(s)
- Anne-Sophie Lemay
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Tik Nga Tong
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,the Centre for Innovation, Toronto, Ontario, Canada
| | - Donald R Branch
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,the Centre for Innovation, Toronto, Ontario, Canada.,University Health Network, Toronto, Ontario, Canada
| | - Mary Huang
- Diagnostic Services, Canadian Blood Services, Toronto, Ontario, Canada
| | | | - Lynne Oldfield
- Diagnostic Services, Canadian Blood Services, Toronto, Ontario, Canada
| | - Janice Hawes
- University Health Network, Toronto, Ontario, Canada
| | | | - Wendy Lau
- Diagnostic Services, Canadian Blood Services, Toronto, Ontario, Canada.,The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
11
|
Kipkeu BJ, Shyian ML, da Silveira Cavalcante L, Duong TT, Yeung RS, Binnington B, Branch DR, Acker JP, Holovati JL. Evaluation of the functional properties of cryopreserved buffy coat-derived monocytes for monocyte monolayer assay. Transfusion 2018; 58:2027-2035. [DOI: 10.1111/trf.14650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 03/08/2018] [Accepted: 03/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Betty J. Kipkeu
- Department of Laboratory Medicine and Pathology; University of Alberta; Edmonton Alberta Canada
| | - Melissa L. Shyian
- Department of Laboratory Medicine and Pathology; University of Alberta; Edmonton Alberta Canada
| | | | | | - Rae S.M. Yeung
- The Hospital for Sick Children; Toronto Ontario Canada
- Department of Paediatrics; University of Toronto; Toronto Ontario Canada
| | - Beth Binnington
- Centre for Innovation; Canadian Blood Services; Toronto Ontario Canada
| | - Donald R. Branch
- Centre for Innovation; Canadian Blood Services; Toronto Ontario Canada
- Department of Medicine; University of Toronto; Toronto Ontario Canada
| | - Jason P. Acker
- Department of Laboratory Medicine and Pathology; University of Alberta; Edmonton Alberta Canada
- Centre for Innovation; Canadian Blood Services; Edmonton Alberta Canada
| | - Jelena L. Holovati
- Department of Laboratory Medicine and Pathology; University of Alberta; Edmonton Alberta Canada
- Centre for Innovation; Canadian Blood Services; Edmonton Alberta Canada
| |
Collapse
|
12
|
Qadri SM, Donkor DA, Yan M, Ning S, Branch DR, Seghatchian J, Sheffield WP. Red blood cells, still vital after all these years: Commentary on Canadian Blood Services' International Symposium 2017. Transfus Apher Sci 2018; 57:298-303. [PMID: 29691151 DOI: 10.1016/j.transci.2018.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Canadian Blood Services (CBS), Canada's national blood transfusion service, has for many years sponsored an annual conference, for the education and awareness of interested participants, showcasing the latest evidence-based understanding of both basic science and clinical issues in transfusion medicine and science. The 15th iteration of this symposium took place September 9, 2017 and focused on some of the vital aspects of red blood cells (RBC), in line with the" 3Rs" concept, namely the provision of the Right red blood cell (RBC) product to the Right patient at the Right time. Presentations touched upon: the evolution of blood banking in North America; the monocyte monolayer assay as a predictor of post-transfusion hemolysis; hemoglobin-based oxygen carriers; RBC alloimmunization; serological approaches to complex RBC antibody problems; randomized clinical trials related to the age of stored RBC; RBC genotyping; pathophysiology, prevention and treatment of hemolytic disease of the fetus and newborn (HDFN); and testing and timing in perinatal serology. This commentary provides summaries of all speakers' presentations annotated with relevant references. Special thanks are due to all contributors for their praiseworthy approaches in sharing their experiences and knowledge on this interesting scientific/clinical and management theme.
Collapse
Affiliation(s)
- Syed M Qadri
- Centre for Innovation of Canadian Blood Services, Hamilton, Ontario, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - David A Donkor
- Centre for Innovation of Canadian Blood Services, Hamilton, Ontario, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Matthew Yan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shuoyan Ning
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Donald R Branch
- Centre for Innovation of Canadian Blood Services, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jerard Seghatchian
- International Consultancy in Blood Components Quality/Safety Improvement, Audit/Inspection and DDR Strategies, London, United Kingdom.
| | - William P Sheffield
- Centre for Innovation of Canadian Blood Services, Hamilton, Ontario, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
13
|
Matthews K, Duffy SP, Myrand-Lapierre ME, Ang RR, Li L, Scott MD, Ma H. Microfluidic analysis of red blood cell deformability as a means to assess hemin-induced oxidative stress resulting from Plasmodium falciparum intraerythrocytic parasitism. Integr Biol (Camb) 2018; 9:519-528. [PMID: 28524208 DOI: 10.1039/c7ib00039a] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hemolytic anemia is one of the hallmarks of malaria and leads to an increase in oxidized heme (hemin) within the plasma of infected individuals. While scavenger proteins sequester much of the circulating heme, it has been hypothesized that extracellular heme may play a central role in malaria pathogenesis. We have previously developed the multiplex fluidic plunger (MFP) device for the measurement of red blood cell (RBC) deformability. Here, we demonstrate that the measurement of changes in RBC deformability is a sensitive method for inferring heme-induced oxidative stress. We further show that extracellular hemin concentration correlates closely with changes in RBC deformability and we confirm that this biophysical change correlates with other indicators of cell stress. Finally, we show that reduced erythrocyte deformability corresponds with both erythrophagocytosis and RBC osmotic fragility. The MFP microfluidic device presents a simple and potentially inexpensive alternative to existing methods for measuring hemolytic cell stress that could ultimately be used to perform clinical assessment of disease progression in severe malaria.
Collapse
Affiliation(s)
- Kerryn Matthews
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC V6T 1Z4, Canada.
| | | | | | | | | | | | | |
Collapse
|
14
|
Stowell SR. Toward functional assays for assessing the significance of anti-ABO(H) alloantibodies. Transfusion 2018; 57:491-494. [PMID: 28297078 DOI: 10.1111/trf.14030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 12/29/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Sean R Stowell
- Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
15
|
Yazer MH, Seheult J, Kleinman S, Sloan SR, Spinella PC. Who's afraid of incompatible plasma? A balanced approach to the safe transfusion of blood products containing ABO-incompatible plasma. Transfusion 2017; 58:532-538. [PMID: 29193106 DOI: 10.1111/trf.14415] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Mark H Yazer
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jansen Seheult
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Steven Kleinman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Victoria, British Columbia, Canada
| | - Steven R Sloan
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Philip C Spinella
- Department of Pediatrics, Division of Critical Care Medicine, Washington University in St Louis, St Louis, Missouri
| |
Collapse
|
16
|
da Silveira Cavalcante L, Branch DR, Duong TT, Yeung RS, Acker JP, Holovati JL. The immune-stimulation capacity of liposome-treated red blood cells. J Liposome Res 2017; 28:173-181. [DOI: 10.1080/08982104.2017.1295991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Luciana da Silveira Cavalcante
- Canadian Blood Services Centre for Innovation, Edmonton, AB, Canada,
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada,
| | - Donald R. Branch
- Canadian Blood Services Centre for Innovation, Toronto, ON, Canada,
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada,
| | - Trang T. Duong
- The Hospital for Sick Children, Toronto, ON, Canada, and
| | - Rae S.M. Yeung
- The Hospital for Sick Children, Toronto, ON, Canada, and
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Jason P. Acker
- Canadian Blood Services Centre for Innovation, Edmonton, AB, Canada,
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada,
| | - Jelena L. Holovati
- Canadian Blood Services Centre for Innovation, Edmonton, AB, Canada,
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada,
| |
Collapse
|
17
|
Tong TN, Branch DR. Use of a Monocyte Monolayer Assay to Evaluate Fcγ Receptor-mediated Phagocytosis. J Vis Exp 2017. [PMID: 28117787 PMCID: PMC5408648 DOI: 10.3791/55039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Although originally developed for predicting transfusion outcomes of serologically incompatible blood, the monocyte monolayer assay (MMA) is a highly versatile in vitro assay that can be modified to examine different aspects of antibody and Fcγ receptor (FcγR)-mediated phagocytosis in both research and clinical settings. The assay utilizes adherent monocytes from peripheral blood mononuclear cells isolated from mammalian whole blood. MMA has been described for use in both human and murine investigations. These monocytes express FcγRs (e.g., FcγRI, FcγRIIA, FcγRIIB, and FcγRIIIA) that are involved in immune responses. The MMA exploits the mechanism of FcγR-mediated interactions, phagocytosis in particular, where antibody-sensitized red blood cells (RBCs) adhere to and/or activate FcγRs and are subsequently phagocytosed by the monocytes. In vivo, primarily tissue macrophages found in the spleen and liver carry out FcγR-mediated phagocytosis of antibody-opsonized RBCs, causing extravascular hemolysis. By evaluating the level of phagocytosis using the MMA, different aspects of the in vivo FcγR-mediated process can be investigated. Some applications of the MMA include predicting the clinical relevance of allo- or autoantibodies in a transfusion setting, assessing candidate drugs that promote or inhibit phagocytosis, and combining the assay with fluorescent microscopy or traditional Western immunoblotting to investigate the downstream signaling effects of FcγR-engaging drugs or antibodies. Some limitations include the laboriousness of this technique, which takes a full day from start to finish, and the requirement of research ethics approval in order to work with mammalian blood. However, with diligence and adequate training, the MMA results can be obtained within a 24-h turnover time.
Collapse
Affiliation(s)
- Tik Nga Tong
- Department of Laboratory Medicine and Pathobiology, University of Toronto
| | - Donald R Branch
- Department of Laboratory Medicine and Pathobiology, University of Toronto; Centre for Innovation, Canadian Blood Services;
| |
Collapse
|
18
|
Tong TN, Burke-Murphy E, Sakac D, Pendergrast J, Cserti-Gazdewich C, Laroche V, Branch DR. Optimal conditions for the performance of a monocyte monolayer assay. Transfusion 2016; 56:2680-2690. [DOI: 10.1111/trf.13766] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 06/14/2016] [Accepted: 06/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Tik Nga Tong
- Department of Laboratory Medicine and Pathobiology; Canadian Blood Services; Toronto, Ontario
- Centre for Innovation; Canadian Blood Services
| | | | | | | | | | | | - Donald R. Branch
- Department of Laboratory Medicine and Pathobiology; Canadian Blood Services; Toronto, Ontario
- Centre for Innovation; Canadian Blood Services
- University Health Network; Toronto, Ontario Canada
- Department of Medicine; University of Toronto
| |
Collapse
|
19
|
Tong TN, Cserti-Gazdewich CM, Branch DR. Value of MMA crossmatch? Transfus Med 2016; 26:301-2. [PMID: 27144777 DOI: 10.1111/tme.12311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 11/27/2022]
Affiliation(s)
- T N Tong
- University Health Network and Centre for Innovation, Canadian Blood Services, Toronto, Canada
| | - C M Cserti-Gazdewich
- University Health Network and Centre for Innovation, Canadian Blood Services, Toronto, Canada
| | - D R Branch
- University Health Network and Centre for Innovation, Canadian Blood Services, Toronto, Canada.
| |
Collapse
|
20
|
Li L, Noumsi GT, Kwok YYE, Moulds JM, Scott MD. Inhibition of phagocytic recognition of anti-D opsonized Rh D+ RBC by polymer-mediated immunocamouflage. Am J Hematol 2015; 90:1165-70. [PMID: 26440218 PMCID: PMC4738408 DOI: 10.1002/ajh.24211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 09/30/2015] [Accepted: 10/05/2015] [Indexed: 11/23/2022]
Abstract
The Rh D antigen posed both a significant clinical risk and inventory supply issue in transfusion medicine. The successful development of the immunocamouflaged RBC has the potential to address both the risk of acute anti‐D transfusion reactions and to improve D− blood inventory in geographic locations where D− blood is rare (e.g., China). The immunocamouflage of RBC was mediated by the covalent grafting of methoxy(polyethylene glycol) to the cell membrane thereby obscuring the D protein from the immune system. To determine the potential efficacy of mPEG‐D+ RBC in D− recipients, anti‐D alloantibodies from previously alloimmunized individuals were utilized. The effects of polymer chain size (2–30 kDa) and grafting concentration (0–4 mM) on antibody binding and erythrophagocytosis were determined using the clinically validated monocyte monolayer assay (MMA) and flow cytometry. The immunocamouflage of D was polymer size and grafting concentration dependent as determined using human anti‐D alloantibodies (both pooled [RhoGAM] and single donors). Importantly, the 20 kDa polymer provided excellent immunocamouflage of D and reached a clinically significant level of protection, as measured by the MMA, at grafting concentrations of ≥1.5 mM. These findings further support the potential use of immunocamouflaged RBC to reduce the risk of acute transfusion reactions following administration of D+ blood to D− recipients in situations where D− units are unavailable or supply is geographically constrained. Am. J. Hematol. 90:1165–1170, 2015. © 2015 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Li Li
- Canadian Blood Services; Ottawa Ontario Canada
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
| | - Ghislain T. Noumsi
- LifeShare Blood Centers; Shreveport Louisiana
- Grifols ImmunoHematology Center; San Marcos Texas
| | - Yin Yu Eunice Kwok
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
| | - Joann M. Moulds
- LifeShare Blood Centers; Shreveport Louisiana
- Grifols ImmunoHematology Center; San Marcos Texas
| | - Mark D. Scott
- Canadian Blood Services; Ottawa Ontario Canada
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
| |
Collapse
|
21
|
Flegel WA. Pathogenesis and mechanisms of antibody-mediated hemolysis. Transfusion 2015; 55 Suppl 2:S47-58. [PMID: 26174897 DOI: 10.1111/trf.13147] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND The clinical consequences of antibodies to red blood cells (RBCs) have been studied for a century. Most clinically relevant antibodies can be detected by sensitive in vitro assays. Several mechanisms of antibody-mediated hemolysis are well understood. Such hemolysis after transfusion is reliably avoided in a donor-recipient pair, if one individual is negative for the cognate antigen to which the other has the antibody. STUDY DESIGN AND RESULTS Mechanisms of antibody-mediated hemolysis were reviewed based on a presentation at the Strategies to Address Hemolytic Complications of Immune Globulin Infusions Workshop addressing intravenous immunoglobulin (IVIG) and ABO antibodies. The presented topics included the rates of intravascular and extravascular hemolysis; immunoglobulin (Ig)M and IgG isoagglutinins; auto- and alloantibodies; antibody specificity; A, B, A,B, and A1 antigens; A1 versus A2 phenotypes; monocytes-macrophages, other immune cells, and complement; monocyte monolayer assay; antibody-dependent cell-mediated cytotoxicity; and transfusion reactions due to ABO and other antibodies. CONCLUSION Several clinically relevant questions remained unresolved, and diagnostic tools were lacking to routinely and reliably predict the clinical consequences of RBC antibodies. Most hemolytic transfusion reactions associated with IVIG were due to ABO antibodies. Reducing the titers of such antibodies in IVIG may lower the frequency of this kind of adverse event. The only way to stop these events is to have no anti-A or anti-B in the IVIG products.
Collapse
Affiliation(s)
- Willy A Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
22
|
Noumsi GT, Billingsley KL, Moulds JM. Successful transfusion of antigen positive blood to alloimmunised patients using a monocyte monolayer assay. Transfus Med 2015; 25:92-100. [PMID: 25828731 DOI: 10.1111/tme.12189] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 01/02/2015] [Accepted: 03/08/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Providing adequate transfusion support for alloimmunised patients for whom antigen negative blood is not readily available is hampered by the risk of a haemolytic reaction. The monocyte monolayer assay (MMA) has shown good correlation between the antibody clinical significance and the fate of antigen positive blood. MATERIALS AND METHODS From 2006 to 2013, the clinical significance of red cell alloantibodies produced by 61 patients was evaluated using a MMA; and antigen positive blood offering the best survival advantage was selected for transfusion following a secondary MMA crossmatch. Post-transfusion, patients were evaluated for clinical signs of haemolysis. RESULTS Overall, 19 of 61 (31·1%) of our antibodies were potentially clinically significant, with a monocyte index (MI) > 5%. There was no correlation between the clinical significance as showed by the MMA, and the specificity of the antibody or the strength of reactivity at antihuman globulin (AHG) phase. Using the MMA as a secondary crossmatch method, 31 alloimmunised patients (including: eight anti-hr(B), four anti-Yt(a), one each anti-Rg1, -Co(a), Er(a), Le(b), -LW, -Sl1) received 103 antigen positive blood units with no clinical sign of a post-transfusion reaction. For three patients (one each anti-Jo(a), -AnWj, unidentified 'HTLA'), initial MMA was performed as part of an investigation of a suspected haemolytic reaction. In each case, the MMA accurately identified the unit responsible for the reaction. CONCLUSION Used as a crossmatch surrogate, the MMA provided valuable information in the decision of transfusing antigen positive blood to alloimmunised patients, avoiding delay because of the search of rare antigen negative units.
Collapse
Affiliation(s)
- G T Noumsi
- LifeShare Blood Centers, Scientific Support Services, Shreveport, Louisiana, USA
| | - K L Billingsley
- LifeShare Blood Centers, Scientific Support Services, Shreveport, Louisiana, USA
| | - J M Moulds
- LifeShare Blood Centers, Scientific Support Services, Shreveport, Louisiana, USA
| |
Collapse
|
23
|
Structure–activity relationships of pyrazole derivatives as potential therapeutics for immune thrombocytopenias. Bioorg Med Chem 2014; 22:2739-52. [DOI: 10.1016/j.bmc.2014.03.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 03/01/2014] [Accepted: 03/10/2014] [Indexed: 11/23/2022]
|
24
|
Kyluik-Price DL, Li L, Scott MD. Comparative efficacy of blood cell immunocamouflage by membrane grafting of methoxypoly(ethylene glycol) and polyethyloxazoline. Biomaterials 2013; 35:412-22. [PMID: 24074839 DOI: 10.1016/j.biomaterials.2013.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 09/04/2013] [Indexed: 02/04/2023]
Abstract
The grafting of low-immunogenic polymers to cells dramatically reduces antigenic recognition and immunogenicity of allogeneic donor cells consequent to steric and charge camouflage (i.e., immunocamouflage). While methoxypoly(ethylene glycol) [mPEG] has historically been utilized for the immunocamouflage of cells, other low-immunogenic polymers such as polyethyloxazoline propionic acid (PEOZ) may also be capable of conferring immunoprotection. Moreover, PEOZ may have attributes that could have enhanced pharmacological and biological utility relative to mPEG. To evaluate the immunocamouflage efficacy of PEOZ relative to mPEG, human red blood cells (RBC) and leukocytes were modified with mPEG or PEOZ. The differential effects of mPEG and PEOZ was assessed via grafting efficacy, cell morphology and viability, immunocamouflage of surface antigens, and the prevention of in vitro immune recognition (RhD and HLA). Although membrane grafting of mPEG and PEOZ were similar, mPEG demonstrated superior immunocamouflage efficacy as measured by antibody binding and phagocytosis of opsonized RBC while PEOZ showed improved RBC morphology. While mPEG appears to be superior to PEOZ in the immunocamouflage of cells, PEOZ may still be a valuable addition to our repertoire of immunomodulatory polymers. Moreover, our results demonstrate the importance of indirect immunocamouflage of antigens found in membrane protein complexes.
Collapse
Affiliation(s)
- Dana L Kyluik-Price
- Canadian Blood Services, University of British Columbia, Life Sciences Centre, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; The Centre for Blood Research, University of British Columbia, Life Sciences Centre, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine at the University of British Columbia, Vancouver, Canada
| | | | | |
Collapse
|
25
|
Moulds JM, Persa R, Rierson D, Billingsley KL, Noumsi GT, Hue-Roye K, Reid ME. Three novel alleles in the Kell blood group system resulting in the Knullphenotype and the first in a Native American. Transfusion 2013; 53:2867-71. [DOI: 10.1111/trf.12205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 02/07/2013] [Accepted: 02/17/2013] [Indexed: 11/28/2022]
|
26
|
Purohit MK, Scovell I, Neschadim A, Katsman Y, Branch DR, Kotra LP. Disulfide linked pyrazole derivatives inhibit phagocytosis of opsonized blood cells. Bioorg Med Chem Lett 2013; 23:2324-7. [DOI: 10.1016/j.bmcl.2013.02.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 02/07/2013] [Accepted: 02/13/2013] [Indexed: 12/29/2022]
|
27
|
Poulsen LO, Freund L, Lylloff K, Grunnet N. Positive Coombs' test associated with ulcerative colitis. A prevalence study. ACTA MEDICA SCANDINAVICA 2009; 223:75-8. [PMID: 3348105 DOI: 10.1111/j.0954-6820.1988.tb15767.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Among 112 patients with ulcerative colitis (UC), a positive Coombs' test was detected in two cases. The immunoglobulins were IgG and no complement could be detected on the red cells. None of the two patients showed laboratory evidence of hemolysis, although reduced red cell survival was suspected in one patient with a 6-year history of UC, previous autoimmune hemolytic anemia and a positive in vitro monocyte-macrophage phagocytosis test. The HLA-antigens in the two patients were different except for the common antigen HLA-A1.
Collapse
Affiliation(s)
- L O Poulsen
- Department of Medical Gastroenterology, Aalborg Hospital, Denmark
| | | | | | | |
Collapse
|
28
|
Hadley AG, Poole GD, Amphlett NW, Lucas GF. The use of interferon-gamma-treated U937 cells in chemiluminescence assays to detect red cell, platelet and granulocyte antibodies of potential clinical significance. CLINICAL AND LABORATORY HAEMATOLOGY 2008; 14:315-26. [PMID: 1478011 DOI: 10.1111/j.1365-2257.1992.tb00107.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The chemiluminescent (CL) response of interferon-gamma-treated U937 (IFN-U937) cells to sensitized target cells has been used to detect red cell, platelet and granulocyte antibodies. A clone of U937 cells was selected which expressed Fc receptor I (Fc gamma RI) and which, after incubation with IFN-gamma for 72 h, was capable of generating high levels of lucigenin-enhanced CL. The CL responses of IFN-U937 cells and peripheral blood human monocytes to sensitized red cells, platelets or granulocytes were then compared. Assays using monocytes or IFN-U937 cells were of comparable sensitivity for detection of antibodies against all three types of target cell. In addition, the use of IFN-U937 cells reduced interassay variation and simplified assay performance. The potential clinical usefulness of these CL assays was suggested by the ability of both monocytes and IFN-U937 cells to respond to red cells, platelets or granulocytes sensitized with sera from pregnant women whose babies had either haemolytic disease of the newborn (HDN), alloimmune thrombocytopenia or alloimmune neutropenia respectively. In addition, monocytes and IFN-U937 cells both responded to red cells sensitized with antibodies against a variety of specificities of assumed (although not documented) clinical significance for blood transfusion recipients. In contrast, monocytes and IFN-U937 cells responded only weakly to red cells sensitized with either anti-D in sera from mothers of babies unaffected by HDN, or with antisera containing high titre antibodies with specificities not normally associated with significantly reduced red cell survival.
Collapse
Affiliation(s)
- A G Hadley
- International Blood Group Reference Laboratory, Bristol, UK
| | | | | | | |
Collapse
|
29
|
Abstract
Observations on rosette formation of red blood cells sensitized with a known number of IgG1 or IgG3 polyclonal or monoclonal anti-Rh(D) antibodies with monocytes, lymphocytes and granulocytes have provided further evidence for the essential role of monocytes/macrophages in red cell destruction. The rosette test with monocytes and the monocyte-monolayer assay (MMA) have confirmed, on a quantitative basis, the greater binding ability of IgG3 than of IgG1 antibodies and that the rate of interaction with red cells increases in proportion to the level of their sensitization. These observations have suggested that the MMA may reflect haemolysis in vivo. It has appeared that the MMA is suitable for assessing haemolysis in many cases of haemolytic disease of the newborn, in autoimmune haemolytic anaemia and in patients with alloantibodies to be transfused. Since in individual cases a clear correlation between the MMA results and haemolysis in vivo was not observed, the factors which may influence such discrepancies are discussed.
Collapse
Affiliation(s)
- B Zupańska
- Institute of Haematology, Warsaw, Poland
| |
Collapse
|
30
|
Karamatic Crew V, Poole J, Long S, Warke N, Colavecchia C, Burton N, Moulds M, Schlanser G, Wilson L, Noumsi G, Moulds JM, Moulds JJ, Daniels G. Two MER2-negative individuals with the same novel CD151 mutation and evidence for clinical significance of anti-MER2. Transfusion 2008; 48:1912-6. [PMID: 18522704 DOI: 10.1111/j.1537-2995.2008.01792.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND MER2 (RAPH1), the only antigen of the RAPH blood group system, is located on the tetraspanin CD151. Only four examples of alloanti-MER2 are known. We report here two new examples of alloanti-MER2, in women of Pakistani and Turkish origin, one of whom showed signs of a hemolytic transfusion reaction (HTR) after transfusion of 3 units of red cells (RBCs). STUDY DESIGN AND METHODS Standard serologic methods were used. A monocyte monolayer assay (MMA) was used to assess the potential clinical significance of one of the antibodies. All exons and flanking intronic sequences of CD151 were amplified and sequenced. A homology model for CD151 second extracellular loop (EC2) was constructed based on the crystal structure of CD81. RESULTS RBCs of both patients did not react with alloanti-MER2, and neither of their antibodies reacted with MER2-negative RBCs. The MMA results suggested that the antibody that appeared to have caused an HTR had the potential to be clinically significant. Both patients were homozygous for a 511C>T mutation in CD151 encoding an Arg171Cys change. This change did not result in any significant structural rearrangement in the protein model. CONCLUSIONS Two MER2-negative patients with anti-MER2 are homozygous for the same novel mutation encoding an amino acid substitution in the EC2 of CD151. One of the antibodies may have been responsible for an HTR, and crossmatch-compatible RBCs should be recommended for transfusion to patients with anti-MER2.
Collapse
Affiliation(s)
- Vanja Karamatic Crew
- Bristol Institute for Transfusion Sciences and International Blood Group Reference Laboratory, Bristol, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Foo AH, Ramkumar S, Helke S, Branch DR. Chemical treatment of anti-D results in improved efficacy for the inhibition of Fcγ receptor–mediated phagocytosis. Transfusion 2007; 47:2250-9. [PMID: 17714414 DOI: 10.1111/j.1537-2995.2007.01454.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND This study investigated whether treatment of immunoglobulins anti-D or intravenous immune globulin (IVIG) with chemicals previously shown to inhibit phagocytosis could result in an enhancement of Fcgamma receptor (FcgammaR) blockade in vitro. If successful, this approach may provide the possibility of targeting these chemicals to monocyte-macrophages for increased efficacy of immunoglobulin-based therapies in vivo. STUDY DESIGN AND METHODS For proof-of-concept, the chemical thimerosal, a prototype FcgammaR inhibitor, was combined with RhIG or IVIG. Residual chemical was removed by extensive dialysis. With a monocyte monolayer assay (MMA) and a concentration of immunoglobulin alone that results in 50 percent inhibition of MMA phagocytosis of antibody-coated red blood cells, the effect of thimerosal treatment on the ability of the immunoglobulin to show a significant enhancement of efficacy was determined. RESULTS It is shown that combining thimerosal with anti-D, either slide and rapid tube or commercially available (WinRho SDF, Cangene), results in a highly significant increase in efficacy over anti-D alone to inhibit phagocytosis in vitro. This effect was not due to residual unbound compound or to cellular toxicity of the chemically treated immunoglobulins. Treatment of IVIG with thimerosal had no significant effect on its ability to inhibit in vitro phagocytosis. CONCLUSION Our results indicate that it is possible to modify an immunoglobulin by chemical treatment such that the treated immunoglobulin demonstrates significantly enhanced ability to inhibit FcgammaR-mediated phagocytosis. It is also demonstrated that IVIG and anti-D appear to respond differently after chemical treatment. Further examination of this strategy is warranted and has the potential to reduce the dose, cost, and possibly, adverse effects of immunoglobulin-based therapies.
Collapse
Affiliation(s)
- Alison H Foo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | | | | | | |
Collapse
|
32
|
Foo AH, Fletcher SP, Langler RF, Porter CH, Branch DR. Structure-function studies for in vitro chemical inhibition of Fc? receptor?mediated phagocytosis. Transfusion 2007; 47:290-8. [PMID: 17302776 DOI: 10.1111/j.1537-2995.2007.01105.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previous studies [Transfusion 2005;45:384] showed that certain chemical compounds containing sulfur-reactive groups can inhibit Fcgamma receptor (FcgammaR)-mediated phagocytosis in vitro. These studies, however, did not prove that only sulfur functionality-induced reactivity was efficacious. In an effort to develop a drug-based approach for the future treatment of immune-mediated cytopenias, these earlier findings have now been extended and this chemically induced interference with FcgammaR-mediated phagocytosis of anti-D-coated red cells (RBCs) was examined to assess the optimal structural requirements for the inhibitory effect. STUDY DESIGN AND METHODS Chemical compounds were purchased or synthesized and used for the assessment of which chemical moiety(-ies) were required for successful inhibition of in vitro phagocytosis of anti-D-coated RBCs with a monocyte monolayer assay. RESULTS Using compounds having similar structures but differences in reactive moieties, it was proved that the only chemical moiety that was required for inhibition of FcgammaR-mediated phagocytosis in vitro was a disulfide bond. It is also shown, however, that a p-nitrophenyl group provides significant enhancement to the inhibitory effect of disulfide-containing compounds. Involvement of carbonyl and hydroxyl functional groups was also able to be ruled out. CONCLUSION Our results confirm and extend previous studies that suggested that only those compounds that target free sulfhydryl groups on the monocyte-macrophage are most effective at blocking phagocytosis of antibody-coated RBCs in vitro. It is also shown that p-nitrophenyl substituent groups have an enhancing effect on the efficacy of disulfide bond-containing compounds. These findings should aid in the design of a drug-based approach for the future treatment of immune cytopenias.
Collapse
Affiliation(s)
- Alison H Foo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, The Division of Cell and Molecular Biology, Toronto General Research Institute, Canadian Blood Services, Toronto, Ontario, Canada
| | | | | | | | | |
Collapse
|
33
|
Rampersad GC, Suck G, Sakac D, Fahim S, Foo A, Denomme GA, Langler RF, Branch DR. Chemical compounds that target thiol-disulfide groups on mononuclear phagocytes inhibit immune mediated phagocytosis of red blood cells. Transfusion 2005; 45:384-93. [PMID: 15752156 DOI: 10.1111/j.1537-2995.2005.04241.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients having immune cytopenias produce antibodies that target hematopoietic cells resulting in their phagocytosis and intracellular destruction. Early reports suggested that phagocytosis could be inhibited by interfering with membrane thiol (SH) groups on phagocytes. Thus, whether chemical compounds that interact with SH or disulfide (SS) groups on mononuclear phagocytes can inhibit phagocytosis of antibody-coated cells was examined. STUDY DESIGN AND METHODS A monocyte monolayer assay (MMA), which examines the in vitro monocyte-macrophage (Mphi) interaction with anti-Rh(D)-coated red cells (RBCs), was used to study the ability of different SH and SS chemicals to inhibit the Fc receptor-mediated phagocytosis of sensitized RBCs. The compounds examined included thimerosal, dithiothreitol (DTT), pentane-1-thiol, and two recently described SH and two SS chemicals that have been synthesized. RESULTS All compounds were found to be able to inhibit phagocytosis to varying degrees correlating to the structure of the molecule. In general, those compounds that interact with free SH groups to inhibit phagocytosis were found better than SH-containing compounds that interact with SSs. Thimerosal and p-nitrophenyl methyl disulfide were the most effective compounds inhibiting phagocytosis. Both chemicals showed greater than 50 percent inhibition at concentrations as low as 10(-9) mol per L. DTT was the least effective compound tested. Only thimerosal showed significant toxicity, as determined by decreased cell viability and increased apoptosis, but only at concentrations of 10(-8) mol per L. The effect of chemical treatment was on attachment rather than on phagocytosis itself. Fcgamma receptor-independent endocytosis was not affected by the chemical treatment. CONCLUSION These studies indicate that pharmacologic strategies that target SH groups on mononuclear phagocytes may have future efficacy for the treatment of immune cytopenias.
Collapse
|
34
|
Arndt PA, Garratty G. A retrospective analysis of the value of monocyte monolayer assay results for predicting the clinical significance of blood group alloantibodies. Transfusion 2004; 44:1273-81. [PMID: 15318848 DOI: 10.1111/j.1537-2995.2004.03427.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cellular assays (e.g., monocyte monolayer assays [MMAs]) have been used to predict the clinical significance of red blood cell (RBC) alloantibodies. STUDY DESIGN AND METHODS Twenty years of MMA data were retrospectively analyzed to 1) determine the optimal cut point (by correlating MMA results from 46 patients with RBC survival study results and/or laboratory and clinical signs of hemolytic transfusion reactions [HTRs] when incompatible blood was transfused), and 2) determine what percentage of 251 unusual alloantibodies (most to high-incidence antigens) were predicted to be clinically significant. RESULTS Two MMA cut points (5% and 20%) were chosen using a receiver-operating characteristics curve. No patients with MMA results less than or equal to 5 percent had clinical signs of a reaction; one-third of patients with MMA results 5.1 to 20 percent versus two-thirds with results greater than 20 percent had clinical signs of a HTR after transfusion of incompatible blood. Using 5-percent or 20-percent cut points, 173 (69%) or 97 (39%) of 251 unusual alloantibodies gave positive MMAs, respectively. CONCLUSION A negative MMA (< or =5%) indicates that incompatible blood can be given without risk of an overt HTR but does not guarantee normal long-term survival of those RBCs. Most unusual alloantibodies are predicted to cause shortened RBC survival, but transfusion of incompatible blood may not result in any clinical or laboratory signs of a HTR. We have used the MMA for approximately 20 years, instead of a 1-hour chromium-51 RBC survival, to aid in the decision to transfuse RBCs incompatible with antibodies to high-incidence antigens.
Collapse
Affiliation(s)
- Patricia A Arndt
- Research Department, American Red Cross Blood Services, Southern California Region, Los Angeles, California, USA.
| | | |
Collapse
|
35
|
Pineda AA, Vamvakas EC, Gorden LD, Winters JL, Moore SB. Trends in the incidence of delayed hemolytic and delayed serologic transfusion reactions. Transfusion 1999; 39:1097-103. [PMID: 10532604 DOI: 10.1046/j.1537-2995.1999.39101097.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND An increasing incidence of delayed hemolytic and delayed serologic transfusion reactions (DHTRs/DSTRs) has been seen at the Mayo Clinic since 1978. Recently, the average length of stay (LOS) for inpatients and the average number of red cell transfusions per inpatient (TPI) decreased, and the albumin and papain technique for RBC antibody detection was replaced by a polyethylene glycol technique. These changes may have affected the incidence of DHTRs/DSTRs. STUDY DESIGN AND METHODS The diagnoses of DHTR and DSTR made at the Mayo Clinic from 1993 through 1998 were reviewed. These data were compared with previously published Mayo Clinic data from 1980 through 1992. The LOS for inpatients and the average TPI were also obtained from hospital data. RESULTS The incidence of DHTR/DSTR increased from 1 in 1899 in 1980 through 1992 to 1 in 1300 in the 1993 through 1998 period (p < 0.05). Similarly, DSTR increased from 1 in 2990 in 1980 through 1992 to 1 in 1612 in the 1993 through 1998 period (p < 0.05). The incidence of DHTR showed a trend toward decrease, from 1 in 5405 in 1980 through 1992 to 1 in 6715 in 1993 through 1998. No alloantibody specificities were statistically associated with DHTRs in 1993 through 1998, unlike in the 1980 through 1992 period. Moreover, the incidence of Jka antibodies increased in 1993 through 1998, while the incidence of other alloantibodies remained stable. Average LOS and TPI declined by 24.5 percent and 8.8 percent, respectively, between the two periods. CONCLUSION Recently, a trend toward a decrease in the incidence of DHTR and a significant increase in DSTRs has occurred at the Mayo Clinic. These changes are most likely due to a combination of factors, including a decrease in average LOS and the adoption of the polyethylene glycol antibody detection system.
Collapse
Affiliation(s)
- A A Pineda
- Department of Laboratory Medicine and Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
| | | | | | | | | |
Collapse
|
36
|
Abstract
A dog which presented with anorexia and fever was found to have strong IgG Coombs' positive immune mediated haemolysis but only marginal anaemia. The abnormalities detected included marked spherocytosis, polychromasia and mild hyperbilirubinaemia. The major presenting signs disappeared after glucocorticoid therapy. Compensated idiopathic immune mediated haemolysis was diagnosed.
Collapse
Affiliation(s)
- J N Mills
- School of Veterinary Studies, Murdoch University, Western Australia
| |
Collapse
|
37
|
Ducrot T, Beliard R, Glacet A, Klein P, Harbonnier S, Benmostefa N, Bourel D. Use of the DAF assay to assess the functional properties of polyclonal and monoclonal RhD antibodies. Vox Sang 1996; 71:30-6. [PMID: 8837354 DOI: 10.1046/j.1423-0410.1996.7110030.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The mechanism whereby passive Rh (D) immunoglobulins suppress the fetomaternal alloimmunization is still unclear. New in vitro tests are needed to better characterize the functional properties of polyclonal anti-Ds. The DAF assay was developed to monitor the antibody-dependent cell-mediated cytotoxicity (ADCC) and the phagocytosis of anti-Rh (D)-sensitized RBCs by effector cells. The principle of this test is based on the oxydization of the 2,7-diaminofluorene (DAF) by the pseudoperoxidase activity of free hemoglobin. The reaction is proportional to the hemoglobin concentration. This test was performed to determine and emphasize the efficacy of different polyclonal anti-D immunoglobulin preparations to mediate lysis and phagocytosis of sensitized RBCs by human peripheral mononuclear cells. The functional properties of different human RhD monoclonal antibodies were also analyzed and compared. The test was found to be convenient to perform and allowed the avoidance of radioactive labelling of RBCs for ADCC studies. It is mainly useful for the direct quantitation of phagocytosis.
Collapse
Affiliation(s)
- T Ducrot
- Laboratoire d'Ingénierie Cellulaire et Moléculaire, Lille, France
| | | | | | | | | | | | | |
Collapse
|
38
|
Lown J, Willis J. Monocyte monolayer assay (MMA) reactivity of alloantibodies reacting by the manual polybrene technique but not by an antiglobulin test. Transfus Med 1995; 5:281-4. [PMID: 8646292 DOI: 10.1111/j.1365-3148.1995.tb00215.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The manual polybrene technique (MP) has been shown to be useful in pretransfusion testing as a rapid method capable of detecting a wide range of red cell antibodies. The clinical significance of alloantibodies reacting by the MP but not by an antiglobulin test (MP+/AGT-) has not been determined. The monocyte monolayer assay (MMA) is an established in vitro technique for assessing the likely clinical significance of red cell antibodies. This was used to examine 21 MP+/AGT- alloantibodies and 41 alloantibodies reacting by a LISS antiglobulin method (LISS-AGT). Two of the 21 MP+/AGT- antibodies (9.5%) produced positive results by the MMA compared with 26/41 (63.4%) of LISS-AGT-reactive antibodies. The incidence of positive reactivity of the latter antibodies in the MMA was similar between those that were reactive and nonreactive by the MP. These results suggest that antibodies reacting by MP and not by an antiglobulin test are less likely to be clinically significant.
Collapse
Affiliation(s)
- J Lown
- Department of Haematology, Royal Perth Hospital, Western Australia
| | | |
Collapse
|
39
|
|
40
|
Kay MM. Regulatory autoantibody and cellular aging and removal. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1994; 347:161-92. [PMID: 7976729 DOI: 10.1007/978-1-4615-2427-4_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M M Kay
- Department of Microbiology and Immunology, University of Arizona College of Medicine, Tucson 85704
| |
Collapse
|
41
|
Detection of red cell sensitisation by antibody and complement: Current practice and future perspectives. ACTA ACUST UNITED AC 1993. [DOI: 10.1007/bf02341967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
42
|
Zupańska B. Clinical application of functional assays for assessing the red cell antibody activity. TRANSFUSION SCIENCE 1993; 14:371-81. [PMID: 10146644 DOI: 10.1016/s0955-3886(05)80010-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Functional assays (the monocyte monolayer assay, the chemiluminescence test, and the antibody dependent cellular cytotoxicity assay) aim to reflect an interaction between sensitized red calls and Fc-gamma receptor bearing mononuclear cells, which plays the main role in immune destruction of erythrocytes in vivo. These assays have been used for predicting the clinical significance of antibodies in hemolytic disease of the newborn, in patients with alloantibodies requiring transfusion and patients suspected of autoimmune hemolytic anemia. This review presents a brief summary of the literature on this subject. In many cases (especially in hemolytic disease of the newborn, RhD) the results of bioassays can assess the functional activity of antibodies in vivo, but further investigation is needed to establish their real value for clinical practice.
Collapse
Affiliation(s)
- B Zupańska
- Institute of Hematology and Blood Transfusion, Warsaw, Poland
| |
Collapse
|
43
|
Kay MM, Marchalonis JJ, Schluter SF, Bosman G. Human erythrocyte aging: cellular and molecular biology. Transfus Med Rev 1991; 5:173-95. [PMID: 1840361 DOI: 10.1016/s0887-7963(91)70207-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- M M Kay
- Department of Microbiology and Immunology, University of Arizona, Tucson 85724
| | | | | | | |
Collapse
|
44
|
Hoffman M. Antibody-coated erythrocytes induce secretion of tumor necrosis factor by human monocytes: a mechanism for the production of fever by incompatible transfusions. Vox Sang 1991; 60:184-7. [PMID: 1862642 DOI: 10.1111/j.1423-0410.1991.tb00900.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The transfusion of incompatible red blood cells (RBC) rapidly results in the development of fever by an unknown mechanism. In this study, the human monocyte secretion of the endogenous pyrogens tumor necrosis factor (TNF) and interleukin-1 (IL-1) was measured. Exposure to human RBC sensitized with antibodies to D or Fya antigens induced the rapid secretion of TNF, but not IL-1. TNF secretion persisted when monocytes remained in contact with sensitized RBC, but returned to baseline several hours after removal of RBC. Thus, TNF secreted by monocytes may be a mediator of fever during the immune-mediated destruction of RBC in vivo.
Collapse
Affiliation(s)
- M Hoffman
- University of North Carolina, Chapel Hill
| |
Collapse
|
45
|
Kay MM, Marchalonis JJ. Hypothesis: synthetic aging antigen can be used to manipulate cellular lifespan. Life Sci 1991; 48:1603-8. [PMID: 2016993 DOI: 10.1016/0024-3205(91)90119-v] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Physiologic removal of old and damaged erythrocytes, platelets, and other terminally differentiated cells is initiated by the appearance of an aging antigen that marks them for death by initiating the binding of IgG autoantibody and subsequent removal by phagocytes. We have developed a synthetic aging antigen peptide that blocks binding of IgG to senescent cells in vitro. We hypothesize that the synthetic antigen can be used to prevent cell destruction in diseases such as autoimmune hemolytic anemias and idiopathic thrombocytopenia purpura, and that the antigen itself can be used to manipulate cellular lifespan in vivo.
Collapse
Affiliation(s)
- M M Kay
- Department of Microbiology and Immunology, University of Arizona, College of Medicine, Tucson 85724
| | | |
Collapse
|
46
|
Garratty G. Predicting the clinical significance of red cell antibodies with in vitro cellular assays. Transfus Med Rev 1990; 4:297-312. [PMID: 2134635 DOI: 10.1016/s0887-7963(90)70272-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- G Garratty
- American Red Cross Blood Services, Los Angeles-Orange Counties Region 90006
| |
Collapse
|
47
|
Abstract
Expansion of transfusion medicine has led to an increasing awareness of the importance of its practice. Specialists in this branch of haematology whose main aim is to provide adequate and safe supplies of blood (and blood products) and to ensure these are used appropriately, are increasingly aware that to do this efficiently requires the development and utilization of new laboratory and technical procedures. Review of cross-matching techniques has led to the introduction of more rapid methods using low ionic strength saline. Use of monoclonal antibodies for blood grouping has made use of new technology, whilst allowing scarce human plasma to be used more appropriately for therapeutic purposes. Similarly, the implementation of a more rational approach to blood ordering, as in a maximum surgical blood-order schedule, allows for the more efficient use of donor blood. The use of microtitre plates for grouping and cross-matching techniques allows for speed and economy in the transfusion laboratory. Their use is also associated with increased automation and computer use. The possibility of using solid-phase techniques, monocyte-macrophage assays and antibody-dependent cellular cytotoxicity assays introduces new techniques differing markedly from time-honoured liquid-phase serology methods. The application of flow cytometry, which has already been shown to be useful in many aspects of haematology, is also of benefit in the field of blood transfusion science. Safety of blood transfusion is an important aspect of its practice and has led to the introduction and development of screening tests for donor blood to exclude infection risks from such organisms as HIV-1, hepatitis B and non-A, non-B hepatitis. Another approach to ensure the safety of transfused blood has been increased usage of autologous transfusion by means of both predeposit donation and intraoperative cell salvage.
Collapse
|
48
|
Zupańska B, Brojer E, McIntosh J, Seyfried H, Howell P. Correlation of monocyte-monolayer assay results, number of erythrocyte-bound IgG molecules, and IgG subclass composition in the study of red cell alloantibodies other than D. Vox Sang 1990; 58:276-80. [PMID: 2399692 DOI: 10.1111/j.1423-0410.1990.tb04999.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Comparisons have been made between the serological and immunological characteristics of 42 blood group alloantibodies (other than D) covering twelve systems using a monocyte-monolayer assay (MMA), a radiometric antiglobulin test for antibody binding and IgG subclass determinations. The results of the MMA correlated well with the level of IgG molecules bound on incompatible cells, and the highest levels in both cases were associated with the presence of the IgG3 subclass. However, limited clinical data shows that, while in general the MMA clearly identifies the clinically significant antibodies, the correlation with the degree of clinical outcome is less well defined, and in some instances other factors may be operating to ameliorate the in vivo effect of the antibody.
Collapse
Affiliation(s)
- B Zupańska
- Institute of Haematology, Warsaw, Poland
| | | | | | | | | |
Collapse
|
49
|
Engelfriet CP, Ouwehand WH. ADCC and other cellular bioassays for predicting the clinical significance of red cell alloantibodies. BAILLIERE'S CLINICAL HAEMATOLOGY 1990; 3:321-37. [PMID: 2224152 DOI: 10.1016/s0950-3536(05)80053-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
50
|
Zupańska B, Brojer E, Richards Y, Lenkiewicz B, Seyfried H, Howell P. Serological and immunological characteristics of maternal anti-Rh(D) antibodies in predicting the severity of haemolytic disease of the newborn. Vox Sang 1989; 56:247-53. [PMID: 2503936 DOI: 10.1111/j.1423-0410.1989.tb02037.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A number of factors were analyzed for their predictive value in indicating the severity of haemolytic disease of the newborn (HDN) in 72 infants. The factors investigated were: maternal antibody titre in the indirect antiglobulin test, the number of antibody molecules on sensitized standard red cells evaluated by a radiometric antiglobulin test, the IgG subclass specificity and the reactivity in monocyte-monolayer assay (MMA) and in the rosette assays with lymphocytes and granulocytes from healthy individuals. The results of the MMA correlate much better with the severity of HDN than the antibody titre. In clinically unaffected infants the reactivity in the MMA never exceeded 20%, while in the severe/very severe group it was always greater than 20% (in 95% of very severe cases even above 50%). The number of IgG-bound molecules was also shown to closely correlate with the clinical severity and there was a much greater proportion of severe/very severe cases exhibiting combined IgG1 and IgG3 specificity. Of all the evaluations performed the rosette assays with lymphocytes and granulocytes were found to be less useful in predicting the severity of HDN.
Collapse
Affiliation(s)
- B Zupańska
- Institute of Haematology, Warsaw, Poland
| | | | | | | | | | | |
Collapse
|