摘要:

AbstractDr Anthony Britten was the head of the blood programme of the League of Red Cross and Red Crescent Societies from 1985 to 1989 and vice chairman of the World Federation of Haemophilia. He was actively involved withVox Sanguinisas Section Editor from 1986 to 1994 and as a very good friend of members of the Editorial Board and FoundationVox Sanguinis. He worked ceaselessly to promote medical services for people with haemophilia, especially in developing countries where safe blood programmes did not exist. He was uniquely able to understand the medical, emotional and social needs of this population as he was born in South Africa with severe haemophilia A, at a time when almost all boys born with bleeding disorders died before they reached maturity. (Two of his uncles died in childhood.) Apart from some happy years spent at a sympathetic prep school, The Ridge, he was educated by family and tutors, for no senior school would accept the risk that such a life‐threatening condition pose

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7140195.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractHematopoietic growth factors, glycoproteins that stimulate self‐renewal, differentiation, and proliferation of responsive hematopoietic cells, promise to revolutionize transfusion medicine. Recombinant DNA technology has made several of these cytokines available at pharmacologic doses, and new candidate agents for clinical application appear regularly. Growth factors prescribed for patients have already reduced the requirement for red blood cell and granulocyte transfusions in selected clinical circumstances. A lineage‐specific thrombopoietin will likely limit the need for platelet transfusions. Hematopoietic cytokine injections have also been used to increase the number of red blood cells, granulocytes and circulating primitive progenitor cells in blood donors. Cytokine‐stimulated peripheral blood progenitor cell infusions have complemented and, in some instances, replaced bone marrow for adjunctive cancer chemotherapy and for bone marrow transplantation. Finally, synergistic combinations of cytokines can effect ex vivo expansion of lymphocytes and of progenitor cells to provide novel blood components. Hematopoietic growth factors are still expensive and their long‐term effects remain to be determined. However, as the biologic activities of cytokines and the physiology of hematopoietic progenitor cells become better understood, the clinical application of novel cellular components may redefine the concept of blood tran

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7140196.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractWhen platelets that are AB0‐nonidentical are transfused, circulating immune complexes (CIC) are formed. In the present study we examined the ability of polyclonal antibodies to two C1q receptors on platelets, cC1q‐R and gC1q‐R, and a monoclonal IgG FcγRII (CD32) antibody directed against the platelet Fc receptor to inhibit the uptake of CIC involving the AB0 blood group system by normal platelets. Four types of immune complexes of varying purity were made in vitro. In addition serum from 5 refractory group A patients who had demonstrable AB0 CIC, 5 patients who had received only AB0‐identical platelets and had no AB0 CIC and 6 normal donors were evaluated. After exposure of normal platelets to serum of patients with demonstrable AB0 CIC there were increased levels of platelet‐associated IgG. This binding was partially inhibited by preincubation of the platelets with either anti‐cC1q‐R (3/5 patients), gC1q‐R (3/5 patients) or IgG FcγRII in 4/5 patients. However, the pattern of inhibition by the three antibodies was variable. Using the artificial immune complexes a more consistent pattern was obtained. The binding of four types of artificial immune complexes to platelets was reduced by 67–99% after preincubation of the platelets with antibodies to the complement and Fc receptors. The present work supports the hypothesis that AB0 CIC bind to Fc and complement receptors on the platelet and if confirmed would suggest a pathophysiological mechanism for the clinical observations of the important role of AB0 in p

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7140205.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractReactivation of recipient antibody to HLA and red blood cell antigens is described in 8 patients after allogeneic bone marrow transplantation. These IgG antibodies can be detected between day 10 and day 40 after transplantation and, in 1 patient, can be shown to be antigen‐independent. We hypothesize that, induced by graft recognition of recipient antigens, antigen‐independent activation of sensitized recipient B cells takes place leading to transient antibody product

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7140212.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractTo establish the incidence and timing of red cell allo‐immunisation following transfusion, pretransfusion and serial post‐transfusion samples were screened for allo‐antibodies in a total of 452 patients who had undergone elective surgery. Antibody screening was performed by 2‐stage papain, manual polybrene and indirect antiglobulin techniques (IAT). Red cell allo‐antibodies were found in 42 patients and 38 of these (8.4% overall) demonstrated antibodies only after transfusion; 76% of them had Rh specificity. This rate of red cell allo‐immunisation is higher than what would be expected if transfused patients were tested only once post‐transfusion, as has been the case in several previous studies. For the type of patients studied, this finding may not be of clinical relevance at present because most patients undergoing elective surgery do not require further transfusion in their lifetime. However, this is changing with the longer life expectancy of the population and the increased probability of repeat surgery. Twenty‐two (58%) of the antibodies were initially detected by the 2‐stage papain and/or polybrene techniques, when the IAT was negative, although later 19 became positive by IAT; this added sensitivity of techniques other than the IAT, to detect early allo‐immunisation may be relevant in pretransfusion testing to prevent haemolytic transfusion reactions in patients requiring re

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7140216.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractWe have studied a previously described solid‐phase test (SPH) for screening and identification of antibodies directed against erythrocyte antigens, in large sample numbers and throughout routine processing. The screening results of all samples from pregnant women, patients and blood donors (n = 36,701) sent to our blood bank from August 1992 to July 1993 were compiled and evaluated. Pregnant women were screened by the SPH‐antiglobulin technique (IAT) and the SPH‐enzyme‐enhanced technique (ENZ), while the patients and blood donors were screened only by the SPH‐IAT. Samples with known alloimmunization were excluded from this study. Positive screening reactions were further investigated by the SPH‐IAT and SPH‐ENZ techniques, the manual hemagglutination tests low ionic‐strength solution IAT and 2‐stage papain. Pregnant women: A positive reaction in one or both of the SPH tests was found in 1.2% of the samples. The SPH tests identified 99 (98.0%) and the manual methods 79 (78.2%) of a total of 101 antibodies. Of the identified antibodies, 61 were to antigens in the Rh blood group system, including 34 Rh immune globulin. The remainder had specificity directed against antigens K, Jka, M, S, Leaand Leb. Patients: A positive reaction in the SPH‐IAT test occurred in 0.9% of the samples. The antibodies identified had specificity directed against antigens D, C, c and E in the Rh blood group system. The remainder had specificity directed against antigens Fya, K, Jka, M and Lea. All antibodies identified by SPH‐IAT, except 1 anti‐M and 2 anti‐Lea, were also identified by manual methods. Blood donors: A positive reaction in the SPH‐IAT test was noted in 0.7% of the samples. The identified antibodies had specificity directed against antigens D, C, E, Fya, K and M. All antibodies identified by the SPH‐IAT, except 1 anti‐D found in a sample from an RhD(+) male, were also identified by the manual methods. This study indicates that the SPH‐IAT test is sensitive for detecting anti‐M. This was also indicated for the SPH‐ENZ test concerning the Jkaantibody. An advantage of using solid‐phase antibody screening tests for a larger series of samples is the possibility of automated sample identification, dilution, dispensing and interpretation of results. The SPH‐IAT and the SPH‐ENZ tests permitted us to select test cells, preferably from our own donor pool. We conclude that the SPH‐IAT and SPH‐ENZ tests are suitable for routine antibody screening of pregnant women and the SPH

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7140221.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractPlasma samples from 109 patients with maternal IgG alloantibodies were investigated using a chemiluminescence (CL) assay, a functional test, to predict which antibodies were clinically significant. The CL assay was able to distinguish between those patients who were unaffected or mildly affected requiring only phototherapy, and those patients with moderate or severe haemolytic disease of the fetus or newborn (HDN) requiring transfusion therapy. The CL result was compared with the anti‐D quantification result, the number of IgG molecules bound per red cell and, in 80% of the cases, the monocyte monolayer assay. If mothers carrying Rh‐negative fetuses were ignored, then the CL assay correctly predicted the outcome for 93.4% of all cases (including those other than D), while the AutoAnalyzer and monocyte assay predicted correctly 92.7% (of the anti‐D patients) and 81.5%, respectively. Greater than 80% of patients with severe or moderate HDN had both IgG1+IgG3 subclasses in the maternal plasma, while those infants who were unaffected or only mildly affected had a greater chance of having IgG1 only (44%) in the maternal plasma, IgG3 only (27%) or both subclasses

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1997.73100546_71_4.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractScreening the FUT6 gene of 40 Swedish individuals, originally selected for genotyping of FUT3, revealed an unexpected high frequency of mutations. Four were originally typed as homozygous for the enzyme lethal mutation G739A byTaqαI restriction pattern, but only one lacked plasma α(1,3)fucosyltransferase activity. Cloning and sequencing of FUT6 from 2 of them revealed a new allele, without the G739A mutation, but with two new point mutations C738T and G977A. Segregation of this allele was confirmed in Swedish and Indonesian families. Since G739A and C738T mutations are only one nucleotide apart and induce the same modification ofTaqαI cleavage, a new screening strategy for FUT6 was adopted. The homozygous inactivating G739A mutation was for the first time identified in Caucasian and Polynesian individuals, both lacking plasma enzyme activity. The mutation C370T was present in 25 of the 40 Swedish individuals and the inactivating mutation C945A was not found at all. These findings stress the dangers of transferring restriction enzyme genotype strategies from one population to another and of inferring phenotypes from genotypes without phenotyping and/or performing confirmatory cloning and sequenci

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7140233.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractAppearance of clumps in stored platelet concentrates (PCs) due to intensive agitation presents a serious practical problem in the quality control of platelet products. It has previously been demonstrated that the appearance of clumps is strongly correlated with the final pH of PCs [1].

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.71402421.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractHuman erythrocytes express complement (C) regulatory proteins, C3b/C4b receptor (CR1, CD35), decay‐accelerating factor (DAF, CD55) and CD59, which protect cells from autologous C attack [1]. CR1 and DAF are C3‐step regulators which destabilize the classical and alternative C3 convertases [1]. In addition, CR1 can bind C4b and C3b in the immune complexes to clear them from the circulation, namely immune adherence [2]. CD59 inhibits the formation of membrane attack complexes

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.71402422.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY