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Kløve-Mogensen K, Haunstrup TM, Masmas TN, Glenthøj A, Höglund P, Hasle H, Nielsen KR, Steffensen R. High-resolution HLA genotyping identifies risk alleles in both class I and II for primary autoimmune neutropenia in early childhood in a Danish cohort. HLA 2024; 103:e15429. [PMID: 38450943 DOI: 10.1111/tan.15429] [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: 12/20/2023] [Revised: 02/16/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
HLA studies in patients with autoimmune neutropenia (AIN) have shown very consistent results for the association with HLA class II alleles at low resolution. This study aimed to examine the association of both HLA class I and class II at high resolution to clarify the contribution of risk alleles to the disease. A total of 107 AIN patients were genotyped for six loci of HLA class I (HLA-A, -B and -C) and class II (HLA-DRB1, -DQB1, and -DPB1) genes by a high-resolution (3-field, 6-digit) analysis and compared with HLA typing of 1000 healthy controls. Compared with the controls, the allele frequencies were significantly higher in AIN patients for A*02:17:01G, C*01:02:01G, DRB1*10:01:01G, DRB1*14:01:01G, DRB1*16:01:01G, DQB1*05:02:01G, and DQB1*05:03:01G but lower significant for C*03:04:01G, DRB1*04:01:01G, DRB1*13:02:01G, DQB1*03:02:01G, and DQB1*06:04:01G. Frequently associated two-locus haplotypes were found to be DRB1*10:01:01G-DQB1*05:01:01G and DRB1*16:01:01G-DQB1*05:02:01G, while the S2 (Q- or D-KRAA) shared epitope (SE) was associated with lower risk. A unique association with HLA alleles was observed between patients with specific anti-HNA-1a antibodies and broad-reacting anti-FcγRIIIb. Anti-HNA-1a antibody-positive patients were associated with C*01:02:01G, DRB1*01:01:01G, DRB1*16:01:01G, DQB1*05:01:01G, DQB1*05:02:01G, DQB1*06:04:01G, and DPB1*10:01:01G; the two-locus haplotypes DRB1*01:01:01G-DQB1*05:01:01G and DRB1*16:01:01G-DQB1*05:02:01G; and the S3P (Q- or R-RRAA) SE. Anti-FcγRIIIb antibody-positive patients were associated with the alleles A*02:17:01G, DRB1*10:01:01G, and DQB1*05:02:01G; the haplotypes DRB1*10:01:01G-DQB1*05:01:01G and DRB1*11:01:02G-DQB1*05:02:01G; and the S3D (DRRAA) SE. The different associations regarding FcγRIIIb antibody specificities could indicate disease heterogeneity.
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Affiliation(s)
- Kirstine Kløve-Mogensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Thure Mors Haunstrup
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Tania Nicole Masmas
- Pediatric Hematopoietic Stem Cell Transplantation and Immunodeficiency, Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Petter Höglund
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rudi Steffensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
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Palmblad J, Sohlberg E, Nilsson CC, Lindqvist H, Deneberg S, Ratcliffe P, Meinke S, Mörtberg A, Klimkowska M, Höglund P. Clinical and immunological features in ACKR1/DARC-associated neutropenia. Blood Adv 2024; 8:571-580. [PMID: 38039514 PMCID: PMC10837479 DOI: 10.1182/bloodadvances.2023010400] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 12/03/2023] Open
Abstract
ABSTRACT ACKR1/DARC-associated neutropenia (NP; ADAN; Online Mendelian Inheritance in Man 611862), caused by a variation in the ACKR1/DARC gene (rs2814778), is common in persons of African or Middle Eastern descent. In a cohort of 66 genetically confirmed subjects with ADAN, we show that absolute neutrophil counts (ANCs) may occasionally be lower than previously recognized (0.1 × 109-0.49 × 109/L for 9% of the subjects), which is similar to ANCs in severe congenital NP (SCNP). ANCs often normalized during inflammation, even mild. Individuals with ADAN (of 327 observed person-years) showed no cases of myelodysplastic syndrome (MDS), which is frequently encountered in SCNP. Unexpectedly, 22% presented with autoantibodies to neutrophils, compared with <1% in controls. Compared with healthy donors, subjects with ADAN demonstrated significantly lower human cationic antimicrobial protein-18/pro-leucin leucin-37 plasma levels; higher levels of nonclassical, proinflammatory, 6-sulfo LacNac-expressing monocytes; and differentially expressed plasma levels of 28 of the 239 analyzed cytokines related to immunity/inflammation, cell signaling, neutrophil activation, and angiogenesis. Collectively, more severe neutropenia in ADAN than previously assumed may complicate differential diagnoses compared with other SCNPs, and various (auto)immune/inflammatory reactions with a distinct profile may be a cause or consequence of this hereditary neutropenia.
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Affiliation(s)
- Jan Palmblad
- The Hematology Center, Karolinska University Hospital Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Ebba Sohlberg
- Center for Infectious Medicine, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Christer C. Nilsson
- The Hematology Center, Karolinska University Hospital Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Henric Lindqvist
- The Hematology Center, Karolinska University Hospital Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Deneberg
- The Hematology Center, Karolinska University Hospital Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Paul Ratcliffe
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Clinical Immunology and Transfusion Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Stephan Meinke
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Anette Mörtberg
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Monika Klimkowska
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital and Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Clinical Immunology and Transfusion Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Höglund P. Chlamydia pathogenesis in mice: Male immunity and the outcome of female infection. Scand J Immunol 2024; 99:e13347. [PMID: 38441316 DOI: 10.1111/sji.13347] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Affiliation(s)
- Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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Buggert M, Höglund P. The prize of prizes: mRNA research paving the way for COVID-19 vaccine success wins the Nobel Prize in Physiology or Medicine 2023. Scand J Immunol 2023; 98:e13340. [PMID: 37953432 DOI: 10.1111/sji.13340] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Affiliation(s)
- Marcus Buggert
- Center for Infectious Medicine (CIM), Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Center for hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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Rydén J, Clements M, Wikman A, Hellström-Lindberg E, Edgren G, Höglund P. Red blood cell alloimmunization in myelodysplastic syndromes: Associations with sex, DAT-positivity, and increased transfusion needs. Transfusion 2023; 63:2040-2051. [PMID: 37818926 DOI: 10.1111/trf.17562] [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: 04/29/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Many patients with myelodysplastic syndromes (MDS) need repeated red blood cell transfusions which entails a risk of immunization and antibody formation. Associations between alloantibodies, autoantibodies and increased transfusion requirements have been reported, but their relationship remains unclear. In this study, we analyzed factors potentially associated with red blood cell alloimmunization, as well as changes in transfusion intensity and post-transfusion hemoglobin increments. METHODS In a retrospective cohort study, we linked Swedish MDS patients diagnosed between 2003 and 2017 to transfusion and immunohematology data. Potentially associated factors were analyzed using Cox proportional hazards regression. The transfusion rate after detected alloimmunization was analyzed using a fixed effects Poisson regression. Post-transfusion hemoglobin increments before and after alloimmunization were compared using a mixed effects regression. RESULTS Alloantibodies following MDS diagnosis were detected in 50 out of 429 patients (11.7%). Female sex and a positive direct antiglobulin test (DAT) were independently associated with alloimmunization, with hazard ratios of 2.02 (95% confidence interval [CI] 1.08-3.78) and 9.72 (95% CI, 5.31-17.74), respectively. The transfusion rate following alloimmunization was increased with an incidence rate ratio of 1.33 (95% CI, 0.98-1.80) and the post-transfusion hemoglobin increment after alloimmunization was 1.40 g/L (95% CI, 0.52-2.28) lower per red blood cell unit (p = .002) compared to before alloimmunization, in multivariable analyses. DISCUSSION Alloimmunization against blood group antigens was associated with sex, DAT-positivity, increased transfusion needs, and lower post-transfusion hemoglobin increments. These findings warrant further investigation to evaluate the clinical significance of up-front typing and prophylactic antigen matching in patients with MDS.
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Affiliation(s)
- Jenny Rydén
- Center for Hematology and Regenerative Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Mark Clements
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Wikman
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Eva Hellström-Lindberg
- Center for Hematology and Regenerative Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Gustaf Edgren
- Department of Cardiology, Södersjukhuset, Stockholm, Sweden
- Department of Medicine, Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
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6
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Schmied L, Luu TT, Søndergaard JN, Hald SH, Meinke S, Mohammad DK, Singh SB, Mayer C, Perinetti Casoni G, Chrobok M, Schlums H, Rota G, Truong HM, Westerberg LS, Guarda G, Alici E, Wagner AK, Kadri N, Bryceson YT, Saeed MB, Höglund P. SHP-1 localization to the activating immune synapse promotes NK cell tolerance in MHC class I deficiency. Sci Signal 2023; 16:eabq0752. [PMID: 37040441 DOI: 10.1126/scisignal.abq0752] [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: 04/13/2023]
Abstract
Natural killer (NK) cells recognize virally infected cells and tumors. NK cell function depends on balanced signaling from activating receptors, recognizing products from tumors or viruses, and inhibitory receptors (such as KIR/Ly49), which recognize major histocompatibility complex class I (MHC-I) molecules. KIR/Ly49 signaling preserves tolerance to self but also conveys reactivity toward MHC-I-low target cells in a process known as NK cell education. Here, we found that NK cell tolerance and education were determined by the subcellular localization of the tyrosine phosphatase SHP-1. In mice lacking MHC-I molecules, uneducated, self-tolerant Ly49A+ NK cells showed accumulation of SHP-1 in the activating immune synapse, where it colocalized with F-actin and the signaling adaptor protein SLP-76. Education of Ly49A+ NK cells by the MHC-I molecule H2Dd led to reduced synaptic accumulation of SHP-1, accompanied by augmented signaling from activating receptors. Education was also linked to reduced transcription of Ptpn6, which encodes SHP-1. Moreover, synaptic SHP-1 accumulation was reduced in NK cells carrying the H2Dd-educated receptor Ly49G2 but not in those carrying the noneducating receptor Ly49I. Colocalization of Ly49A and SHP-1 outside of the synapse was more frequent in educated compared with uneducated NK cells, suggesting a role for Ly49A in preventing synaptic SHP-1 accumulation in NK cell education. Thus, distinct patterning of SHP-1 in the activating NK cell synapse may determine NK cell tolerance.
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Affiliation(s)
- Laurent Schmied
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Thuy T Luu
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Jonas N Søndergaard
- Center for Infectious Disease Education and Research (CIDER), Osaka University, Suita 565-0871, Japan
| | - Sophia H Hald
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Stephan Meinke
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Dara K Mohammad
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
- Department of Food Technology, College of Agricultural Engineering Sciences, Salahaddin University-Erbil, Erbil KRG-Kurdistan Region, Iraq
| | - Sunitha B Singh
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Biomedicum, Solnavägen 9, S-171 65 Stockholm, Sweden
| | - Corinna Mayer
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Giovanna Perinetti Casoni
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Michael Chrobok
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Heinrich Schlums
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Giorgia Rota
- Department of Biochemistry, University of Lausanne, 1066 Epalinges, Switzerland
| | - Hieu M Truong
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Lisa S Westerberg
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Biomedicum, Solnavägen 9, S-171 65 Stockholm, Sweden
| | - Greta Guarda
- Università della Svizzera Italiana, Faculty of Biomedical Sciences, Institute for Research in Biomedicine, 6500 Bellinzona, Switzerland
| | - Evren Alici
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Arnika K Wagner
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Nadir Kadri
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
| | - Yenan T Bryceson
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Huddinge C2:66, S-141 86 Stockholm, Sweden
- Broegelmann Research Laboratory, Department of Clinical Sciences, University of Bergen, Jonas Lies vei 87, Laboratory Building 5th floor, N-5021 Bergen, Norway
| | - Mezida B Saeed
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Biomedicum, Solnavägen 9, S-171 65 Stockholm, Sweden
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, NEO building, Blickagången 16, S-141 57 Stockholm, Sweden
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Huddinge C2:66, S-141 86 Stockholm, Sweden
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Fioredda F, Skokowa J, Tamary H, Spanoudakis M, Farruggia P, Almeida A, Guardo D, Höglund P, Newburger PE, Palmblad J, Touw IP, Zeidler C, Warren AJ, Dale DC, Welte K, Dufour C, Papadaki HA. The European Guidelines on Diagnosis and Management of Neutropenia in Adults and Children: A Consensus Between the European Hematology Association and the EuNet-INNOCHRON COST Action. Hemasphere 2023; 7:e872. [PMID: 37008163 PMCID: PMC10065839 DOI: 10.1097/hs9.0000000000000872] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/09/2023] [Indexed: 04/03/2023] Open
Abstract
Neutropenia, as an isolated blood cell deficiency, is a feature of a wide spectrum of acquired or congenital, benign or premalignant disorders with a predisposition to develop myelodysplastic neoplasms/acute myeloid leukemia that may arise at any age. In recent years, advances in diagnostic methodologies, particularly in the field of genomics, have revealed novel genes and mechanisms responsible for etiology and disease evolution and opened new perspectives for tailored treatment. Despite the research and diagnostic advances in the field, real world evidence, arising from international neutropenia patient registries and scientific networks, has shown that the diagnosis and management of neutropenic patients is mostly based on the physicians' experience and local practices. Therefore, experts participating in the European Network for the Innovative Diagnosis and Treatment of Chronic Neutropenias have collaborated under the auspices of the European Hematology Association to produce recommendations for the diagnosis and management of patients across the whole spectrum of chronic neutropenias. In the present article, we describe evidence- and consensus-based guidelines for the definition and classification, diagnosis, and follow-up of patients with chronic neutropenias including special entities such as pregnancy and the neonatal period. We particularly emphasize the importance of combining the clinical findings with classical and novel laboratory testing, and advanced germline and/or somatic mutational analyses, for the characterization, risk stratification, and monitoring of the entire spectrum of neutropenia patients. We believe that the wide clinical use of these practical recommendations will be particularly beneficial for patients, families, and treating physicians.
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Affiliation(s)
| | - Julia Skokowa
- Department of Oncology, Hematology, Immunology, Rheumatology, and Clinical Immunology, University Hospital Tübingen, Germany
| | - Hannah Tamary
- The Rina Zaizov Hematology/Oncology Division, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Israel
| | - Michail Spanoudakis
- Department of Hematology, Warrington and Halton Teaching Hospitals NHS foundation Trust, Warrington, United Kingdom
| | - Piero Farruggia
- Pediatric Onco-Hematology, ARNAS Civico Di Cristina Benfratelli Hospital, Palermo, Italy
| | - Antonio Almeida
- Department of Hematology, Hospital da Luz Lisboa, Portugal
- Faculdade de Medicina, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Daniela Guardo
- Unit of Hematology, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Petter Höglund
- Clinical Immunology and Transfusion Medicine Clinic, Karolinska University Hospital, Stockholm, Sweden
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Jan Palmblad
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Ivo P. Touw
- Department of Hematology and Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Cornelia Zeidler
- Department of Oncology, Hematology, Immunology and Bone Marrow Transplantation, Hannover Medical School, Hannover, Germany
| | - Alan J. Warren
- Department of Hematology, University of Cambridge, United Kingdom
- Cambridge Institute for Medical Research, University of Cambridge, United Kingdom
- Wellcome Trust–Medical Research Council Stem Cell Institute, University of Cambridge, United Kingdom
| | | | - Karl Welte
- University Children’s Hospital Tübingen, Germany
| | - Carlo Dufour
- Unit of Hematology, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Helen A. Papadaki
- Hemopoiesis Research Laboratory, School of Medicine, University of Crete, Heraklion, Greece
- Department of Hematology, University Hospital of Heraklion, Crete, Greece
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8
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Kløve-Mogensen K, Steffensen R, Masmas TN, Glenthøj A, Jensen CF, Haunstrup TM, Ratcliffe P, Höglund P, Hasle H, Nielsen KR. Genetic variations in low-to-medium-affinity Fcγ receptors and autoimmune neutropenia in early childhood in a Danish cohort. Int J Immunogenet 2023; 50:65-74. [PMID: 36754570 DOI: 10.1111/iji.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/09/2023] [Accepted: 01/22/2023] [Indexed: 02/10/2023]
Abstract
Autoimmune neutropenia (AIN) in early childhood is caused by autoantibodies directed against antigens on the neutrophil membrane and is a frequent cause of neutropenia in children. Association of AIN with Fcγ receptor (FCGR) 3B variants is well described. In this study, we investigate genetic variations in the FCGR locus and copy number variation of FCGR3B. A total of 130 antibody-positive AIN patients, 64 with specific anti-HNA-1a antibodies and 66 with broad-reacting anti-FcγRIIIb antibodies, were genotyped with a multiplex ligation probe assay and compared with healthy controls. Positive findings were confirmed with real-time q-PCR. We determined copy numbers of the FCGR2 and FCGR3 genes and the following SNPs: FCGR2A Q62W (rs201218628), FCGR2A H166R (rs1801274), FCGR2B I232T (rs1050501), FCGR3A V176F (rs396991), haplotypes for FCGR2B/C promoters (rs3219018/rs780467580), FCGR2C STOP/ORF and HNA-1 genotypes in FCGR3B (rs447536, rs448740, rs52820103, rs428888 and rs2290834). Generally, associations were antibody specific, with all associations being representative of the anti-HNA-1a-positive group, while the only association found in the anti-FcγRIIIb group was with the HNA-1 genotype. An increased risk of AIN was observed for patients with one copy of FCGR3B; the HNA genotypes HNA-1a, HNA-1aa or HNA-1aac; the FCGR2A 166H and FCGR2B 232I variations; and no copies of FCGR2B 2B.4. A decreased risk was observed for HNA genotype HNA-1bb; FCGR2A 166R; FCGR2B 232T; and one copy of FCGR2B promoter 2B.4. We conclude that in our Danish cohort, there was a strong association between variation in the FCGR locus and AIN. The findings of different genetic associations between autoantibody groups could indicate the presence of two different disease entities and disease heterogeneity.
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Affiliation(s)
- Kirstine Kløve-Mogensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rudi Steffensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Tania Nicole Masmas
- Pediatric Hematopoietic Stem Cell Transplantation and Immunodeficiency, Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christina Friis Jensen
- Department of Pediatrics and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Thure Mors Haunstrup
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Paul Ratcliffe
- Department of medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Petter Höglund
- Department of medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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9
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Wikman A, Diedrich B, Björling K, Forsberg PO, Harstad AM, Henningsson R, Höglund P, Sköld H, Östman L, Sandgren P. Cryopreserved platelets in bleeding management in remote hospitals: A clinical feasibility study in Sweden. Front Public Health 2023; 10:1073318. [PMID: 36743180 PMCID: PMC9894868 DOI: 10.3389/fpubh.2022.1073318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/27/2022] [Indexed: 01/21/2023] Open
Abstract
Background Balanced transfusions, including platelets, are critical for bleeding patients to maintain hemostasis. Many rural hospitals have no or limited platelet inventory, with several hours of transport time from larger hospitals. This study aimed to evaluate the feasibility of using cryopreserved platelets that can be stored for years, in remote hospitals with no or limited platelet inventory. Material and methods Three remote hospitals participated in a prospective study including adult bleeding patients where platelet transfusions were indicated. Cryopreserved platelets were prepared in a university hospital, concentrated in 10 ml, transported on dry ice, and stored at -80°C at the receiving hospital. At request, the concentrated platelet units were thawed and diluted in fresh frozen plasma. The indications, blood transfusion needs, and laboratory parameters pre- and post-transfusion, as well as logistics, such as time from request to transfusion and work efforts in preparing cryopreserved platelets, were evaluated. Results Twenty-three bleeding patients were included. Nine patients (39%) were treated for gastrointestinal bleeding, five (22%) for perioperative bleeding, and four (17%) for trauma bleeding. The transfusion needs were 4.9 ± 3.3 red blood cell units, 3.2 ± 2.3 plasma units, and 1.9 ± 2.2 platelet units, whereof cryopreserved were 1.5 ± 1.1 (mean ± SD). One patient had a mild allergic reaction. We could not show the difference in laboratory results between pre- and post-transfusion of the cryopreserved units in the bleeding patients. The mean time from the order of cryopreserved platelets to transfusion was 64 min, with a range from 25 to 180 min. Conclusion Cryopreserved platelets in remote hospitals are logistically feasible in the treatment of bleeding. The ability to have platelets in stock reduces the time to platelet transfusion in bleeding patients where the alternative often is many hours delay. Clinical effectiveness and safety previously shown in other studies are supported in this small feasibility study.
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Affiliation(s)
- Agneta Wikman
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden,Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden,*Correspondence: Agneta Wikman ✉
| | - Beatrice Diedrich
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden,Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Karl Björling
- Department of Anaesthesiology and Intensive Care, Visby Hospital, Visby, Sweden
| | - Per-Olof Forsberg
- Department Laboratory Medicine, Central Hospital of Karlstad, Karlstad, Sweden
| | - Anna-Maria Harstad
- Department of Anaesthesiology and Intensive Care, Central Hospital of Karlstad, Karlstad, Sweden
| | - Ragnar Henningsson
- Department of Anaesthesiology and Intensive Care, Central Hospital of Karlstad, Karlstad, Sweden
| | - Petter Höglund
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden,Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge Karolinska Institutet, Stockholm, Sweden
| | - Hans Sköld
- Department of Anaesthesiology and Intensive Care, Torsby Hospital, Torsby, Sweden
| | - Lars Östman
- Department of Anaesthesiology and Intensive Care, Visby Hospital, Visby, Sweden
| | - Per Sandgren
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden,Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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10
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Höglund P, Ljunggren H, Jonsson R. Nobel 2022: An extraordinary achievement relevant to immunity. Scand J Immunol 2022. [DOI: 10.1111/sji.13234] [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: 11/27/2022]
Affiliation(s)
- Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden
| | - Hans‐Gustaf Ljunggren
- Center for Infectious Medicine (CIM), Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden
| | - Roland Jonsson
- Broegelmann Research Laboratory, Department of Clinical Science, Faculty of Medicine University of Bergen Bergen Norway
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11
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Höglund P. Antigen presentation in mucosal tissues: Dendritic cells and
GP2. Scand J Immunol 2022. [DOI: 10.1111/sji.13224] [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: 11/26/2022]
Affiliation(s)
- Petter Höglund
- Department of Medicine Huddinge Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet Stockholm Sweden
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12
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Haroun-Izquierdo A, Vincenti M, Netskar H, van Ooijen H, Zhang B, Bendzick L, Kanaya M, Momayyezi P, Li S, Wiiger MT, Hoel HJ, Krokeide SZ, Kremer V, Tjonnfjord G, Berggren S, Wikström K, Blomberg P, Alici E, Felices M, Önfelt B, Höglund P, Valamehr B, Ljunggren HG, Björklund A, Hammer Q, Kveberg L, Cichocki F, Miller JS, Malmberg KJ, Sohlberg E. Adaptive single-KIR +NKG2C + NK cells expanded from select superdonors show potent missing-self reactivity and efficiently control HLA-mismatched acute myeloid leukemia. J Immunother Cancer 2022; 10:jitc-2022-005577. [PMID: 36319065 PMCID: PMC9628692 DOI: 10.1136/jitc-2022-005577] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Natural killer (NK) cells hold great promise as a source for allogeneic cell therapy against hematological malignancies, including acute myeloid leukemia (AML). Current treatments are hampered by variability in NK cell subset responses, a limitation which could be circumvented by specific expansion of highly potent single killer immunoglobulin-like receptor (KIR)+NKG2C+ adaptive NK cells to maximize missing-self reactivity. METHODS We developed a GMP-compliant protocol to expand adaptive NK cells from cryopreserved cells derived from select third-party superdonors, that is, donors harboring large adaptive NK cell subsets with desired KIR specificities at baseline. We studied the adaptive state of the cell product (ADAPT-NK) by flow cytometry and mass cytometry as well as cellular indexing of transcriptomes and epitopes by sequencing (CITE-Seq). We investigated the functional responses of ADAPT-NK cells against a wide range of tumor target cell lines and primary AML samples using flow cytometry and IncuCyte as well as in a mouse model of AML. RESULTS ADAPT-NK cells were >90% pure with a homogeneous expression of a single self-HLA specific KIR and expanded a median of 470-fold. The ADAPT-NK cells largely retained their adaptive transcriptional signature with activation of effector programs without signs of exhaustion. ADAPT-NK cells showed high degranulation capacity and efficient killing of HLA-C/KIR mismatched tumor cell lines as well as primary leukemic blasts from AML patients. Finally, the expanded adaptive NK cells had preserved robust antibody-dependent cellular cytotoxicity potential and combination of ADAPT-NK cells with an anti-CD16/IL-15/anti-CD33 tri-specific engager led to near-complete killing of resistant CD45dim blast subtypes. CONCLUSIONS These preclinical data demonstrate the feasibility of off-the-shelf therapy with a non-engineered, yet highly specific, NK cell population with full missing-self recognition capability.
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Affiliation(s)
- Alvaro Haroun-Izquierdo
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Marianna Vincenti
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Herman Netskar
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Hanna van Ooijen
- Department of Applied Physics, Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Bin Zhang
- University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota, USA
| | - Laura Bendzick
- University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota, USA
| | - Minoru Kanaya
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Pouria Momayyezi
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Shuo Li
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Merete Thune Wiiger
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Hanna Julie Hoel
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Silje Zandstra Krokeide
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Veronika Kremer
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Geir Tjonnfjord
- Department of Hematology, Oslo University Hospital and K.G. Jebsen Centre for B-cell malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stéphanie Berggren
- Vecura, Karolinska Center for Cell Therapy Clinical Research Center, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Wikström
- Vecura, Karolinska Center for Cell Therapy Clinical Research Center, Karolinska University Hospital, Stockholm, Sweden
| | - Pontus Blomberg
- Vecura, Karolinska Center for Cell Therapy Clinical Research Center, Karolinska University Hospital, Stockholm, Sweden
| | - Evren Alici
- Center for Hematology and Regenerative Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Martin Felices
- University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota, USA
| | - Björn Önfelt
- Department of Applied Physics, Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden
- Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | | | - Hans-Gustaf Ljunggren
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Björklund
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden
| | - Quirin Hammer
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Lise Kveberg
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Frank Cichocki
- University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota, USA
| | - Jeffrey S Miller
- University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota, USA
| | - Karl-Johan Malmberg
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ebba Sohlberg
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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13
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Höglund P. Gender bias in complex autoimmune disorders: Clinically characterized cohorts pave the way for new knowledge. Scand J Immunol 2022. [DOI: 10.1111/sji.13211] [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: 11/26/2022]
Affiliation(s)
- Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM) Karolinska Institutet Stockholm Sweden
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14
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Höglund P. SJI
50 years: Immunosurveillance in the brain and our highest impact factor ever. Scand J Immunol 2022. [DOI: 10.1111/sji.13204] [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: 11/28/2022]
Affiliation(s)
- Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM) Karolinska Institutet Stockholm Sweden
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15
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Kløve-Mogensen K, Steffensen R, Masmas TN, Glenthøj A, Haunstrup TM, Ratcliffe P, Höglund P, Hasle H, Nielsen KR. ABO, secretor, and Lewis carbohydrate histo-blood groups are associated with autoimmune neutropenia of early childhood in Danish patients. Transfusion 2022; 62:1636-1642. [PMID: 35792132 PMCID: PMC9544446 DOI: 10.1111/trf.17002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/22/2022] [Accepted: 06/05/2022] [Indexed: 12/02/2022]
Abstract
Background Autoimmune neutropenia of early childhood (AIN) is caused by autoantibodies directed against antigens on the neutrophil membrane. The ABO, secretor, and Lewis histo‐blood group systems control the expression of carbohydrate antigens and have previously been linked to autoimmune diseases. We aimed to investigate the association between genotypes and the risk of AIN in Danish patients. Study Design and Methods One hundred fifty‐four antibody‐positive AIN patients were included. Controls (n = 400) were healthy unrelated Danish blood donors. Molecular determination of ABO, secretor (FUT2), and Lewis (FUT3) genotypes were determined using real‐time polymerase chain reaction (qPCR) or Sanger sequencing to infer the prevalence of Lewis antigens (Lea and Leb) and secretor (SeSe or Sese) or nonsecretor (sese) phenotypes. Results Blood type O was more common in controls (46.8%) than in AIN patients (36.4%) (OR = 0.65; p = 0.028). Secretors of H Leb antigens were less frequent among AIN patients (25.2%) than controls (35.0%) (OR = 0.62; p = 0.037). Discussion ABO blood group antigens and the secretion of these antigens are associated with a diagnosis of AIN. The mechanism underlying the association between autoimmunity and interaction among ABO, secretor, and Lewis genotypes has not yet been elucidated, but several studies indicate a connection to the gut microbiota.
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Affiliation(s)
- Kirstine Kløve-Mogensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rudi Steffensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Tania Nicole Masmas
- Pediatric Hematopoietic Stem Cell Transplantation and Immunodeficiency, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Andreas Glenthøj
- Center for Hemoglobinopathies, Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Thure Mors Haunstrup
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Paul Ratcliffe
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Henrik Hasle
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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16
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Höglund P. Resource article: A new category of SJI publications. Scand J Immunol 2022; 96:e13199. [PMID: 35775963 DOI: 10.1111/sji.13199] [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: 11/29/2022]
Affiliation(s)
- Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden
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17
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Luu TT, Søndergaard JN, Peña-Pérez L, Kharazi S, Krstic A, Meinke S, Schmied L, Frengen N, Heshmati Y, Kierczak M, Bouderlique T, Wagner AK, Gustafsson C, Chambers BJ, Achour A, Kutter C, Höglund P, Månsson R, Kadri N. FOXO1 and FOXO3 Cooperatively Regulate Innate Lymphoid Cell Development. Front Immunol 2022; 13:854312. [PMID: 35757763 PMCID: PMC9218573 DOI: 10.3389/fimmu.2022.854312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/19/2022] [Indexed: 12/03/2022] Open
Abstract
Natural killer (NK) cells play roles in viral clearance and early surveillance against malignant transformation, yet our knowledge of the underlying mechanisms controlling their development and functions remain incomplete. To reveal cell fate-determining pathways in NK cell progenitors (NKP), we utilized an unbiased approach and generated comprehensive gene expression profiles of NK cell progenitors. We found that the NK cell program was gradually established in the CLP to preNKP and preNKP to rNKP transitions. In line with FOXO1 and FOXO3 being co-expressed through the NK developmental trajectory, the loss of both perturbed the establishment of the NK cell program and caused stalling in both NK cell development and maturation. In addition, we found that the combined loss of FOXO1 and FOXO3 caused specific changes to the composition of the non-cytotoxic innate lymphoid cell (ILC) subsets in bone marrow, spleen, and thymus. By combining transcriptome and chromatin profiling, we revealed that FOXO TFs ensure proper NK cell development at various lineage-commitment stages through orchestrating distinct molecular mechanisms. Combined FOXO1 and FOXO3 deficiency in common and innate lymphoid cell progenitors resulted in reduced expression of genes associated with NK cell development including ETS-1 and their downstream target genes. Lastly, we found that FOXO1 and FOXO3 controlled the survival of committed NK cells via gene regulation of IL-15Rβ (CD122) on rNKPs and bone marrow NK cells. Overall, we revealed that FOXO1 and FOXO3 function in a coordinated manner to regulate essential developmental genes at multiple stages during murine NK cell and ILC lineage commitment.
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Affiliation(s)
- Thuy T Luu
- Department of Medicine Huddinge, Huddinge, Karolinska Institute, Stockholm, Sweden.,Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Jonas Nørskov Søndergaard
- Department of Microbiology, Tumor and Cell Biology, Science for Life Laboratory, Karolinska Institute, Stockholm, Sweden
| | - Lucía Peña-Pérez
- Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Shabnam Kharazi
- Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Aleksandra Krstic
- Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Stephan Meinke
- Department of Medicine Huddinge, Huddinge, Karolinska Institute, Stockholm, Sweden.,Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Laurent Schmied
- Department of Medicine Huddinge, Huddinge, Karolinska Institute, Stockholm, Sweden.,Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Nicolai Frengen
- Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Yaser Heshmati
- Department of Medicine Huddinge, Huddinge, Karolinska Institute, Stockholm, Sweden.,Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Marcin Kierczak
- Department of Cell and Molecular Biology, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Thibault Bouderlique
- Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Arnika Kathleen Wagner
- Department of Medicine Huddinge, Huddinge, Karolinska Institute, Stockholm, Sweden.,Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Charlotte Gustafsson
- Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Benedict J Chambers
- Department of Microbiology, Tumor and Cell Biology, Science for Life Laboratory, Karolinska Institute, Stockholm, Sweden
| | - Adnane Achour
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institute, and Division of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Claudia Kutter
- Department of Microbiology, Tumor and Cell Biology, Science for Life Laboratory, Karolinska Institute, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Huddinge, Karolinska Institute, Stockholm, Sweden.,Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Robert Månsson
- Center for Hematology and Regenerative Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.,Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Nadir Kadri
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institute, and Division of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
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18
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Höglund P. Two immunology happenings this June: Iceland hosts
SSI
2022 and follicular T cells celebrate
SJI
50 years. Scand J Immunol 2022. [DOI: 10.1111/sji.13193] [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: 11/30/2022]
Affiliation(s)
- Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM) Department of Medicine Huddinge Stockholm Sweden
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19
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Bergman P, Broliden P, Ratcliffe P, Lourda M, Flesch B, Höglund P, Palmblad J. Mutation in the TACI gene and autoimmune neutropenia: A case report. Am J Hematol 2022; 97:E207-E210. [PMID: 35293001 DOI: 10.1002/ajh.26532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/01/2022] [Accepted: 03/11/2022] [Indexed: 01/02/2023]
Affiliation(s)
- Peter Bergman
- Department of Infectious Diseases Karolinska University Hospital Huddinge Stockholm Sweden
- Laboratory Medicine, Karolinska Institutet Stockholm Sweden
| | - Per‐Anders Broliden
- Department of Hematology Karolinska University Hospital Huddinge Stockholm Sweden
| | - Paul Ratcliffe
- Department of Clinical Immunology Transfusion Medicine, Karolinska University Hospital Huddinge Stockholm Sweden
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden
| | - Magda Lourda
- Center for Infectious Medicine, Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden
- Childhood Cancer Research Unit, Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Brigitte Flesch
- German Red Cross Blood Service Rhineland‐Palatinate and Saarland Bad Kreuznach Germany
- German Red Cross Blood Service West Hagen Germany
| | - Petter Höglund
- Department of Clinical Immunology Transfusion Medicine, Karolinska University Hospital Huddinge Stockholm Sweden
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden
| | - Jan Palmblad
- Department of Hematology Karolinska University Hospital Huddinge Stockholm Sweden
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20
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Corthay A, Höglund P. Immunology according to Dembic: Preserving integrity is key. Scand J Immunol 2022; 95:e13173. [PMID: 35474516 DOI: 10.1111/sji.13173] [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: 11/28/2022]
Affiliation(s)
- Alexandre Corthay
- Tumor Immunology Lab, Department of Pathology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden
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21
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Höglund P. Innate lymphoid cells-From homeostasis to disease. Scand J Immunol 2022; 95:e13165. [PMID: 35362150 DOI: 10.1111/sji.13165] [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: 11/30/2022]
Affiliation(s)
- Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden
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22
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Höglund P. Clearing the mist of autoimmunity pathogenesis: Dedication and persistence is key. Scand J Immunol 2022; 95:e13147. [PMID: 35191066 DOI: 10.1111/sji.13147] [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: 11/29/2022]
Affiliation(s)
- Petter Höglund
- Center for hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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23
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Höglund P. What's in the tissue? Immunology's new playground. Scand J Immunol 2022; 95:e13141. [PMID: 35040510 DOI: 10.1111/sji.13141] [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: 11/28/2022]
Affiliation(s)
- Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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Höglund P. Scandinavian journal of immunology: The first 50 years. Scand J Immunol 2021; 95:e13127. [PMID: 34936118 DOI: 10.1111/sji.13127] [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: 11/29/2022]
Affiliation(s)
- Petter Höglund
- Center for Hematology and Regenerative Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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25
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Höglund P. Scandinavian Society for Immunology return to its roots: Back in Aarhus after 50 years. Scand J Immunol 2021; 94:e13117. [PMID: 34811776 DOI: 10.1111/sji.13117] [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: 11/28/2022]
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26
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Hedberg P, Sirel M, Moll K, Kiwuwa MS, Höglund P, Ribacke U, Wahlgren M. Red blood cell blood group A antigen level affects the ability of heparin and PfEMP1 antibodies to disrupt Plasmodium falciparum rosettes. Malar J 2021; 20:441. [PMID: 34794445 PMCID: PMC8600353 DOI: 10.1186/s12936-021-03975-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/07/2021] [Indexed: 11/23/2022] Open
Abstract
Background The histo-blood group ABO system has been associated with adverse outcomes in COVID-19, thromboembolic diseases and Plasmodium falciparum malaria. An integral part of the severe malaria pathogenesis is rosetting, the adherence of parasite infected red blood cells (RBCs) to uninfected RBCs. Rosetting is influenced by the host’s ABO blood group (Bg) and rosettes formed in BgA have previously been shown to be more resilient to disruption by heparin and shield the parasite derived surface antigens from antibodies. However, data on rosetting in weak BgA subgroups is scarce and based on investigations of relatively few donors. Methods An improved high-throughput flow cytometric assay was employed to investigate rosetting characteristics in an extensive panel of RBC donor samples of all four major ABO Bgs, as well as low BgA expressing samples. Results All non-O Bgs shield the parasite surface antigens from strain-specific antibodies towards P. falciparum erythrocyte membrane protein 1 (PfEMP1). A positive correlation between A-antigen levels on RBCs and rosette tightness was observed, protecting the rosettes from heparin- and antibody-mediated disruption. Conclusions These results provide new insights into how the ABO Bg system affects the disease outcome and cautions against interpreting the results from the heterogeneous BgA phenotype as a single group in epidemiological and experimental studies. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03975-w.
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Affiliation(s)
- Pontus Hedberg
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, 171 65, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, 171 76, Stockholm, Sweden
| | - Madle Sirel
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Kirsten Moll
- Department of Medicine, Huddinge, Karolinska University Hospital, 141 86, Stockholm, Sweden
| | - Mpungu Steven Kiwuwa
- Department of Child Health and Development Centre, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Petter Höglund
- Department of Medicine, Huddinge, Karolinska University Hospital, 141 86, Stockholm, Sweden
| | - Ulf Ribacke
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Mats Wahlgren
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, 171 65, Stockholm, Sweden.
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Karlström C, Gryfelt G, Schmied L, Meinke S, Höglund P. Platelet transfusion improves clot formation and platelet function in severely thrombocytopenic haematology patients. Br J Haematol 2021; 196:224-233. [PMID: 34528253 DOI: 10.1111/bjh.17820] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 12/16/2022]
Abstract
Prophylactic platelet (PLT) transfusion is a common practice in severely thrombocytopenic patients that reduces mortality, but responses to platelet transfusions are variable and difficult to predict in individual patients. In this prospective study, we evaluated the outcome of PLT transfusions in 40 patients with haematological malignancies, linking corrected count increment (CCI) to clot formation and agonist-induced platelet activation after transfusion. The CCI was highly variable between patients and 34% showed no response (1-h CCI < 7,5). Short time since the last PLT transfusion and extended storage time of the PLT product were linked to poor transfusion response, while patient sex, C-reactive protein or the number of chemotherapy cycles prior to transfusion did not influence transfusion outcome. High CCI and good PLT responsiveness to agonist stimulation predicted efficient clot formation in rotational thromboelastometry, but transfusion did not restore poor PLT function in patients to the level of healthy controls. Our study provides new insights into factors affecting PLT transfusion outcome in haematology patients with severe thrombocytopenia, and suggests that the thrombocytopenic environment, or disease-associated factors, may hamper platelet responsiveness.
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Affiliation(s)
- Cecilia Karlström
- Department of Medicine Huddinge, Center for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden.,Medical Unit Haematology, Karolinska University Hospital, Stockholm, Sweden
| | - Gunilla Gryfelt
- Medical Unit Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Laurent Schmied
- Department of Medicine Huddinge, Center for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden
| | - Stephan Meinke
- Department of Medicine Huddinge, Center for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Center for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden.,Medical Unit Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
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28
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Ganesan S, Höglund P. MHC class I molecules co-stimulate NK1.1 signaling and enhance Ca 2+ flux in murine NK cells. Eur J Immunol 2021; 51:2531-2534. [PMID: 34453339 DOI: 10.1002/eji.202048709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 02/04/2021] [Accepted: 08/05/2021] [Indexed: 11/07/2022]
Abstract
Simultaneous triggering of NK1.1 and MHC class I on NK cells gives a higher Ca2+ flux response compared to triggering the NK1.1 receptor alone. The data suggest a novel costimulatory role for MHC class I molecules on NK cell responses.
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Affiliation(s)
- Sridharan Ganesan
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden.,Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Huddinge, Sweden
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29
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Affiliation(s)
- Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM) Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden
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30
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Mörtberg A, Pütsep K, Höglund P. The blood protein hCAP-18 in neutropenia: An 18-month experience of a new ELISA for clinical use. Scand J Immunol 2021; 94:e13037. [PMID: 33662157 DOI: 10.1111/sji.13037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 12/18/2022]
Abstract
Neutropenia as an isolated clinical finding may include aetiologies ranging from severe disease to a transient condition, and differential diagnosis may be challenging. Previous data and clinical experience suggest that low levels of the neutrophil-derived protein human 18 kDa cathelicidin antimicrobial protein (hCAP-18) in the blood are predictive of more severe forms of neutropenia. The objective of this study was to present the results from a newly developed ELISA method that has been used in clinical routine in Sweden since 2018 for quantification of hCAP-18 in blood plasma. Using this method, we report that patients with severe disease analysed during the study period presented with low or undetectable levels of blood plasma hCAP-18, validating its use as screening tool for severe neutropenia. Furthermore, neutropenic patients as a group displayed lower levels of hCAP-18 as compared to blood donors. Within the group of neutropenic patients, those with neutrophil antibodies displayed significantly higher hCAP-18 levels compared to patients with idiopathic neutropenia. By including an analysis of hCAP-18 in the primary investigation of neutropenia, an increased accuracy in differential diagnosis is achieved, thus contributing to reduced costs of neutropenia management.
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Affiliation(s)
- Anette Mörtberg
- Medical Unit Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Katrin Pütsep
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Medical Unit Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.,Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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31
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Schmied L, Höglund P, Meinke S. Platelet-Mediated Protection of Cancer Cells From Immune Surveillance - Possible Implications for Cancer Immunotherapy. Front Immunol 2021; 12:640578. [PMID: 33777033 PMCID: PMC7988080 DOI: 10.3389/fimmu.2021.640578] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [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: 12/11/2020] [Accepted: 02/09/2021] [Indexed: 12/19/2022] Open
Abstract
The growing insights in the complex interactions between metastatic cancer-cells and platelets have revealed that platelet tumor cell interactions in the blood stream are an important factor supporting tumor metastasis. An increased coagulability of platelets facilitates the vascular evasion and establishment of solid tumor metastasis. Furthermore, platelets can support an immunosuppressive tumor microenvironment or shield tumor cells directly from engagement of cytotoxic lymphocytes as e.g., natural killer (NK) cells. Platelets are both in the tumor microenvironment and systemically the quantitatively most important source of TGF-β, which is a key cytokine for immunosuppression in the tumor microenvironment. If similar platelet-tumor interactions are of physiological relevance in hematological malignancies remains less well-studied. This might be important, as T- and NK cell mediated graft vs. leukemia effects (GvL) are well-documented and malignant hematological cells have a high exposure to platelets compared to solid tumors. As NK cell-based immunotherapies gain increasing attention as a therapeutic option for patients suffering from hematological and other malignancies, we review the known interactions between platelets and NK cells in the solid tumor setting and discuss how these could also apply to hematological cancers. We furthermore explore the possible implications for NK cell therapy in patients with solid tumors and patients who depend on frequent platelet transfusions. As platelets have a protective and supportive effect on cancer cells, the impact of platelet transfusion on immunotherapy and the combination of immunotherapy with platelet inhibitors needs to be evaluated.
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Affiliation(s)
- Laurent Schmied
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Stephan Meinke
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Huddinge, Sweden
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32
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Luu TT, Schmied L, Nguyen NA, Wiel C, Meinke S, Mohammad DK, Bergö M, Alici E, Kadri N, Ganesan S, Höglund P. Short-term IL-15 priming leaves a long-lasting signalling imprint in mouse NK cells independently of a metabolic switch. Life Sci Alliance 2021; 4:4/4/e202000723. [PMID: 33593878 PMCID: PMC7918643 DOI: 10.26508/lsa.202000723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/25/2022] Open
Abstract
NK cell reactivity is dynamically regulated by IL-15, and NK cells do not need more than a few minutes of exposure to remember the cytokine for several hours. IL-15 priming of NK cells is a broadly accepted concept, but the dynamics and underlying molecular mechanisms remain poorly understood. We show that as little as 5 min of IL-15 treatment in vitro, followed by removal of excess cytokines, results in a long-lasting, but reversible, augmentation of NK cell responsiveness upon activating receptor cross-linking. In contrast to long-term stimulation, improved NK cell function after short-term IL-15 priming was not associated with enhanced metabolism but was based on the increased steady-state phosphorylation level of signalling molecules downstream of activating receptors. Inhibition of JAK3 eliminated this priming effect, suggesting a cross talk between the IL-15 receptor and ITAM-dependent activating receptors. Increased signalling molecule phosphorylation levels, calcium flux, and IFN-γ secretion lasted for up to 3 h after IL-15 stimulation before returning to baseline. We conclude that IL-15 rapidly and reversibly primes NK cell function by modulating activating receptor signalling. Our findings suggest a mechanism by which NK cell reactivity can potentially be maintained in vivo based on only brief encounters with IL-15 trans-presenting cells.
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Affiliation(s)
- Thuy T Luu
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden
| | - Laurent Schmied
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden
| | - Ngoc-Anh Nguyen
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden
| | - Clotilde Wiel
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Stephan Meinke
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden
| | - Dara K Mohammad
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden.,Department of Food Technology, College of Agricultural Engineering Sciences, Salahaddin University-Erbil, KRG-Kurdistan Region, Iraq
| | - Martin Bergö
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Evren Alici
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden.,Cell Therapy Institute, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Nadir Kadri
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden
| | - Sridharan Ganesan
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Centre for Haematology and Regenerative Medicine (HERM), Karolinska Institutet, Huddinge, Sweden
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Mirlashari MR, Vetlesen A, Nissen-Meyer LSH, Naper C, Tjønnfjord GE, Njerve IU, Ezligini F, Landmark BF, Meinke S, Sandgren P, Höglund P, Hetland G. HLA class I depletion by citric acid, and irradiation of apheresis platelets for transfusion of refractory patients. Transfusion 2021; 61:1222-1234. [PMID: 33580979 DOI: 10.1111/trf.16282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/07/2020] [Accepted: 12/17/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Patients can form antibodies to foreign human leukocyte antigen (HLA) Class I antigens after exposure to allogeneic cells. These anti-HLA class I antibodies can bind transfused platelets (PLTs) and mediate their destruction, thus leading to PLT refractoriness. Patients with PLT refractoriness need HLA-matched PLTs, which require expensive HLA typing of donors, antibody analyses of patient sera and/or crossmatching. An alternative approach is to reduce PLT HLA Class I expression using a brief incubation in citric acid on ice at low pH. METHODS AND MATERIALS Apheresis PLT concentrates were depleted of HLA Class I complexes by 5 minutes incubation in ice-cold citric acid, at pH 3.0. Surface expression of HLA Class I complexes, CD62P, CD63, phosphatidylserine, and complement factor C3c was analyzed by flow cytometry. PLT functionality was tested by thromboelastography (TEG). RESULTS Acid treatment reduced the expression of HLA Class I complexes by 71% and potential for C3c binding by 11.5-fold compared to untreated PLTs. Acid-treated PLTs were significantly more activated than untreated PLTs, but irrespective of this increase in steady-state activation, CD62P and CD63 were strongly upregulated on both acid-treated and untreated PLTs after stimulation with thrombin receptor agonist peptide. Acid treatment did not induce apoptosis over time. X-ray irradiation did not significantly influence the expression of HLA Class I complexes, CD62P, CD63, and TEG variables on acid treated PLTs. CONCLUSION The relatively simple acid stripping method can be used with irradiated apheresis PLTs and may prevent transfusion-associated HLA sensitization and overcome PLT refractoriness.
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Affiliation(s)
| | - Annette Vetlesen
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Christian Naper
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
| | - Geir Erland Tjønnfjord
- Department of Hematology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ida Unhammer Njerve
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
| | - Farshid Ezligini
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Stephan Meinke
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden.,Function Area Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Per Sandgren
- Function Area Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden.,Function Area Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Geir Hetland
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Zhao J, Gabriel E, Norda R, Höglund P, Baden L, Diedrich BA, Marits P, Enoksson SL, Gansner JM, Kaufman R, Dickman PW, Edgren G. Frequent platelet donation is associated with lymphopenia and risk of infections: A nationwide cohort study. Transfusion 2021; 61:464-473. [PMID: 33186486 PMCID: PMC7894559 DOI: 10.1111/trf.16175] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recently, plateletpheresis donations using a widely used leukoreduction system (LRS) chamber have been associated with T-cell lymphopenia. However, clinical health consequences of plateletpheresis-associated lymphopenia are still unknown. STUDY DESIGN AND METHODS A nationwide cohort study using the SCANDAT3-S database was conducted with all platelet- and plasmapheresis donors in Sweden between 1996 and 2017. A Cox proportional hazards model, using donations as time-dependent exposures, was used to assess the risk of infections associated with plateletpheresis donations using an LRS chamber. RESULTS A total of 74 408 apheresis donors were included. Among donors with the same donation frequency, plateletpheresis donors using an LRS chamber were at an increased risk of immunosuppression-related infections and common bacterial infections in a dose-dependent manner. While very frequent donors and infections were rare in absolute terms resulting in wide confidence intervals (CIs), the increased risk was significant starting at one-third or less of the allowed donation frequency in a 10-year exposure window, with hazard ratios reaching 10 or more. No plateletpheresis donors that used an LRS chamber experienced a Pneumocystis jirovecii, aspergillus, disseminated mycobacterial, or cryptococcal infection. In a subcohort (n = 42), donations with LRS were associated with low CD4+ T-cell counts (Pearson's R = -0.41; 95% CI, - 0.63 to -0.12). CONCLUSION Frequent plateletpheresis donation using an LRS chamber was associated with CD4+ T-cell lymphopenia and an increased risk of infections. These findings suggest a need to monitor T-lymphocyte counts in frequent platelet donors and to conduct future investigations of long-term donor health and for regulators to consider steps to mitigate lymphodepletion in donors.
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Affiliation(s)
- Jingcheng Zhao
- Department of Medicine Solna, Clinical Epidemiology DivisionKarolinska InstitutetStockholmSweden
| | - Erin Gabriel
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Rut Norda
- Department of Immunology, Genetics and PathologyUppsala UniversityUppsalaSweden
| | - Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regnerative Medicine (HERM)Karolinska InstitutetStockholmSweden
- Department of Clinical Immunology and Transfusion MedicineKarolinska University HospitalStockholmSweden
| | - Lindsey Baden
- Division of Infectious DiseasesBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Beatrice A. Diedrich
- Department of Clinical Immunology and Transfusion MedicineKarolinska University HospitalStockholmSweden
- Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
| | - Per Marits
- Department of Clinical Immunology and Transfusion MedicineKarolinska University HospitalStockholmSweden
- Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
| | - Sara L. Enoksson
- Department of Clinical Immunology and Transfusion MedicineKarolinska University HospitalStockholmSweden
- Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
| | - John M. Gansner
- Hematology DivisionBrigham and Women's HospitalBostonMassachusettsUSA
| | - Richard Kaufman
- Department of PathologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Paul W. Dickman
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Gustaf Edgren
- Department of Medicine Solna, Clinical Epidemiology DivisionKarolinska InstitutetStockholmSweden
- Department of CardiologySödersjukhusetStockholmSweden
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Höglund P. Talk of the town in 2021: Covid-19 vaccines likely take centre stage. Scand J Immunol 2021; 93:e13014. [PMID: 33372339 PMCID: PMC7883282 DOI: 10.1111/sji.13014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Höglund P, Ljunggren HG, Jonsson R. Covid-19, SSI 50 years and Nobel: Three immunological reasons to remember 2020. Scand J Immunol 2020; 92:e12997. [PMID: 33241904 PMCID: PMC7744915 DOI: 10.1111/sji.12997] [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: 11/30/2022]
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37
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Flesch BK, Reil A, Nogués N, Canals C, Bugert P, Schulze TJ, Huiskes E, Porcelijn L, Höglund P, Ratcliffe P, Schönbacher M, Kerchrom H, Kellershohn J, Bayat B. Multicenter Study on Differential Human Neutrophil Antigen 2 Expression and Underlying Molecular Mechanisms. Transfus Med Hemother 2020; 47:385-395. [PMID: 33173457 DOI: 10.1159/000505523] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/18/2019] [Indexed: 12/29/2022] Open
Abstract
Background The human neutrophil antigen 2 (HNA-2), which is expressed on CD177, is undetectable in 3-5% of the normal population. Exposure of these HNA-2<sub>null</sub> individuals to HNA-2-positive cells can cause immunization and pro-duction of HNA-2 antibodies, which can induce immune neutropenia and transfusion-related acute lung injury. In HNA-2-positive individuals, neutrophils are divided into a CD177<sup>pos.</sup> and a CD177<sup>neg.</sup> subpopulation. The molecular background of HNA-2 deficiency and the bimodal expression pattern, however, are not completely decoded. Study Design An international collaboration was conducted on the genetic analysis of HNA-2-phenotyped blood samples, including HNA-2-deficient individuals, mothers, and the respective children with neonatal immune neutropenia and regular blood donors. Results From a total of 54 HNA-2<sub>null</sub> individuals, 43 were homozygous for the CD177 *787A>T substitution. Six carried the CD177 *c.1291G>A single nucleotide polymorphism. All HNA-2-positive samples with >40% CD177<sup>pos.</sup> neutrophils carried the *787A wild-type allele, whereas a lower rate of CD177<sup>pos.</sup> neutrophils was preferentially associated with *c.787AT heterozygosity. Interestingly, only the *c.787A allele sequence was detected in complementary DNA (cDNA) sequence analysis carried out on all *c.787AT heterozygous individuals. However, cDNA analysis after sorting of CD177<sup>pos.</sup> and CD177<sup>neg.</sup> neutrophil subsets from HNA-2-positive individuals showed identical sequences, which makes regulatory elements within the promoter unlikely to affect CD177 gene transcription in different CD177 neutrophil subsets. Conclusion This comprehensive study clearly demonstrates the impact of single nucleotide polymorphisms on the expression of HNA-2 on the neutrophil surface but challenges the hypothesis of regulatory epigenetic effects being implicated in the bimodal CD177 expression pattern.
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Affiliation(s)
- Brigitte K Flesch
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany.,German Red Cross Blood Service West, Hagen, Germany
| | | | - Núria Nogués
- Immunohematology Laboratory, Blood and Tissue Bank, Barcelona, Spain
| | - Carme Canals
- Immunohematology Laboratory, Blood and Tissue Bank, Barcelona, Spain
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service of Baden-Württemberg, Hessen gGmbH, Mannheim, Germany
| | - Torsten J Schulze
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service of Baden-Württemberg, Hessen gGmbH, Mannheim, Germany.,Institute Springe, German Red Cross Blood Service NSTOB, Springe, Germany
| | - Elly Huiskes
- Department of Immunohematology Diagnostics, Sanquin, Amsterdam, The Netherlands
| | - Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin, Amsterdam, The Netherlands
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Ratcliffe
- Center for Hematology and Regenerative Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marlies Schönbacher
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Hans Kerchrom
- Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Josina Kellershohn
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
| | - Behnaz Bayat
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
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Höglund P. Scandinavian Society for Immunology turns 50: Snapshots of Scandinavian immunology today and the future of this learned society. Scand J Immunol 2020; 92:e12976. [DOI: 10.1111/sji.12976] [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: 11/27/2022]
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39
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Fragiadaki I, Papadakis S, Sevastaki G, Sfyridaki K, Mavroudi I, Goulielmos GN, Kanellou P, Mörtberg A, Höglund P, Gemenetzi K, Stamatopoulos K, Chatzidimitriou A, Palmblad J, Papadaki HA. Increased frequency of the single nucleotide polymorphism of the DARC/ACKR1 gene associated with ethnic neutropenia in a cohort of European patients with chronic idiopathic neutropenia. Am J Hematol 2020; 95:E163-E166. [PMID: 32243614 DOI: 10.1002/ajh.25813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/26/2020] [Accepted: 03/28/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Irene Fragiadaki
- Hemopoiesis Research Laboratory, School of MedicineUniversity of Crete and Department of Hematology, University Hospital of Heraklion Heraklion Greece
| | - Stavros Papadakis
- Hemopoiesis Research Laboratory, School of MedicineUniversity of Crete and Department of Hematology, University Hospital of Heraklion Heraklion Greece
| | | | | | - Irene Mavroudi
- Hemopoiesis Research Laboratory, School of MedicineUniversity of Crete and Department of Hematology, University Hospital of Heraklion Heraklion Greece
| | - George N. Goulielmos
- Department of Internal MedicineMolecular Pathology and Human Genetics Section, School of Medicine, University of Crete Crete Greece
| | - Peggy Kanellou
- Department of HematologyVenizeleion General Hospital Heraklion, Crete Greece
| | - Anette Mörtberg
- Department of Clinical Immunology and Transfusion MedicineKarolinska University Hospital Huddinge Stockholm Sweden
| | - Petter Höglund
- Department of Clinical Immunology and Transfusion MedicineKarolinska University Hospital Huddinge Stockholm Sweden
- Department of Medicine Karolinska Institutet Stockholm Sweden
- Center for Hematology and Regenerative Medicine (HERM)Karolinska University Hospital Huddinge Stockholm Sweden
| | - Katerina Gemenetzi
- Institute of Applied Biosciences, Centre for Research & Technology Hellas Thessaloniki Greece
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research & Technology Hellas Thessaloniki Greece
| | | | - Jan Palmblad
- Department of Medicine Karolinska Institutet Stockholm Sweden
| | - Helen A. Papadaki
- Hemopoiesis Research Laboratory, School of MedicineUniversity of Crete and Department of Hematology, University Hospital of Heraklion Heraklion Greece
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40
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Affiliation(s)
- Petter Höglund
- Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden
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41
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Luu TT, Wagner AK, Schmied L, Meinke S, Freund JE, Kambayashi T, Ravens I, Achour A, Bernhardt G, Chambers BJ, Höglund P, Kadri N. IL-15 and CD155 expression regulate LAT expression in murine DNAM1 + NK cells, enhancing their effectors functions. Eur J Immunol 2020; 50:494-504. [PMID: 31834938 DOI: 10.1002/eji.201948233] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/14/2019] [Accepted: 12/11/2019] [Indexed: 01/19/2023]
Abstract
NK cells are innate immune cells characterized by their ability to spontaneously lyse tumor and virally infected cells. We have recently demonstrated that IL-15-sufficient DC regulate NK cell effector functions in mice. Here, we established that among ITAM-proximal signaling molecules, the expression levels of the scaffold molecule Linker for Activation of T cells (LAT) and its transcription factor ELF-1 were reduced 4 days after in vivo depletion of DC. Addition of IL-15, a cytokine presented by DC to NK cells, regulates LAT expression in NK cells with a significant effect on the DNAM1+ subset compared to DNAM1- cells. We also found that LAT expression is regulated via interaction of the DNAM1 receptor with its ligand CD155 in both immature and mature NK cells, independently of NK cell education. Finally, we found that LAT expression within DNAM1+ NK cells might be responsible for enhanced calcium mobilization following the triggering of activating receptors on NK cells. Altogether, we found that LAT expression is tightly regulated in DNAM1+ NK cells, via interaction(s) with DC, which express CD155 and IL-15, resulting in rapid activation of the DNAM1+ subset during activating receptor triggering.
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Affiliation(s)
- Thuy T Luu
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Arnika K Wagner
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Laurent Schmied
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Stephan Meinke
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Jacquelyn E Freund
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Taku Kambayashi
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Inga Ravens
- Institute of Immunology, Building 11, Hannover Medical School, Hannover, Germany
| | - Adnane Achour
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institute, and Division of Infectious Diseases, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Gunter Bernhardt
- Institute of Immunology, Building 11, Hannover Medical School, Hannover, Germany
| | - Benedict J Chambers
- Center for Infectious Medicine, Department of Medicine, Huddinge, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.,Clinic for Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Nadir Kadri
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institute, and Division of Infectious Diseases, Karolinska University Hospital, Solna, Stockholm, Sweden
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42
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Höglund P. Immunotherapy of food allergy: Are combinations the way forward? Scand J Immunol 2019; 91:e12859. [PMID: 31884730 DOI: 10.1111/sji.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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43
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Höglund P. Scandinavian Journal of Immunology 2019 – A Norwegian Winterreise and increased impact factor. Scand J Immunol 2019. [DOI: 10.1111/sji.12847] [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: 11/30/2022]
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44
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Meinke S, Karlström C, Höglund P. Complement as an Immune Barrier in Platelet Transfusion Refractoriness. Transfus Med Rev 2019; 33:231-235. [PMID: 31679761 DOI: 10.1016/j.tmrv.2019.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 09/05/2019] [Indexed: 12/15/2022]
Abstract
Patients with hematological cancers often have low platelet counts because of progressing bone marrow failure or cytostatic therapy. A large fraction of those patients need platelet transfusions, which can be life-saving if bleedings occur and also allow diagnostic and therapeutic interventions. The outcomes of platelet transfusions are not always easy to predict in terms of bleeding control or increase in platelet count. Reasons could be disease-specific factors, fever, or infections leading to platelet consumption, but the immune system may also be involved, in particular, in patients previously immunized against foreign human leukocyte antigens (HLA). Mechanisms underlying immune-mediated platelet destruction in the presence of antibodies again HLA are not well understood in clinical situations. This review discusses the role of complement in platelet refractoriness, with a focus on HLA antibody-mediated platelet refractoriness. We summarize recent work in this area, discuss complement-platelet interactions in general terms, and a suggest a possible role of complement in platelet transfusion in general.
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Affiliation(s)
- Stephan Meinke
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Sweden
| | - Cecilia Karlström
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Sweden; Theme Hematology, Karolinska University Hospital, Sweden
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge, Karolinska Institutet, Sweden; Function area Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Sweden.
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45
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Gavin C, Meinke S, Heldring N, Heck KA, Achour A, Iacobaeus E, Höglund P, Le Blanc K, Kadri N. The Complement System Is Essential for the Phagocytosis of Mesenchymal Stromal Cells by Monocytes. Front Immunol 2019; 10:2249. [PMID: 31616424 PMCID: PMC6763726 DOI: 10.3389/fimmu.2019.02249] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 07/09/2019] [Accepted: 09/05/2019] [Indexed: 12/12/2022] Open
Abstract
Mesenchymal stromal cell (MSC) therapy is a promising tool in the treatment of chronic inflammatory diseases. This has been ascribed to the capacity of MSC to release a large variety of immune-modulatory factors. However, all aspects of the mode of therapeutic MSC action in different diseases remain unresolved, mainly because most of the infused MSC are undetectable in the circulation within hours after infusion. The aim of this study was to elucidate the fate of MSC after contact with plasma. We found that upon contact with blood, complement proteins including C3b/iC3b are deposited on MSC. Importantly, we also found that complement bound to MSC enhanced their phagocytosis by classical and intermediate monocytes via a mechanism that involves C3 but not C5. Thus, we describe for the first time a mechanism which might explain, at least partly, why MSC are not found in the blood circulation after infusion. Our results indicate that MSC immune-modulatory effects could be mediated by monocytes that have phagocytosed them.
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Affiliation(s)
- Caroline Gavin
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stephan Meinke
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Nina Heldring
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kathleen Anne Heck
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Adnane Achour
- Science for Life Laboratory, Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ellen Iacobaeus
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.,Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Katarina Le Blanc
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Center of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Nadir Kadri
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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46
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Rydén J, Clements M, Hellström-Lindberg E, Höglund P, Edgren G. A longer duration of red blood cell storage is associated with a lower hemoglobin increase after blood transfusion: a cohort study. Transfusion 2019; 59:1945-1952. [PMID: 30793325 DOI: 10.1111/trf.15215] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND RBC concentrates are commonly stored for up to 42 days but there has been conflicting evidence on the effect of storage duration and clinical outcomes. Most clinical studies have focused on possible associations between duration of storage time and risk for adverse outcomes, including mortality. Recent clinical trials did not find any such associations, but fewer studies have addressed whether storage time affects component efficacy. The main aim of this study was to determine the effect of RBC storage time on hemoglobin increment in transfused patients. STUDY DESIGN AND METHODS Transfusion data on a cohort of patients with myelodysplastic syndromes were linked to hemoglobin measurements taken between 2 days before and 28 days after a transfusion episode. We applied a mixed-effect linear regression model, accounting for patient characteristics and time from transfusion to next hemoglobin measurement, to study the effect of RBC storage on the hemoglobin increment. RESULTS The study population consisted of 225 patients who received 6437 RBC units. Compared to units stored less than 5 days, transfusion of blood units stored 5 to 9, 10 to 19, 20 to 29, or 30 or more days resulted in hemoglobin increases that were 0.83 (95% confidence interval [CI], 0.24-1.41), 0.92 (95% CI, 0.34-1.51), 1.33 (95% CI, 0.65-2.02) and 1.51 (95% CI, 0.58-2.43) g/L lower, respectively, per RBC unit. Results were consistent in sensitivity analyses. CONCLUSIONS Longer RBC storage was associated with a smaller increase in hemoglobin concentration after transfusion. Although statistically significant, the effect was modest, and its clinical relevance in subgroups of patients should be investigated in prospective clinical trials.
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Affiliation(s)
- Jenny Rydén
- Department of Medicine, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden.,Hematology Center, Karolinska University Hospital, Stockholm, Sweden
| | - Mark Clements
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Eva Hellström-Lindberg
- Department of Medicine, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden.,Hematology Center, Karolinska University Hospital, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Gustaf Edgren
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Södersjukhuset, Stockholm, Sweden
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47
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Ganesan S, Höglund P. Inhibitory Receptor Crosslinking Quantitatively Dampens Calcium Flux Induced by Activating Receptor Triggering in NK Cells. Front Immunol 2019; 9:3173. [PMID: 30693005 PMCID: PMC6339929 DOI: 10.3389/fimmu.2018.03173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/23/2018] [Accepted: 12/24/2018] [Indexed: 11/30/2022] Open
Abstract
Natural killer (NK) cell function is regulated by a balance between activating and inhibitory receptors, but the details of this receptor interplay are not extensively understood. We developed a flow cytometry-based assay system in which Ca2+ flux downstream of antibody-mediated activating receptor triggering was studied in the presence or absence of inhibitory receptor co-crosslinking. We show that the inhibitory influence on activating receptor-induced Ca2+ flux is quantitatively regulated, both on murine and human NK cells. Furthermore, both activating and inhibitory receptors operate in an additive way, suggesting that a fine-tuned balance between activating and inhibitory receptors regulate proximal NK cell signaling. We also demonstrate that murine NK cell expression of H2Dd lowered the capacity of Ly49A to deliver inhibitory signals after antibody crosslinking, suggesting that the cis interaction between H2Dd and Ly49A reduce the signaling capacity of Ly49A in this setting. Finally, we show that priming of NK cells by IL-15 rapidly augments Ca2+ flux after activating receptor signaling without attenuating the potential of inhibitory receptors to reduce Ca2+ flux. Our data shed new light on NK cell inhibition and raises new questions for further studies.
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Affiliation(s)
- Sridharan Ganesan
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden.,Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Huddinge, Sweden
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48
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Ljunggren HG, Jonsson R, Höglund P. Seminal immunologic discoveries with direct clinical implications: The 2018 Nobel Prize in Physiology or Medicine honours discoveries in cancer immunotherapy. Scand J Immunol 2019; 88:e12731. [PMID: 30485497 DOI: 10.1111/sji.12731] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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49
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Karlström C, Linjama T, Edgren G, Lauronen J, Wikman A, Höglund P. HLA-selected platelets for platelet refractory patients with HLA antibodies: a single-center experience. Transfusion 2018; 59:945-952. [DOI: 10.1111/trf.15108] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Cecilia Karlström
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge; Karolinska Institutet; Stockholm Sweden
- Hematology Center; Karolinska University Hospital; Stockholm Sweden
| | - Tiina Linjama
- Finnish Red Cross Blood Service; Histocompatibility Laboratory; Helsinki Finland
| | - Gustaf Edgren
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm Sweden
- Department of Cardiology; Södersjukhuset, Stockholm Sweden
| | - Jouni Lauronen
- Finnish Red Cross Blood Service; Histocompatibility Laboratory; Helsinki Finland
| | - Agneta Wikman
- Clinical Immunology and Transfusion Medicine; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine (HERM), Department of Medicine Huddinge; Karolinska Institutet; Stockholm Sweden
- Clinical Immunology and Transfusion Medicine; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
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50
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Palmblad J, Höglund P. Ethnic benign neutropenia: A phenomenon finds an explanation. Pediatr Blood Cancer 2018; 65:e27361. [PMID: 30117263 DOI: 10.1002/pbc.27361] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/21/2018] [Accepted: 06/25/2018] [Indexed: 01/29/2023]
Abstract
Ethnic benign neutropenia (ENP) is the most common form of neutropenia (NP) worldwide, if an absolute blood neutrophil count (ANC) of < 1.5 G/L is used as definition. In 2009, ENP was associated with a gene variation in the ACKR1/DARC gene, the same variation that also confers the Duffy-null trait. In 2017, a novel mechanism for ENP was introduced, questioning if ENP is a true neutropenic state, when the body's total neutrophil count (TBNC) is concerned. Here, we summarize the current knowledge of ENP, asking (1) How well does the peripheral blood ANC predict the TBNC? (2) Can we improve methods for assessing TBNC? (3) Will estimates of TBNC predict infection propensity and reduce the need for further, costly workup?
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Affiliation(s)
- Jan Palmblad
- Department of Medicine Karolinska Institutet, The Hematology Center, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine Karolinska Institutet, Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital Huddinge, and Center for Hematology and Regenerative Medicine (HERM), Stockholm, Sweden
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