RESUMEN
BACKGROUND: Patients can form antibodies to foreign human leukocyte antigen (HLA) Class I antigens after exposure to allogeneic cells. These anti-HLA class I antibodies can bind transfused platelets (PLTs) and mediate their destruction, thus leading to PLT refractoriness. Patients with PLT refractoriness need HLA-matched PLTs, which require expensive HLA typing of donors, antibody analyses of patient sera and/or crossmatching. An alternative approach is to reduce PLT HLA Class I expression using a brief incubation in citric acid on ice at low pH. METHODS AND MATERIALS: Apheresis PLT concentrates were depleted of HLA Class I complexes by 5 minutes incubation in ice-cold citric acid, at pH 3.0. Surface expression of HLA Class I complexes, CD62P, CD63, phosphatidylserine, and complement factor C3c was analyzed by flow cytometry. PLT functionality was tested by thromboelastography (TEG). RESULTS: Acid treatment reduced the expression of HLA Class I complexes by 71% and potential for C3c binding by 11.5-fold compared to untreated PLTs. Acid-treated PLTs were significantly more activated than untreated PLTs, but irrespective of this increase in steady-state activation, CD62P and CD63 were strongly upregulated on both acid-treated and untreated PLTs after stimulation with thrombin receptor agonist peptide. Acid treatment did not induce apoptosis over time. X-ray irradiation did not significantly influence the expression of HLA Class I complexes, CD62P, CD63, and TEG variables on acid treated PLTs. CONCLUSION: The relatively simple acid stripping method can be used with irradiated apheresis PLTs and may prevent transfusion-associated HLA sensitization and overcome PLT refractoriness.
Asunto(s)
Ácido Cítrico/efectos adversos , Antígenos de Histocompatibilidad Clase I/efectos de los fármacos , Transfusión de Plaquetas/métodos , Inmunodeficiencia Combinada Grave/inducido químicamente , Anticuerpos/inmunología , Tipificación y Pruebas Cruzadas Sanguíneas/métodos , Plaquetas/efectos de la radiación , Femenino , Antígenos de Histocompatibilidad Clase I/inmunología , Antígenos de Histocompatibilidad Clase I/metabolismo , Antígenos de Histocompatibilidad Clase I/efectos de la radiación , Prueba de Histocompatibilidad/economía , Prueba de Histocompatibilidad/métodos , Humanos , Selectina-P/metabolismo , Transfusión de Plaquetas/efectos adversos , Plaquetoferesis/métodos , Tetraspanina 30/metabolismo , Tromboelastografía/métodos , Trombocitopenia/terapia , Regulación hacia Arriba/genéticaRESUMEN
Foscarnet is a main treatment for disseminated cytomegalovirus infection in immunocompromised patients. One of its documented side effects is hypocalcemia. Hypercalcemia, in contrast, was described anecdotally before, almost exclusively in adults with human immunodeficiency virus infection or posttransplantation. We describe a case of severe hypercalcemia during foscarnet treatment in an infant with IL-7 Rα deficient severe combined immunodeficiency, resolved after treatment cessation. We speculate that this unusual side effect is caused by foscarnet binding to the inorganic matrix of bone.
Asunto(s)
Infecciones por Citomegalovirus/tratamiento farmacológico , Foscarnet/administración & dosificación , Hipercalcemia/inducido químicamente , Inmunodeficiencia Combinada Grave/inducido químicamente , Matriz Ósea/metabolismo , Foscarnet/metabolismo , Humanos , Hipercalcemia/etiología , Lactante , Subunidad alfa del Receptor de Interleucina-7/deficienciaRESUMEN
OBJECTIVE: To investigate the possibility of the oil from Hippophae rhamnoides (OHR) in supporting the hematopoitic reconstitution after high dose chemotherapy. METHOD: The mice were fed with OHR and variation of blood cell counts of the mice was recorded. Animal models of myelosuppression were built by 5-Fu intra-peritoneal infusion. The effects of OHR in the hematopoietic reconstitution were observed. RESULTS: The counts of erythrocytes of OHR group were significantly elevated. The blood cell counts in myelosuppression mice fed with OHR exceeded those in control group, and the mortality was decreased. CONCLUSION: OHR can improve the hematopoiesis of erythroid linage. Like G-CSF, OHR can stimulate the recovery of hematopoiesis after chemotherapy.