ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00012.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.Twelve murine monoclonal antibodies, which react with human red cells of common Rh phenotype but give weak or negative reactions with Rh null erythrocytes, were used in quantitative binding assays and competitive binding assays to investigate the abundance and organization of polypeptides involved in the expression of antigens of the Rh blood group system. Antibodies of the R6A‐type (R6A, BRIC‐69, BRIC‐207) and the 2D10‐type (MB‐2D10, LA 18.18, LA23.40) recognize related structures and 100,000–200,000 molecules of each antibody bind maximally to erythrocytes of common Rh phenotype. Antibodies of the BRIC‐125 type (BRTCs 32, 122,125, 126, 168, 211) recognize structures that are unrelated to those recognized by R6A‐type and 2D10‐type antibodies and between 10,000 and 50,000 antibody molecules bind maximally to erythrocytes of the common Rh phenotype. The binding of antibodies of the R6A‐type and the 2D10‐type, but not of antibodies of the BRIC‐125‐type could be partially inhibited by human anti‐D antibodies (polyclonal and monoclonal) and a murine anti‐e‐like antibody. These results are consistent with evidence (Moore&Green 1987; Aventel al., 1988b) that the Rh blood group antigens are associated with a complex that comprises two groups of related polypeptides ofMr30,000 andMr35,000–100,000, respectively, and suggest that there are 1–2 × 105copies of this complex per erythrocyte. The polypeptide recognized by antibodies of the BRIC‐125 type is lik

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00013.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.This study describes the comparative measurement of D antigen site density using a fluorescent indirect antiglobulin test (FIAT) read by flow cytometry. The test results confirmed the continuum of D antigen strength from weakest D through to R2R2and also allowed the majority of weak D samples to be adequately distinguished from D‐negative sample

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00014.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.Three IgM human monoclonal antibodies to Jkb, and one IgM human monoclonal antibody to Jkawere produced from the lymphocytes of two immunized donors. Two of the anti‐Jkbmonoclonal antibodies (MS‐7 and MS‐9) are of the IgM(κ) isotype and one (MS‐8) is an IgM(λ). The anti‐Jkamonoclonal antibody (MS‐15) is of the IgM(κ) isotype. They are all specific for their respective antigens, and give positive agglutinations in saline by the immediate spin technique, even against Jk(a + b +) cells. The heterohybridomas have been shown to be suitable for bulk culture and produce levels of antibody that reach 18 μg/ml in the spent culture supernatant. They offer considerable advantages over currently available reagents in terms of stability, simplicity and speed of use, and will provide a reliable and unlimited supply of what are at the moment rare and unsatisfac

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00015.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.In our experience, some examples of mouse monoclonal antibodies of anti‐B blood group specificity develop a precipitate when stored at 4°C. This poses problems during the preparation of blood grouping reagents containing anti‐B, and in the storage and use of such reagents. Here we show that this problem can be circumvented by alteration of the glycan moiety of the secreted immunoglobulin, either by glycosidase treatment of the partially purified immunoglobulin, or by the addition of glycan processing inhibitors to the hybridoma cell cultures. These findings have importance for the manufacture of monoclonal antibodies, and highlight a possible new role for carbohydrate in immunoglobulin interaction and immune complex forma

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00016.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.A countrywide prospective study on open‐heart surgery patients was performed between 1987 and 1989 to determine the prevalence and nature of post‐transfusion hepatitis in Finland. Altogether 685 coronary by‐pass operation patients, who received on average 12·3 units of blood products, were postoperatively followed for 6 months. Ten blood samples were drawn from each patient. Hepatitis was diagnosed when the alanine aminotransferase values exceeded the upper normal value 2·5 times in one sample and twice in another, and non‐viral causes could reasonably be excluded. Eleven hepatitis cases (1·6%) were recorded with a mean incubation period of 8·4 weeks; all represented the non‐A, non‐B type. The majority had mild symptoms or were asymptomatic but two became icteric. Six patients (55%) had abnormal alanine aminotransferase values for at least 6 months, which indicates possible chronicity. These 685 open‐heart surgery patients received a total of 8,436 units of blood products; thus the rate of NANBH cases per 1000 units was as low as 1·3. This is less than recently reported in six other p

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00017.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.Six of 11 (55%) non‐A, non‐B hepatitis (NANBH) patients seroconverted to hepatitis C virus antibody (anti‐HCV) positivity 8–16 weeks after transfusions in a prospective post‐transfusion hepatitis study on 685 open‐heart surgery patients in Finland. Five of them had a seropositive donor, and two of the five non‐converted NANBH patients had received an anti‐HCV positive unit. Among 36 studied donors who were positive in the anti‐HCV ELISA, reactivity of both the antigen bands in a recombinant immunoblot assay (RIBA) for anti‐HCV was significantly associated with NANBH (P<0·00005) in the recipient. In addition, infective anti‐HCV positive donors had raised ALT values more often than seropositive donors which caused no seroconversion or infection in the

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00018.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.There is as yet only scarce information regarding the natural history and long‐term clinical sequelae of patients who survive the acute complications of severe drug‐related immune haemolysis, the effect of the mode of drug administration for sensitization and possible alterations of serological characteristics of drug‐dependent antibodies during the post‐sensitization period. We therefore followed 24 patients with nomifensine‐induced haemolytic anaemia for up to 6 years after the haemolytic attack. All patients had suffered from a severe haemolytic episode. None of the patients showed any abnormal findings upon reinvestigation (complete history and physical examination; extended biochemical and haematological laboratory status), particularly with respect to renal function. Drug‐dependent antibodies remained detectable in 19 of 21 sera, while drug‐independent autoantibodies, demonstrable in six patients during the acute phase of haemolysis, could no longer be detected. With regard to the mode of drug administration, the majority of patients (15 out of 24) had developed the haemolysis at the beginning (immediately after a single dose) or during a second course of drug therapy (n= 8 and 7, respectively). The immune response did not appear to be dose‐ or time‐dependent. This study confirms the benign long‐term prognosis of patients who survive life‐threatening complications in drug‐induced immune haemolytic anaemia. In addition, it indicates that drug‐dependent antibodies may remain detectable over long periods of time, and that irregular drug administration might be associated with a higher r

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00019.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.A prospective, randomized, controlled trial to examine the effects of antithrombin supplementation on mortality, coagulation and renal function has been carried out on 132 intensive care patients. Antithrombin activity was measured in all patients on admission to the intensive care unit (ICU). Patients with an antithrombin activity of less than 70% were randomized to either receive antithrombin replacement or to act as controls. Antithrombin activity was maintained above 70% in the treated patients throughout their stay on ICU. Ninety‐three patients had an antithrombin activity of less than 70% and 35 received replacement therapy. Patients with antithrombin activity below 70% remained on the ICU significantly longer and had a significantly higher mortality rate than patients with antithrombin activity above 70%. Antithrombin supplementation neither reduced mortality nor shortened the intensive care stay. Fifty patients with reduced antithrombin activity remained on the ICU for at least 4 days, 25 received antithrombin and 25 acted as controls; coagulation parameters and renal function have been monitored in these patients. Fibrinogen concentration and platelet count were unaffected by antithrombin replacement. Antithrombin supplementation did not appear to reduce the incidence of impaired renal function in sepsis, trauma and postoperative patients. The creatinine clearance fell below 20 ml/min in eight patients in the no‐treatment arm while by comparison only three patients in the treatment arm developed impaired renal function. Our study does not demonstrate a clear role for the use of antithrombin supplementation in intensive care, however the finding that antithrombin reduced renal impairment is encouraging and a larger study to confirm this finding is at present under

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00020.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.In Rh‐negative women, it is important to quantify the magnitude of an Rh‐positive fetomaternal haemorrhage (FMH) so that sufficient Rh immune globulin (RhIg) can be administered early in the postpartum period to prevent alloimmunization. The standard post‐partum dose of Rhlg varies from 100 μg in the UK to 300 μg in North America. It is therefore important to identify all Rh‐negative women who have had an FMH greater than 10 ml in the UK or greater than 30 ml in North America because an FMH greater than these amounts will affect the dose of RhIg that is administered. As acid‐elution techniques can overestimate the magnitude of an FMH in the presence of an elevated maternal haemoglobin F level, we performed a prospective study to determine how often this occurred. Of 1,894 consecutive Rh‐negative mothers who delivered Rh‐positive infants, whose blood was screened for an FMH greater than 10 ml of fetal blood using an acid‐elution procedure, 11 were found to have an FMH over 10 ml. In five of these 11 women, the volume of FMH was less than 10 ml using an alternative technique (rosette test) to assess the FMH size. Six of these women were found to have β‐thalassaemia minor on the basis of a low MCV, and high haemoglobin A2and/or high haemoglobin F levels. In five of these the FMH was significantly overestimated by the acid‐elution technique compared to the rosette technique. Therefore, in the presence of a maternal condition, which may result in an elevated haemoglobin F level, an FMH estimated to be over 10 ml in the UK or 30 ml in North America using an acid‐elution procedure, should be confirmed by an alternative technique, which does not involve the estimation, directly or indi

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00021.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY