摘要:

ABSTRACTThe aftermath of the HIV catastrophe and hepatitis virus transmission to hemophiliacs has been characterized by continuous efforts to improve the purity of factor VIII and factor IX concentrates, increasing sophistication of the virucidal methods used, and the introduction of recombinant factor VIII. The cost of hemophilia care is substantial and there is a large price difference between products depending on their purity; generally, the purer the concentrate, the higher the price. The use of expensive highly purified concentrates may be questioned if these products are not superior in terms of safety, efficacy or convenience. The properties of concentrates used in hemophilia care are discussed in this review, as are their safety and side effects. The available data do not clearly reveal any clinical difference between factor VIII concentrates, although the highly purified products may be of theoretical benefit. With regard to factor IX, purified products do not seem to carry any risk of the well‐known thromboembolic complications which occur in certain situations after treatment with prothrombin complex concentrate

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01295.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTThe functional capacity of transfused platelets was evaluated with in vitro bleeding time (IVBT) and corrected count increment (CCI) in order to compare platelet concentrates (PCs) derived from pooled buffy coats (BC‐PCs) with PCs collected by apheresis (A‐PCs). The suspension medium in the BC‐PCs was 30% CPD plasma and 70% of an additive solution (containing sodium and potassium chloride, sodium citrate and phosphate, mannitol), and in the A‐PCs the medium was 100% CPD plasma. IVBT was evaluated using a Thrombostat 4000/2. BC‐PC and A‐PC were transfused 57 and 41 times, respectively to 36 patients with chemotherapy‐induced thrombocytopenia. PCs transfused within 2 days of donation were considered fresh, and those transfused within 3–5 days were considered stored. IVBT was determined before, as well as 10–30 min and 24 h after transfusion; CCI was determined 10–30 min and 24 h after transfusion. The median pretransfusion IVBT value was 486 s. It was measurable in 21 of 98 (21%) of the transfusions, i.e. below the cutoff limit of 486 s. Ten to 30 min after transfusion, the IVBT showed a measurable reduction in 90% of the transfusions with fresh BC‐PCs, 92% of those with fresh A‐PCs, 63% of those with stored BC‐PCs and 79% of those with stored A‐PCs. After 24 h, the corresponding values were 63% for fresh BC‐PCs, 50% for fresh A‐PCs, 26% for stored BC‐PCs and 38% for stored A‐PCs. The median value of CCI 10–30 min after transfusion was 20 for fresh BC‐PCs, 17 for fresh A‐PCs, 16 for stored BC‐PCs and 14 for stored A‐PCs. The difference in IVBT between fresh and stored BC‐PCs was significant (p = 0. 032), unlike that between fresh and stored A‐PC. After 24 h the corresponding values were 7 for fresh BC‐PCs, 4 for fresh A‐PCs, 4 for stored BC‐PCs and 3 for stored A‐PCs. When all transfusions with fresh PCs (BC‐PCs+A‐PCs) were compared with all transfusions with stored PCs, a statistical difference was demonstrated in both CCI (p = 0.027) and IVBT (p = 0.043). Spearman's rank correlation coefficient (rs) was ‐0.41 between CCI and IVBT486s10–30 min after transfusion, and 4.55 between the posttransfusion plateled count and IVBT, indicating a relatively poor correlation between CCI and IVBT, and a slightly better correlation between platelet count and IVBT. In conclusion, BC‐PCs showed a slightly higher CCI and a better response in IVBT than A‐PCs. No statistical difference was demonstrated between BC‐PCs and A‐PCs transfused within 2 days after donation, with respect to function and recovery in vivo. BC‐PCs stored for 3 days or more showed about the same CCI and IVBT as stored A‐PC but significantly lower CCI and higher IVBT than fresh BC‐PCs. This may indicate that the preparation and/or storage conditions were not optimal. IVBT seems

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01296.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTTo assess alterations in coagulation proteins in stored platelet concentrates, we used a series of platelet parameters and measures of coagulation activation to compare samples collected before unit donation, during the processing of platelet concentrates (PC) from CPDA‐1 blood, and in storage up to 5 days as well as stored platelet‐poor plasma (PPP). Storage‐dependent increases in activated partial thromboplastin time and prothrombin time were seen in both PC and PPP. However, FVII, FXI, FXII, kallikrein activity and prothrombin F1.2 levels remained unchanged in stored PC. Surprisingly, in stored PPP, significant alterations in FXII, FVII, kallikrein and prothrombin F1.2 levels were seen. Platelet morphology and surface marker studies demonstrated platelet activation during storage. These data suggest that the presence of platelets in the CLX storage container partially suppresses coagulation activation at significant cost to platelet viab

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01297.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTHIV+ patients form autoantibodies against CD4+ and CD8+ lymphocytes. It was shown that anti‐CD4+ lymphocyte autoantibodies are associated with the depletion of CD4+ cells. In the present study we analyzed the relationship of anti‐CD4+ and anti‐CDS+ autoantibodies with the CD8+ lymphocyte decrease commonly observed during HIV disease. IgM and IgG antibodies as well as complement fragments were determined on the surface of CD4+ and CD8+ lymphocytes using double fluorescence flow cytometry. Anti‐CD8+ lymphocyte autoantibodies were found more often in HIV+ hemophilia patients (75/105 = 71%) than HIV‐ hemophilia patients (13/37 = 35%; p<0.0001), patients with pharyngeal carcinoma (20/44 = 45%; p = 0.002), habitual abortions (3/13 = 23%; p = 0.0009) or healthy individuals (93/223 = 42%; p<0.0001). Anti‐CD8+ antibodies, mostly of the IgM type, occurred significantly more frequently than anti‐CD4+ antibodies in healthy controls (p<0.0001), patients with pharyngeal carcinoma (p = 0.0001), or HIV‐ patients (p = 0.01). In HIV+ patients, however, anti‐CD4+ autoantibodies were found more often than anti‐CD8+ antibodies (85 vs 71%; p = 0.02). 70 of 104 (67%) HIV+ patients had autoantibodies on both CD4+ and CD8+ lymphocytes and the IgG/IgM/C3d autoantibody pattern was identical in 31 (44%) of the patients. Interestingly, peripheral blood CD8+ cell counts were significantly associated with anti‐CD4+ (p = 0.01) but not with anti‐CD8+ lymphocyte autoantibodies. It is hypothesized that the inhibition and depletion of CD4+ cells by anti‐CD4+ autoantibodies is associated with a loss of regulatory functions that leads to a depletion of antiviral c

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01298.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTThe discovery of a natural Gerbich antigen (anti‐Ge2) in the serum of a propositus prompted us to study his red blood cells (RBCs) by using monoclonal antibodies (mAbs) directed against glycophorin (GP) C and GPD. An mAb directed against the Ge4 antigen (mAb NaM10‐7G11) agglutinated both untreated and trypsin‐treated cells, demonstrating the expression of a trypsin‐resistant GPC (namely, GPC of the Gerbich type: GPCGe). Surprisingly, an anti‐Ge3 antibody (mAb NaM19‐3C4) agglutinated untreated cells, showing that they also express the Ge3 antigen that may be carried by normal GPC and CPD or by the abnormal GPC of the Yussef (Yus) type (GPCYus). Immunoblotting analysis performed with an mAb directed against the C‐terminal portion of GPC showed that the propositus' RBCs do not contain normal GPC and GPD but both GPCGeand GPCYus. Analysis of RBCs from the family demonstrated that, like the propositus, 2 of the 3 sisters had inherited both the GYPCGeand the GYPCYusalleles from the parents, who carried either the GYPCGeor the GYPCYusallele. The third sister had inherited the normal GYPC alleles from her parents, whereas the child of the propositus had inherited the GYPCGeallele. Interestingly, natural anti‐Ge2 antibodies were identified in the serum of 2 of the 3 Ge‐neg

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01299.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTThe human Lewis gene encodes an α(1,3/1,4)‐fucosyltransferase responsible for synthesis of the Leaand Lebantigens. To define the molecular background for non‐functional Lewis genes we have sequenced PCR‐amplified DNA fragments from two Le(a‐b‐) individuals. One was homozygously mutated at nucleotides 202 (T→C) and 314 (C→T), altering Trp68to Arg and Thrl05to Met, and the other was homozygously mutated at nucleotides 59 (T→G) and 1067 (T→A), altering Leu20to Arg and Ile356to Lys. Using PCR we screened for these and additionally one other mutation atnucleotide 508 (G→A) among 40 Caucasians. Of 15 Le(a‐b‐) individuals, 7 typed asle59/1067le202/314, 4 asle202/314le202/314and 1 asle59/10671e59/1067. Of 21 Le(a‐b+) and 4 Le(a+b‐), 17 typed asLeLeand 7 asLele202/314. A pedigree study of 8 Lewis‐positive individuals showed that the mutations at nucleotides 202 and 314 w

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01300.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTClonal characteristics of ABO antibodies in 18 paired samples of serum and breast milk were analyzed by isoelectric focusing and affinity immunoblotting. Anti‐A and/or ‐B (anti‐A/B) IgM showed a uniform, polyclonal spectrotype with more than 20 bands and only minimal interindividual differences. In contrast, IgG spectrotypes were oligoclonal (<12 bands) and individually distinct. IgA of serum as well as of breast milk showed oligoclonal motifs of up to 15 bands, but with more interindividual variance in intensity than IgM. The bands did not appear at an identical pH in milk and serum samples. The uniformity of IgM spectrotypes could be due to an absence of somatic mutations and thus reflect the use of unmutated germline genes. The greater clonal heterogeneity of IgG as compared to IgA indicates a difference in isotype‐switch regulation. Somatic hypermutation may be less active during the switch from IgM to IgA than during the switch to IgG, or the latter switch may be accompanied by a repertoire shift. Alternatively, the anti‐A/B IgA and IgG antibody populations could be derived from different clonal p

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01301.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTA patient was reported with suspected acute post‐transfusion hepatitis C virus (HCV) infection, 5 months after the transfusion of 2 units of red cells. The archived serum samples of the two implicated donations were retested by the original 3rd‐generation assay together with another 3rd‐generation assay and RI‐BA III, and were tested for HCV RNA using the PCR. Both donations were anti‐HCV negative but one was found to be PCR positive. This donor was a regular donor and was identified as the husband of a donor identified 18 months earlier as being HCV positive. This case is an example of transmission of HCV in the window period of infection, and a probable example of the transmission of HCV from wife to husband through intimat

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01302.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01303.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01304.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY