Previously, both primary and secondary anti-D alloimmunizations induced by "Asian type" DEL (RHD1227A allele) were observed in two incidents. We investigated how often these alloimmunization events occur. Th...Previously, both primary and secondary anti-D alloimmunizations induced by "Asian type" DEL (RHD1227A allele) were observed in two incidents. We investigated how often these alloimmunization events occur. The transfusions of any D-negative patients were investigated in the First Affiliated Hospital of Xi'an Jiaotong University Medical College, China, during the entire 2009. The antigens of D, C, c, E, and e were routinely serotyped. The "Asian type" DEL variant was genotyped and the RHD heterozygote was determined through two published methods. The changes in anti-D levels were monitored by the indirect antiglobulin test (IAT) and flow cytometry. Thirty D-negative transfused patients were included in the study. We focused on 11 recipients who were transfused with packed red blood cells (RBCs) from DEL donors at least one time. Of those 11 recipients, seven were anti-D negative before transfusion and four were anti-D positive (one patient with an autoantibody). One of the seven pre-transfusion anti-D negative patients produced a primary-response anti-D after being transfused with 400 ml of DEL blood twice. All four pre-transfusion antibody positive patients were not observed hemoglobin (Hb) levels increased, as expected after transfusions. Two patients had an increase in anti-D from 1:8 to 1:64 by IAT, which was also shown by flow cytometry. None of the patients experienced an acute hemolytic episode. Our data indicated that the primary anti-D induced by DEL transfusion or the secondary anti-D elevated by DEL in a truly D-negative patient might not be unusual. We suggest that a truly D-negative childbearing-aged woman should avoid DEL transfusion to protect her from primary anti-D allosensitization. In addition, anti-D positive recipients should also avoid DEL red cell transfusion due to the delayed hemolytic transfusion reaction (DHTR).展开更多
Rh血型抗体是除ABO血型抗体外最有意义的红细胞血型抗体,临床上常因Rh血型不合而引起免疫溶血性输血反应和母婴血型不合相关溶血性疾病,尤其是新生儿溶血病（hemolytic disease of newborn,HDN）。母婴Rh血型不合溶血性疾病发病的基础为...Rh血型抗体是除ABO血型抗体外最有意义的红细胞血型抗体,临床上常因Rh血型不合而引起免疫溶血性输血反应和母婴血型不合相关溶血性疾病,尤其是新生儿溶血病（hemolytic disease of newborn,HDN）。母婴Rh血型不合溶血性疾病发病的基础为胎-母输血,展开更多
新生儿溶血病（hemolytic disease of the newborn,HDN）是因母胎红细胞血型不合,母体的免疫系统被胎儿红细胞致敏而产生血型IgG类抗体,这种血型IgG类抗体可以通过胎盘进入胎儿的血液循环,胎儿的红细胞被母亲的IgG血型抗体包被,并在婴...新生儿溶血病（hemolytic disease of the newborn,HDN）是因母胎红细胞血型不合,母体的免疫系统被胎儿红细胞致敏而产生血型IgG类抗体,这种血型IgG类抗体可以通过胎盘进入胎儿的血液循环,胎儿的红细胞被母亲的IgG血型抗体包被,并在婴儿的单核巨噬细胞系统内受到破坏而引起的免疫性溶血性疾病[1]。溶血出现后继发引起胎儿或新生儿发生贫血、肝脾肿大等症状,展开更多
: Phaeocystis globosa Scherffel, an organism that causes harmful algal blooms, is a genus of the family Prymnesiophyta (or Haptophyta) with eurythermal and euryhaline characteristics. P. globosa has been confirmed to ...: Phaeocystis globosa Scherffel, an organism that causes harmful algal blooms, is a genus of the family Prymnesiophyta (or Haptophyta) with eurythermal and euryhaline characteristics. P. globosa has been confirmed to produce hemolytic substances, which are a mixture of liposaccharides. In the present study, the hemolytic properties of extract of P. globosa are analyzed further. The effects of temperature, pH, different divalent cations, and membrane lipids on extract-induced hemolysis are discussed, as is the possible hemolytic mechanism. The results of the present study showed that the hemolytic activity of the extract was approximately 127.1 hemolytic units (HU)/L. The hemolytic reaction became fastest and a 50% decrease in absorbance was induced at 30 min at 37 °C, and at pH 7.0; Hg2+ was the strongest inhibitor of the hemolysis compared with the other divalent cations and many membrane lipids, except for phosphatidic acid, inhibited the hemolytic activity to different degrees. These results suggest that the toxin may make pores in the surface of red blood cells and that Hg2+ either combines with the hemolysin or closes the pores, hence inhibiting its further hemolytic reaction. The toxin probably has no specific membrane receptor in the red blood cell membrane.展开更多
Hemolytic uremic syndrome （HUS） is a rare disease. In this work the authors review the recent findings on HUS, considering the different etiologic and patho-genetic classifications. New findings in genetics and, in ...Hemolytic uremic syndrome （HUS） is a rare disease. In this work the authors review the recent findings on HUS, considering the different etiologic and patho-genetic classifications. New findings in genetics and, in particular, mutations of genes that encode the complement-regulatory proteins have improved our understanding of atypical HUS. Similarly, the comple-ment proteins are clearly involved in all types of thrombotic microangiopathy： typical HUS, atypical HUS and thrombotic thrombocytopenic purpura （TTP）. Fur-thermore, several secondary HUS appear to be related to abnormalities in complement genes in predisposed patients. The authors highlight the therapeutic as-pects of this rare disease, examining both “traditional therapy” （including plasma therapy, kidney and kidney-liver transplantation） and “new therapies”. The latter include anti-Shiga-toxin antibodies and anti-C5 mono-clonal antibody “eculizumab”. Eculizumab has been recently launched for the treatment of the atypical HUS, but it appears to be effective in the treatment of typical HUS and in TTP. Future therapies are in phases Ⅰ and Ⅱ. They include anti-C5 antibodies, which are more purifed, less immunogenic and absorbed orally and, anti-C3 antibodies, which are more powerful, but potentially less safe. Additionally, infusions of recombinant complement-regulatory proteins are a potential future therapy.展开更多
新生儿溶血病(hemolytic disease of newborn,HDN)是指母婴血型不合引起的胎儿或新生儿免疫性溶血性疾病。在人类29个血型系统中,多数血型系统都能引起HDN,但最常见的是Rh(D)HDN,在国外发病率较高;其次是ABO-HDN,在我国人群中发病率为15...新生儿溶血病(hemolytic disease of newborn,HDN)是指母婴血型不合引起的胎儿或新生儿免疫性溶血性疾病。在人类29个血型系统中,多数血型系统都能引起HDN,但最常见的是Rh(D)HDN,在国外发病率较高;其次是ABO-HDN,在我国人群中发病率为15.6%[1-2],其他系统HDN偶见报道。对HDN的早期诊断与防治,现已成为临床研究的热点。展开更多
基金supported by the National Natural Science Foundation of China(No. 30670893)the Foundation of Science and Technology Development Scheme of Shaanxi Province (No. 2010K16-01-12), China
文摘Previously, both primary and secondary anti-D alloimmunizations induced by "Asian type" DEL (RHD1227A allele) were observed in two incidents. We investigated how often these alloimmunization events occur. The transfusions of any D-negative patients were investigated in the First Affiliated Hospital of Xi'an Jiaotong University Medical College, China, during the entire 2009. The antigens of D, C, c, E, and e were routinely serotyped. The "Asian type" DEL variant was genotyped and the RHD heterozygote was determined through two published methods. The changes in anti-D levels were monitored by the indirect antiglobulin test (IAT) and flow cytometry. Thirty D-negative transfused patients were included in the study. We focused on 11 recipients who were transfused with packed red blood cells (RBCs) from DEL donors at least one time. Of those 11 recipients, seven were anti-D negative before transfusion and four were anti-D positive (one patient with an autoantibody). One of the seven pre-transfusion anti-D negative patients produced a primary-response anti-D after being transfused with 400 ml of DEL blood twice. All four pre-transfusion antibody positive patients were not observed hemoglobin (Hb) levels increased, as expected after transfusions. Two patients had an increase in anti-D from 1:8 to 1:64 by IAT, which was also shown by flow cytometry. None of the patients experienced an acute hemolytic episode. Our data indicated that the primary anti-D induced by DEL transfusion or the secondary anti-D elevated by DEL in a truly D-negative patient might not be unusual. We suggest that a truly D-negative childbearing-aged woman should avoid DEL transfusion to protect her from primary anti-D allosensitization. In addition, anti-D positive recipients should also avoid DEL red cell transfusion due to the delayed hemolytic transfusion reaction (DHTR).
文摘新生儿溶血病（hemolytic disease of the newborn,HDN）是因母胎红细胞血型不合,母体的免疫系统被胎儿红细胞致敏而产生血型IgG类抗体,这种血型IgG类抗体可以通过胎盘进入胎儿的血液循环,胎儿的红细胞被母亲的IgG血型抗体包被,并在婴儿的单核巨噬细胞系统内受到破坏而引起的免疫性溶血性疾病[1]。溶血出现后继发引起胎儿或新生儿发生贫血、肝脾肿大等症状,
文摘: Phaeocystis globosa Scherffel, an organism that causes harmful algal blooms, is a genus of the family Prymnesiophyta (or Haptophyta) with eurythermal and euryhaline characteristics. P. globosa has been confirmed to produce hemolytic substances, which are a mixture of liposaccharides. In the present study, the hemolytic properties of extract of P. globosa are analyzed further. The effects of temperature, pH, different divalent cations, and membrane lipids on extract-induced hemolysis are discussed, as is the possible hemolytic mechanism. The results of the present study showed that the hemolytic activity of the extract was approximately 127.1 hemolytic units (HU)/L. The hemolytic reaction became fastest and a 50% decrease in absorbance was induced at 30 min at 37 °C, and at pH 7.0; Hg2+ was the strongest inhibitor of the hemolysis compared with the other divalent cations and many membrane lipids, except for phosphatidic acid, inhibited the hemolytic activity to different degrees. These results suggest that the toxin may make pores in the surface of red blood cells and that Hg2+ either combines with the hemolysin or closes the pores, hence inhibiting its further hemolytic reaction. The toxin probably has no specific membrane receptor in the red blood cell membrane.
文摘Hemolytic uremic syndrome （HUS） is a rare disease. In this work the authors review the recent findings on HUS, considering the different etiologic and patho-genetic classifications. New findings in genetics and, in particular, mutations of genes that encode the complement-regulatory proteins have improved our understanding of atypical HUS. Similarly, the comple-ment proteins are clearly involved in all types of thrombotic microangiopathy： typical HUS, atypical HUS and thrombotic thrombocytopenic purpura （TTP）. Fur-thermore, several secondary HUS appear to be related to abnormalities in complement genes in predisposed patients. The authors highlight the therapeutic as-pects of this rare disease, examining both “traditional therapy” （including plasma therapy, kidney and kidney-liver transplantation） and “new therapies”. The latter include anti-Shiga-toxin antibodies and anti-C5 mono-clonal antibody “eculizumab”. Eculizumab has been recently launched for the treatment of the atypical HUS, but it appears to be effective in the treatment of typical HUS and in TTP. Future therapies are in phases Ⅰ and Ⅱ. They include anti-C5 antibodies, which are more purifed, less immunogenic and absorbed orally and, anti-C3 antibodies, which are more powerful, but potentially less safe. Additionally, infusions of recombinant complement-regulatory proteins are a potential future therapy.
文摘新生儿溶血病(hemolytic disease of newborn,HDN)是指母婴血型不合引起的胎儿或新生儿免疫性溶血性疾病。在人类29个血型系统中,多数血型系统都能引起HDN,但最常见的是Rh(D)HDN,在国外发病率较高;其次是ABO-HDN,在我国人群中发病率为15.6%[1-2],其他系统HDN偶见报道。对HDN的早期诊断与防治,现已成为临床研究的热点。
