ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296804.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

Because of the rising incidence of bacterial growth and septic platelet transfusions in aging units, platelet storage is currently limited in the United States to 5 days. This approved shelf life of platelets might be altered if methods were devised to rapidly detect infected units and/or to decrease the incidence of bacterially contaminated platelets. An investigation was conducted on the effect of a prototype blood collection system with an in‐line filter for the production of white cell‐reduced platelet‐rich plasma on the growth of bacteria in platelets prepared from whole blood that had been inoculated withStaphylococcus epidermidis. Additional studies were conducted with a chemiluminescence‐linked ribosomal RNA (rRNA) gene probe and with blood gas analysis to identify possible methods for the rapid detection of bacterial contamination. All units were followed for 9 days of storage. The filtration of the platelet‐rich plasma resulted in an approximate 2 log10reduction in white cells with an average loss of 6.7 percent of platelets. Filtration did not appear to alter bacterial growth. In all platelet units that supported growth, pO2dropped to negligible values and pCO2rose relative to culture‐negative units. The changes were most sensitive and specific beyond 5 days of storage. The universal bacterial rRNA probe assay was able to detectS.epidermidisin concentrations as low as 1 × 103colony‐forming units per mL in some cases and reliably detected all units contaminated at a concentration of 1 × 104colony‐forming units per mL. The use of this probe for the testing of older (or all) platelet units (pooled, individual, or apheresis) could lead to a decrease in the incidence of septic platelet transfusion reactions and possibly to an increase in the acceptable storage pe

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296805.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

It has previously been reported that the transfusion of allogeneic whole blood increases sepsis‐related mortality and decreases the ability of the host to kill bacteria that have translocated from the intestinal tract. To determine which blood component contributes to this adverse effect, the impact of the transfusion of white cells (WBCs), red cells (RBCs), and plasma on microbial translocation, bacteria killing, and mortality rate was studied. Blood from C3H/HeJ mice was separated into WBCs, RBCs, and plasma, and these fractions were transfused to Balb/c mice. Controls received sterile saline. Five days after transfusion, all Balb/c mice underwent a 20‐percent burn and gavage with 1 × 1010Escherichia colilabeled with14C‐glucose. Mortality was observed for 10 days. Four additional groups, receiving the same treatment as above, were sacrificed 4 hours after the burn, and mesenteric lymph nodes, liver, kidney, and blood were harvested aseptically. For each tissue, quantitative colony counts, radionuclide counts, and percentage of translocated bacteria that remained alive were calculated. By radionuclide counts, no difference was observed in the degree of 14CE. colitranslocation among the groups. In contrast, the percentage of viable bacteria and the mortality rate were significantly higher in the group receiving allogeneic WBCs than in all other groups (p<0.05). It is concluded that WBCs are the component in transfused blood that has an adverse effect on host resistance to gut‐derived i

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296806.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The concentration of IgG, IgA, and IgM, as well as IgG subclasses, was measured by an enzyme‐linked immunosorbent assay in autoantibodies eluted from red cells (RBCs); the number of molecules of each isotype per RBC was calculated. Three groups were analyzed: Group 1 included 23 patients with autoimmune hemolytic anemia (AIHA) associated with warm autoantibodies of IgG class; Group 2 included 11 patients without anemia but with a positive direct antiglobulin test (DAT); Group 3 included 10 healthy DAT‐negative subjects. The mean number of IgG molecules per RBC in Group 1 (920) was about three times that in Group 2 (306) and about 17 times that in Group 3 (54). The range of RBC‐bound IgG showed an overlap between the two groups of patients. The mean number of IgM and IgA molecules per RBC was low in the three groups. IgG1 predominated in all groups except in two patients with AIHA, in whom IgG3 made up at least 50 percent of total IgG. The mean number of IgG1, IgG2, and IgG4 molecules per RBC in Group 1 was about three times that in Group 2, whereas the mean number of IgG3 molecules per RBC was 10 times as high (p<0.001). It follows that IgG3 was more common in patients of Group 1, but it was also detected in patients of Gr

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296807.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

Three cases of IgAκ cold agglutinins (CAs) were studied. One had anti‐Pr1specificity, one had anti‐Pra, and one had anti‐Sa. The CAs recognize O‐glycans of glycophorins. The findings supplement previous data on anti‐Pr1specificities of four IgAκ CAs. Because all IgA kappa CAs described recognize O‐glycans of glycophorins, a close association between the CA IgA isotype and specificities for O‐glycans becomes apparent. It is unlikely, however, that the striking association reflects interrelations between IgA CA structure and specificity, because anti‐Sa specificity and all anti‐Pr subspecificities were originally d

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296808.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

Many epitopes of the blood group MN sialoglycoprotein glycophorin A (GPA) are clinically important and have been implicated in alloimmunization and autoimmune hemolytic anemia. However, the factors that contribute to the immunogenicity and antigenicity of GPA epitopes are poorly understood. To study this question, linear determinants were defined to include all GPA exofacial regions that were free of linked carbohydrate (GPA 27–34, GPA 52–62, and GPA 65–70), and peptides corresponding to these amino acids were synthesized. All defined GPA determinants were shown to contain residues accessible to the immune system. Immunogenicity was measured by binding rabbit antisera, produced by using red cells (RBCs), RBC membrane, and purified GPA as immunogens, to peptide antigens in an enzyme‐linked immunosorbent assay. GPA 27–34 and GPA 52–62 were shown to be immunogenic, but GPA 65–70 was not. Comparison of the binding of antisera to peptide and purified GPA antigens showed that the defined determinants were less immunogenic than other, nondefined GPA epitopes. Antigenicity algorithms (hydrophilicity, surface probability, flexibility, and antigenic index) predicted that GPA 27–34 and, to a lesser extent, GPA 52–62 would be antigenic, while GPA 65–70 would be nonantigenic. Antigenicity, measured by the binding of rabbit antipeptide sera to RBCs, RBC membrane, and purified GPA, was demonstrated for the GPA 52–62 determinant alone. Results differed among molecular forms of GPA, which indicated that the specific conformation assumed by GPA is important in determining the immunogenicity and antigenicity of its epitopes. GPA immunogenicity and antigenicity are distinct phenomena that do not always predict one another, and, while accessibility to the immune system is required for immunogenicity and antigenicity, it alone is in

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296809.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The ability of the monocyte monolayer assay (MMA) and the chemiluminescence test (CLT) to predict the clinical significance of alloantibodies associated with hemolytic disease of the newborn (HDN) was assessed by the use of 22 well‐characterized antisera—predominantly anti‐D—from alloimmunized pregnant women. Seventeen sera were obtained before delivery from women whose infants were antigen positive for the antibody specificities identified in the maternal serum. With testing of these 17 sera by MMA, 10 results were in agreement with the presence or absence of HDN, but there were 5 false‐positive and 2 false‐negative results. With the CLT, 16 results were in agreement with the presence or absence of HDN, and there was 1 false‐negative result. Five sera were obtained from women whose infants were antigen negative for the antibody specificities identified in the maternal serum. The CLT and the MMA were both subject to false‐positive results with these sera. These results suggest that the CLT may be more valuable than the MMA as a noninvasive test for predicting the clinical significance of alloan

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296810.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

Four methods were compared as to their suitability for excluding IgA deficiency in the investigation of suspected anti‐IgA transfusion reactions. The methods were radial immunodiffusion, passive hemagglutination inhibition, sandwich enzyme‐linked immunosorbent assay, and membrane enzyme immunoassay. Parallel testing was performed on sera from 40 patients or blood donors previously found to have anti‐IgA and low or undetectable levels of IgA. All test methods identified the 40 sera as having abnormally low IgA levels. The membrane enzyme immunoassay required 10 minutes or less for testing, as compared to 3 hours for passive hemagglutination inhibition, 4 hours for sandwich enzyme‐linked immunosorbent assay, and 48 hours for radial immunodiffusion. The membrane enzyme immunoassay offers the potential for a rapid, instrument‐free screen of IgA levels and therefore may be useful in identifying those patients with suspected anti‐IgA anaphylactic transfusion reactions who are not IgA deficient and do not require IgA‐deficient blood components for additional

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296811.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The risk of transfusion‐associated graft‐versus‐host disease (TA‐GVHD) is related to the number of viable T cells transfused. Whether white cell (WBC)‐reduced blood components would carry a decreased risk of TA‐GVHD was considered, and the allogeneic mixed lymphocyte reaction was used as an in vitro model for TA‐GVHD. An exponential decline in the mixed lymphocyte reaction was found to occur, as a result of either an arithmetic increase in the dose of gamma irradiation given to responding cells or a logarithmic decrease in the number of unirradiated responding cells. Irradiation of responding cells with 600 cGy or a 0.6 log10reduction in the number of responding cells produced a 95‐percent decline in the mixed lymphocyte reaction. Although these studies do not validate the use of WBC reduction as a substitute for gamma irradiation for the prevention of TA‐GVHD, they suggest that the relative risk of TA‐GVHD resulting from the use of standard cellular components versus WBC‐reduced components merits

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296812.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

A polymerase chain reaction (PCR) assay was developed and optimized to detect cytomegalovirus (CMV) DNA in the blood of 86 normal donors who had originally tested seropositive for CMV. Evidence of previous or current infection with CMV was determined by rescreening of the blood for CMV antibodies and by detecting the presence of infectious virus in the white cells by cell culture. DNA was extracted from the blood of donors by a manual or an automated method and amplified by PCR using primers from the major immediate early gene of CMV DNA. The amplified product was detected by visualization of a fluorescent 435‐base pair DNA band in an electrophoretic agarose gel after ethidium bromide staining and confirmed by slot‐blot DNA hybridization using an oligonucleotide probe with complementarity for the major immediate early gene. Seven (8%) of the 86 donors were positive for CMV DNA in both fluorescence and hybridization studies. These donors were also antibody positive. While 74 (86%) of the 86 donors were positive for the presence of CMV antibodies in enzyme‐linked immunosorbent assay, none was positive for virus in cell culture. PCR has the potential to be an effective and reliable procedure for the detection of CMV DNA in donor blood, but further study is required for this technique to be used for diagnostic or routine screening pur

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33693296813.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY