Responder Individuality in Red Blood Cell Alloimmunization

Körmöczi, Günther F.; Mayr, Wolfgang R.

doi:10.1159/000369179

Cited by 46 publications

(31 citation statements)

References 66 publications

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“…280,281 An immunovigilance registry of allo-(RBC, HLA, and HPA) immunized patients will assist selection of eligible patients (patient groups) for pre-emptive matching. 282 Such a registry can also stimulate collaborative studies that aim to reverse antibody production 283 and explore new treatment for severe complications of incompatible transfusions, transplants, or unborn children. 284 3.…”

Section: Evidence-based Indications Of Virtually All (Individualmentioning

confidence: 99%

The European Hematology Association Roadmap for European Hematology Research: a consensus document

et al. 2016

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T he European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness of the burden of blood disorders on European society, which purely in economic terms is estimated at €23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology of blood disorders, and has improved diagnostics and treatments, sometimes in revolutionary ways. This progress highlights the potential of focused basic research programs such as this EHA Roadmap. The EHA Roadmap identifies nine 'sections' in hematology: normal hematopoiesis, malignant lymphoid and myeloid diseases, anemias and related diseases, platelet disorders, blood coagulation and hemostatic disorders, transfusion medicine, infections in hematology, and hematopoietic stem cell transplantation. These sections span 60 smaller groups of diseases or disorders. The EHA Roadmap identifies priorities and needs across the field of hematology, including those to develop targeted therapies based on genomic profiling and chemical biology, to eradicate minimal residual malignant disease, and to develop cellular immunotherapies, combination treatments, gene therapies, hematopoietic stem cell treatments, and treatments that are better tolerated by elderly patients.

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Section: Evidence-based Indications Of Virtually All (Individualmentioning

confidence: 99%

The European Hematology Association Roadmap for European Hematology Research: a consensus document

et al. 2016

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“…Hence, transfusion exposes recipients to numerous RBC alloantigens, including Kell, Duffy, and Kidd, which induce formation of Ag-specific IgG alloantibodies in 3–10% of all recipients and as many as 30–50% of transfusion-dependent patients with sickle cell disease (1–7). Such responses can cause potentially fatal hemolytic transfusion reactions (8, 9). Moreover, substantial morbidity and mortality can occur for patients who have alloantibodies against multiple Ags.…”

mentioning

confidence: 99%

Type I IFN Is Necessary and Sufficient for Inflammation-Induced Red Blood Cell Alloimmunization in Mice

Gibb

Liu

Natarajan

et al. 2017

The Journal of Immunology

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During RBC transfusion, production of alloantibodies against RBC non-ABO Ags can cause hemolytic transfusion reactions and limit availability of compatible blood products, resulting in anemia-associated morbidity and mortality. Multiple studies have established that certain inflammatory disorders and inflammatory stimuli promote alloimmune responses to RBC Ags. However, the molecular mechanisms underlying these findings are poorly understood. Type I IFNs (IFN-α/β) are induced in inflammatory conditions associated with increased alloimmunization. By developing a new transgenic murine model, we demonstrate that signaling through the IFN-α/β receptor is required for inflammation-induced alloimmunization. Additionally, mitochondrial antiviral signaling protein—mediated signaling through cytosolic pattern recognition receptors was required for polyinosinic-polycytidylic acid—induced IFN-α/β production and alloimmunization. We further report that IFN-α, in the absence of an adjuvant, is sufficient to induce RBC alloimmunization. These findings raise the possibility that patients with IFN-α/β—mediated conditions, including autoimmunity and viral infections, may have an increased risk of RBC alloimmunization and may benefit from personalized transfusion protocols and/or targeted therapies.

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“…The situation is more complex than for platelets because the triggers of inflammation are less clearly identified. The age of blood is a likely but unproven factor, and the effects of storage lesions and erythrocyte Ag alloimmunization (105). Various teams have provided indirect evidence after examining whether RBC collection can stress RBCs and subsequently stress endothelial cells exposed to such RBCs (at least in ex vivo/in vitro models) (106, 107).…”

Section: From Bench To Bedside: Paths To Improve Patients’ Safetymentioning

confidence: 99%

Transfusion as an Inflammation Hit: Knowns and Unknowns

et al. 2016

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Transfusion of blood cell components is frequent in the therapeutic arsenal; it is globally safe or even very safe. At present, residual clinical manifestations are principally inflammatory in nature. If some rare clinical hazards manifest as acute inflammation symptoms of various origin, most of them linked with conflicting and undesirable biological material accompanying the therapeutic component (infectious pathogen, pathogenic antibody, unwanted antigen, or allergen), the general feature is subtler and less visible, and essentially consists of alloimmunization or febrile non-hemolytic transfusion reaction. The present essay aims to present updates in hematology and immunology that help understand how, when, and why subclinical inflammation underlies alloimmunization and circumstances characteristic of red blood cells and – even more frequently – platelets that contribute inflammatory mediators. Modern transfusion medicine makes sustained efforts to limit such inflammatory hazards; efforts can be successful only if one has a clear view of each element’s role.

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Responder Individuality in Red Blood Cell Alloimmunization

Cited by 46 publications

References 66 publications

The European Hematology Association Roadmap for European Hematology Research: a consensus document

The European Hematology Association Roadmap for European Hematology Research: a consensus document

Type I IFN Is Necessary and Sufficient for Inflammation-Induced Red Blood Cell Alloimmunization in Mice

Transfusion as an Inflammation Hit: Knowns and Unknowns

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