Modified haemagglutination inhibition assay for the detection of canine parvovirus type 2 antibodies in dog sera.

Canine parvovirus type 2 (CPV-2) infection is associated with severe gastroenteritis in puppies. Quantification of CPV-2 specific antibodies before vaccination can reveal the presence of interfering maternal-derived immunity and facilitate timing of effective immunisation. Inhibition of haemagglutination (HI) is commonly used to measure CPV-2-specific antibody levels in serum. However, the presence of nonspecific agglutinins in canine serum and artefactual precipitation of red blood cells (RBC) are both limitations of the assay. In this study, we compared the standard HI protocol with a refined HI protocol, in which canine serum was pre-incubated with porcine RBC for 12 h to remove nonspecific agglutinins and a lower concentration (0.1% vs. 0.8%) of porcine RBC suspensions was used to limit artefactual precipitation of RBC. A panel of canine sera, collected from 80 dogs of different ages and with different neutralising antibody titres, was analysed. Nonspecific agglutinins were identified in most (97%) serum samples from puppies <4 months of age and in only 7% dogs 6 months old. Pre-treatment of serum samples was effective in removing nonspecific agglutinins from all samples and artefactual precipitation of RBCs was not noted when 0.1% RBC suspensions were used. Refinement of the HI protocol has increased the accuracy of interpretation and reduced the interference of nonspecific agglutinins, primarily seen in puppies. This reduces the likelihood of incorrect assessment of passive or active immunity in puppies when deciding whether to administer or defer vaccination, which could potentially leave them susceptible to CPV-2 infection.

Seroprevalence of leptospirosis in an endemic mixed urban and semi-urban setting-A community-based study in the district of Colombo, Sri Lanka.

Leptospirosis is endemic in Sri Lanka. There is a need for updated seroprevalence studies in endemic areas, to improve the understanding of disease dynamics, risk factors, control methods, and for clinical diagnosis. The cut-off titres for the microscopic agglutination test (MAT) for diagnosis of acute leptospirosis depend on community seroprevalence, and can vary based on locality and serovar. This study aimed to identify the seroprevalence, geographical determinants, and associations of seropositivity of leptospirosis in the district of Colombo in Sri Lanka, and to determine diagnostic cut-off titres for MAT in the community studied. This study utilized a stratified cluster sampling model in the Colombo district of Sri Lanka, to sample individuals living in urban and semi-urban areas. Serovar specific MAT titres were measured on recruited individuals using a panel of saprophytic (Leptospira biflexa) and 11 pathogenic Leptospira spp. serovars. Associations between environmental risk factors and MAT positivity were examined, with location mapping using GIS software. A total of 810 individuals were included. The mean age was 51.71 years (SD 14.02) with male predominance (60%). A total of 429 (53%) tested positive at a titer of 1/40 or more for the saprophytic Leptospira biflexa serovar Patoc. Pathogenic serovar MAT was positive at a titer of 1/40 or more for at least one serovar in 269 (33.2%) individuals. From the perspective of screening for clinical disease, serovar-specific cut-off titres of 1/80 for Leptospira spp. serovars Hebdomadis, Icterohaemorrhagiae, Pomona, Ratnapura and Patoc, 1/160 for serovars Pyrogenes and Cynopteri, and 1/40 for other serovars were determined, based on the 75th quartile MAT titre for each serovar. Serovar Pyrogenes (15.9%) had the highest seroprevalence, with serovars Ratnapura, Bankinang and Australis accounting for 9.9%, 9.6% and 9.3% respectively. When the proposed new cut-offs were applied, Bankinang(9.6%) Australis(9.3%), Pyrogenes(6.9%) and Ratnapura(6.9%) were the most prevalent serovars. No significant differences in seroprevalence or serovar patterns were noted between urban and semi-urban settings. Individuals seropositive for Australis, Ratnapura and Icterohaemorrhagiae were clustered around main water bodies as well as around smaller tributaries and paddy fields. Those positive for the serovar Pyrogenes were clustered around inland tributaries, smaller water sources and paddy fields. Associations of MAT positivity included high risk occupational exposure, environmental exposure including exposure to floods, bathing in rivers and lakes, using well-water for bathing, contact with stagnant water, propensity to skin injuries, presence of rats in the vicinity, and proximity to water sources. For pathogenic serovars, high-risk occupational exposure remained statistically significant following adjustment for other factors (adjusted OR = 2.408, CI 1.711 to 3.388; p<0.0001; Nagelkerke R2 = 0.546). High risk occupational exposure was determined to be independently associated with seropositivity. Baseline community MAT titres vary according to serovar, and presumably the locality. Testing against saprophytic serovars is unreliable. Thus, diagnostic MAT titre cut-offs should be determined based on region and serovar, and the use of a single diagnostic MAT cut-off for all populations is likely to result in false negatives.

Clinical significance of isoagglutinin titre with the current desensitization protocol in ABO-incompatible kidney transplantation.

AIM: ABO-incompatible (ABOi) kidney transplantation (KT) has become a routine procedure with graft survival rates comparable to those of ABO-compatible KT. However, the clinical significance of the isoagglutinin titre in ABOi KT remains uncertain. Therefore, in this study, we analysed the clinical outcomes of ABOi KT according to the baseline and post-operative isoagglutinin titre. METHODS: All patients who received ABOi KT between 2009 and 2013 were reviewed and followed up until December 2016. The patients were classified according to baseline (<1:128 or ≥1:128) and post-operative rebound isoagglutinin titre (<1:16 or ≥1:16), and the clinical outcomes of KT were compared. RESULTS: Patients with a high baseline isoagglutinin titre showed a poor titre reduction rate (1.48 ± 0.41 vs 1.32 ± 0.34, P = 0.008), and more patients experienced titre rebound ≥1:16 after KT (15.0% vs 35.8%, P = 0.002). The occurrence of both T-cell-mediated rejection and antibody-mediated rejection did not show a significant difference (P = 0.805 and 0.714, respectively). The rate of rejection-free survival was not different among groups (P = 0.680, log-rank test). Furthermore, the rate of death-censored graft survival was not different among groups (P = 0.701, log-rank test). Urinary tract infection was the most frequently reported infectious complication overall. The incidence of urinary tract infection, pneumonia and viral infections (BK virus and cytomegalovirus) was not different among groups. CONCLUSION: In conclusion, high baseline isoagglutinin titre was associated with a high rebound isoagglutinin titre, low titre reduction rates and more sessions of plasmapheresis. However, the isoagglutinin titre may not be as important as it was in the past in ABOi KT if appropriate desensitization is performed.

Lipoproteins from vertebrate host blood plasma are involved in Trypanosoma cruzi epimastigote agglutination and participate in interaction with the vector insect, Rhodnius prolixus.

Chagas disease, infecting ca. 8 million people in Central and South America, is mediated by the protozoan parasite, Trypanosoma cruzi. The parasite is transmitted by the bite of blood sucking triatomine insects, such as Rhodnius prolixus, that had previously fed on parasite-infected vertebrate blood and voided their contaminated feces and urine into the wound. The stages of the parasite life cycle in both the insect vector and human host are well-known, but determinants of infection in the insect gut are complex and enigmatic. This paper examines the possible role of the R. prolixus gut agglutinins in the parasite life cycle. The results, derived from gut extracts made from R. prolixus fed on various diets with different vertebrate blood components, and cross adsorption experiments, showed for the first time that R. prolixus has two distinct gut agglutinins originating from their vertebrate blood meal, one for T. cruzi (the parasite agglutinin, PA) and the other for the erythrocytes (the hemagglutinin, HA). Again, uniquely, the results also demonstrate that these two agglutinins are derived, respectively, from the plasma and erythrocyte components of the vertebrate blood. Subsequent experiments, examining in more detail the nature of the plasma components forming the T. cruzi PA, used fractionated extracts of the vertebrate plasma (high density lipoprotein, HDL; low density lipoprotein, LDL, and delipidated plasma) in agglutination assays. The results confirmed the identity of the PA as a high density lipoprotein (HDL) in the plasma of the vertebrate blood meal which agglutinates parasites in the R. prolixus gut. In addition, the use of single or double labeled HDL in fluorescence and confocal microscopy showed the interaction of the labeled HDL with the parasite surface and its internalization at later times. Finally, results of T. cruzi parasitization of R. prolixus, incorporating various vertebrate blood components, resulted in highly significant increases in infectivity in the presence of HDL from the 2nd day of infection, thus confirming the important role of this molecule in T. cruzi infection of R. prolixus.

Hemolisina e aglutinina como teste para pesquisa de doadores “O” Perigosos

Atualmente os bancos de sangue produzem hemocompoentes sanguíneos específicos, ondesão transfundidos conforme a necessidade de cada receptor. A rotatividade e o curto períododo tempo de estocagem das plaquetas tornam a sua disponibilidade muitas vezes prejudicada,sendo comum encontrar estoques de serviços de hemoterapia com quantidade baixas deplaqueta, de modo que muitas vezes se faz necessário a transfusão de plaquetas do tipo O empacientes não O, ocasionando a transferência passiva de anticorpos anti-A e anti-B para oreceptor (gerando incompatibilidade ABO menor). Para prevenir possíveis reaçõeshemolíticas decorrentes de transfusões por incompatibilidade menor, há técnicas de pesquisade aglutinina e/ou o teste de hemolisina como medida profilática. Assim, foi realizada umarevisão bibliográfica das técnicas de hemolisina e aglutinina, técnicas empregadas paradiagnosticar doadores de sangue “O” perigosos, na rotina de bancos de sangue, como medidaprofilática para prevenção de reações hemolítica agudas em transfusões de plaquetas nãoisogrupo. A bibliografia foi construída mediante a base de dados PUBMED e BVS-BRASILonde foi selecionado estudos que abordavam testes com hemolisina e ou aglutinina,associados ou não com a pesquisa de antiglobulina direto (TAD). Com a realização doreferente estudo foi possível verificar que atualmente há discordâncias na literatura em seutilizar testes de pesquisa do título de isoaglutinina ou pesquisa de hemolisina para identificardoadores “O” perigosos, pois os resultados do teste de hemolisina e aglutinina não secorrelacionam e que ainda há poucos estudos que possam avaliar as técnicas empregadas paraidentificar doadores “O” perigosos

Currently blood banks produce specific blood blood components, which are transfused asneeded for each receiver. The turnover and short period platelet storage time make itsavailability often impaired, is common to find transfusion service inventories with lowamount of platelets, so that often it is necessary transfusion type platelets in the patients werenot, causing the passive transfer of anti-a and anti-B for the receiver (generating less ABOincompatibility). To prevent possible hemolytic transfusion reactions due to for minorincompatibilities, there agglutinin search techniques and / or hemolysin test as a prophylacticmeasure. Thus, a literature review of the techniques of hemolysin and agglutinin employedtechniques used to diagnose blood donors was carried out "O" dangerous in routine bloodbanks, as a prophylactic measure to prevent acute hemolytic reactions not isogrupo platelettransfusions. The bibliography was built by the database PUBMED and BVS-BRAZIL wherehe was selected studies that addressed tests and hemolysin or agglutinin, associated or notwith the direct antiglobulin search (TAD). With the completion of the referent study weobserved that currently there are disagreements in the literature using isoaglutinina title searchtests or hemolysin research to identify donors "O" dangerous, because the results of thehemolysin and agglutinin test did not correlate and that there are few studies to evaluate thetechniques used to identify donors "the" dangerous

Desensitization in ABO-Incompatible Kidney Transplantation With Low ABO Iso-Agglutinin Titers.

BACKGROUND: In ABO-incompatible (ABOi) kidney transplantation (KT) with low iso-agglutinin (IG) titers (IGT), standard pre-conditioning treatment might be excessive. To try to answer this question, we evaluated the pre-conditioning requirements of a group of ABOi KT with low ABO IGT in our center. Our main objective was to assess desensitization requirements for ABOi KT with low IGT (<16) at Hospital Clinic of Barcelona from 2006 to 2014. METHODS: A retrospective study of desensitization (rituximab and plasma exchange [PE]) requirements for ABOi KT with IGT <16 was conducted. RESULTS: One and 5 years after KT, patient survival was 100%. Renal graft survival was 90% at 1 and 5 years after KT. Mean PE performed before KT was 1.7 (standard deviation [SD], 1.703); 50% of the patients did not receive PE after transplantation, 30% received 2 sessions of PE, and 20% received only 1. The average is 0.8 (SD, 0.91).Follow-up IG determinations remained with low titers (≤8/8). No rebounds of titers were observed during the first 4 to 6 months after transplantation. CONCLUSIONS: Recipients with IGT ≤8 required none or only 1 PE session to reach acceptable titers (titers ≤4) to perform ABOi KT safely. This information is useful to assess the possibility of a minimized desensitization protocol in ABOi KT donors with low titers of IG to reduce adverse effects, reduce cost, and simplify pre-transplant logistics.

ABO blood group IgM isoagglutinins interact with tumor-associated O-glycan structures in pancreatic cancer.

PURPOSE: The ABO gene locus is associated with the risk of developing pancreatic ductal adenocarcinoma (PDAC) resulting in an increased incidence in individuals with non-O blood groups. Up to 90% of PDAC specimens display alterations in mucin type O-GalNAc glycosylation. Because aberrant O-GalNAc glycans (Tn and T antigen) are structurally related to blood group A and B glycans, we investigated the role of IgM isoagglutinins in PDAC. EXPERIMENTAL DESIGN: Binding studies of IgM isoagglutinins toward blood group A, B, Tn antigen, and T antigen glycoconjugates from patients with PDAC and healthy individuals were conducted. Isoagglutinin titers and total IgM were compared between patients with PDAC and control group. An anti-A antibody was used for immunoprecipitation of aberrant O-glycosylated tumor proteins and subsequent mass spectromic analysis. RESULTS: We found that IgM isoagglutinins bind blood group antigens, Tn and T glycoconjugates as well as tumor-derived glycoproteins. Blood group A isoagglutinins exhibited a strong binding toward blood group B antigen and T antigen, whereas blood group B showed binding to blood group A antigen and Tn antigen. Furthermore, we confirmed a decreased frequency in individuals with blood group O and observed a significant decrease of IgM isoagglutinin titers in PDAC sera compared with control sera, whereas total IgM levels were unaltered. We identified new PDAC-derived O-GalNAc glycoproteins by mass spectrometry using a blood group A-specific antibody. CONCLUSION: Our data elucidated a novel interaction of blood group IgM isoagglutinins and PDAC O-GalNAc glycoproteins that may contribute to the pathogenesis and progression of pancreatic cancer.

Prevalence and spatial analysis of antileptospiral agglutinins in dairy cattle - Microregion of Sete Lagoas, Minas Gerais, 2009/2010 / Prevalência e análise espacial de aglutininas antileptospira em gado leiteiro - Microrregião de Sete Lagoas, Minas Gerais, 2009/2010

The aim of this study was to evaluate the seroprevalence of leptospirosis in the dairy herds from Minas Gerais, Brazil, during the years 2009 and 2010. A total of 2,915 serum samples were collected from the lactating cows of 151 properties in eleven municipalities located in the Sete Lagoas region. The Microscopic Agglutination Test was used to detect antileptospiral agglutinins. An individual animal prevalence of 20.7 percent (95 percent CI = 17.1 percent - 24.3 percent) and a herd prevalence of 80.8 percent (95 percent CI = 73.8 percent = 87.7 percent) were determined. The most prevalent serovars were hardjoprajitno at 19.4 percent; hardjoprajitno strain Norma at 17.4 percent; and hardjo-bovis at 17.4 percent. These results show the significance of the hardjo serovar in bovine leptospirosis cases in Minas Gerais...

Avaliou-se a prevalência de aglutininas antileptospira em rebanhos leiteiros durante os anos de 2009 e 2010. Foram coletadas 2.915 amostras de soro de vacas lactantes de 151 propriedades localizadas na região de Sete Lagoas - MG. Foi utilizado o teste de aglutinação microscópica (MAT) para detecção de aglutininas antileptospira. Prevalência animal de 20,7 por cento (95 por cento CI = 17,1 por cento-24,3 por cento) e prevalência de rebanho de 80,8 por cento (95 por cento CI = 73,8 por cento = 87,7 por cento) foram reportadas. Os sorotipos mais prevalentes no estudo foram hardjoprajitno (19,4 por cento); hardjoprajitno estirpe Norma (17,4 por cento) e hardjo-bovis (17,4 por cento). Estes resultados demostram a importância da sorovariedade hardjo nos casos de leptospirose bovina do estado de Minas Gerais...

Significance of isoagglutinin titer in ABO-incompatible kidney transplantation.

ABO-incompatible (ABO-i) kidney transplantation (KT) has emerged for overcoming the shortage of organ donors. Although this technique initially achieved only low graft survival due to isoagglutinin, recently developed desensitization protocols have improved survival to levels that are comparable to ABO-compatible KT. However, isoagglutinin is still regarded as a major obstacle to ABO-i KT. In this study, we evaluate the impact of isoagglutinin titer on clinical outcomes as well as factors that may influence isoagglutinin titers. In total, data from 95 patients who underwent ABO-i KT were analyzed. Preoperatively, rituximab administration and plasmapheresis were performed until the titer was reduced to ≤1:4. Retrospective analysis included blood group; timing and dosage of rituximab; isoagglutinin titer; number of plasmapheresis; and clinical outcomes including graft survival and serum creatinine. Graft survival was 95.8% (n = 91) and average serum creatinine at 1- and 1.5-year post-ABOi-KT was 1.3. Three patients died of sepsis. The identified predictors of titer-rebound after transplant were short interval (<7 days) between rituximab and first plasmapheresis (P = 0.004); high initial titer (≥256) (P = 0.023); low titer-reduction rate (P < 0.001); and blood group O (P < 0.001). One patient who experienced a rebound developed antibody-mediated rejection. With low-dose (200 mg) rituximab, the change in isoagglutinin titer-rebound was not significant and the infection rate was significantly decreased (P = 0.001). In conclusion, isoagglutinin titer-rebound within the first 2 weeks after KT may be a risk factor for rejection. The factors identified as affecting titer-rebound after KT were high initial isoagglutinin titer, low titer-reduction rate, short interval, and blood group O.

Outcomes after major or bidirectional ABO-mismatched allogeneic hematopoietic progenitor cell transplantation after pretransplant isoagglutinin reduction with donor-type secretor plasma with or without plasma exchange.

BACKGROUND: Major ABO mismatch in hematopoietic progenitor cell transplantation (HPCT) is associated with a range of immunohematologic consequences including progenitor cell infusion (PCI)-related hemolysis, delayed red blood cell engraftment, and pure red cell aplasia (PRCA). Although pretransplant (recipient) isoagglutinin reduction may be associated with decreased immunohematologic complications in this setting, there is no consensus with respect to strategies for isoagglutinin reduction. STUDY DESIGN AND METHODS: This observational study assessed the efficacy of a standardized pretransplant isoagglutinin reduction strategy incorporating donor-type secretor plasma infusions with or without plasma exchange to prevent PCI-associated hemolysis and PRCA in major or bidirectional ABO-mismatched peripheral blood HPCT. All major or bidirectional ABO-mismatched HPCTs performed between 1999 and 2010 were identified from an institutional database. Immunohematologic outcomes were determined retrospectively by review of individual medical records. RESULTS: In total 110 major or bidirectional ABO-mismatched HPCTs had been performed. No patient developed hemolysis after PCI. With respect to PRCA incidence, 16 patients (15%) were excluded due to early mortality and three (3%) due to incomplete data; of the remaining 91 patients, five (5%) developed PRCA. Patients with PRCA had significantly higher pretransplant isoagglutinin titers (p = 0.0001) compared to those who did not develop PRCA. CONCLUSIONS: Use of a standardized pretransplant isoagglutinin reduction strategy including donor-type secretor plasma infusions is both safe and efficient in preventing PCI-associated hemolysis and is associated with low rates of posttransplant PRCA.

Kinetics of anti-blood type isoagglutinin titers and B lymphocytes in ABO-incompatible living donor liver transplantation with rituximab and plasma exchange.

BACKGROUND: A novel immunosuppression protocol using rituximab and plasma exchange treatment was developed for ABO-incompatible living donor liver transplantation (ABO-I LDLT). The aim of this study was to investigate the kinetics of anti-blood type isoagglutinin titers and the number of blood B lymphocytes in ABO-I LDLT with the new protocol and their impact on the outcomes after ABO-I LDLT. METHODS: Fifteen patients underwent ABO-I LDLT plus splenectomy with the new protocol between November 2005 and December 2010, and their data were retrospectively analyzed. RESULTS: CD19-positive lymphocytes in the blood rapidly disappeared after rituximab treatment and began to recover approximately 6 months later. Anti-blood type isoagglutinin titers were lowered by pretransplant plasma exchange (2(3)∼2(12)→2(1)∼2(8)). Although the anti-donor blood type isoagglutinin titers remained consistently low after transplantation in comparison to the pretreatment levels, they persisted long after LDLT, whereas posttransplant biopsy specimens showed sustained A/B antigens on the graft livers. ABO-I hepatitis C virus-positive patients were prone to acceleration of hepatitis C viremia and cytomegalovirus antigenemia in comparison to the control patients. CONCLUSIONS: Although the new protocol for ABO-I LDLT yielded great success with 100% graft survival, the acceptable anti-blood type isoagglutinin titers just before LDLT, and its application to hepatitis C-positive patients must be determined.

Evaluation of serological tests for diagnosis of Bordetella pertussis infection in adolescents and adults.

BACKGROUND AND OBJECTIVE: Bacterial agglutination antibodies against Bordetella pertussis, Yamaguchi and Tohama strains, are frequently measured for serodiagnosis of pertussis infection in Japan. To determine the serological criteria, the comparative titres of bacterial agglutination antibody and anti-pertussis toxin (PT) antibody were evaluated. METHODS: Antibody titres were analysed in 36 definitive (fourfold increase in agglutination antibody) and 137 presumptive (high titre of single-antibody) cases of B. pertussis infection among adolescents and adults, and in a control group of 318 healthy volunteers. RESULTS: When a single Yamaguchi agglutinin titre of ≥ 1:1280 (> three SD above the geometric mean for the control group) was taken as diagnostic, the sensitivity and specificity at 4-5 weeks after onset of cough were 58% and 98%, respectively. Using this criterion, the clinical findings in presumptive cases were almost identical to those in definitive cases. When the two tests were compared using 318 control sera, there was no association between the Tohama agglutinin titre and the anti-PT antibody titre, whereas a weak association between the Yamaguchi agglutinin titre and the anti-PT antibody titre was observed. When the numbers of pertussis cases with high antibody titres in the two tests were compared, 60% of cases with a Yamaguchi agglutinin titre of ≥1:1280 showed an anti-PT antibody titre of ≥100 EU/mL. CONCLUSIONS: These results indicate that the bacterial agglutination test is a method with low sensitivity and specificity for the diagnosis of B. pertussis infection. Therefore, to yield an accurate diagnosis, anti-PT antibody levels should be measured instead of bacterial agglutination antibody.

Anti-Leptospira sp. agglutinins in ewes in the Federal District, Brazil.

To define the prevalence of anti-Leptospira sp. agglutinins in ewes in the Federal District, Brazil, serum samples from 157 ewes were tested for antibodies against serovars of Leptospira sp. by the microscopic agglutination test. Antibodies were detected in three flocks in a prevalence of 3% (95% CI = 0.4%-5.7%). Considering that sheep and cattle were raised together, the lack of sanitary control could represent a risk to cattle production, which is the most important activity in the Centre-West region of Brazil.

[Clinical and experimental parallels between immunological observations of irradiated animals and patients injured during Chernobyl accident].

Immunological parameters in different periods of acute radiation syndrome (ARS) of experimental animals and Chernobyl reactor accident-injured patients have been studied. 148 patients and experimental animals (123 dogs and 198 monkeys) were observed after radiation exposure of different levels (from a sub-lethal dose to the minimal absolute lethal dose). We have found the increase in the C-reactive protein, fluctuation of normal antibody titers and the complement in blood serum, as well as the growing number of skin microbes after exposures to lethal doses. Experimental results match clinical data in terms of ARS progress phases but differ from the latter in terms of the time of clinical manifestations. The highest rate of clinical manifestations is observed on the 7-14 days for experimental animals (rats, dogs and monkeys) and on the 20-30 days for patients after radiation exposure. Regenerative processes in animals run faster than those in humans.

[Incompatible living donors in kidney tranplantation]. / El donante incompatible en trasplante renal de donante vivo.

Renal transplant is the best option of treatment of chronic kidney disease and the shortage of cadaveric donors has caused the rapid increase of living donor programs. Provided that an important proportion of the donor-recipient pairs are incompatible between them, ABO incompatibility or positive cross-match test, one of the most important challenges of last decade, has been the solution of the above mentioned problem. For it there have begun the crossed-over transplant programs (also called donors' exchange programs) in his different combinations and these kind of transplants has been consolidated by an excellent results. To eliminate the titles of anti-HLA antibodies and the isoaglutinines we have different resources, beeing the most importants plasmapheresis, the immunoadsortion, immunoglobulin infusion, Rituximab use and splenectomy. They need all of them of the concomitant use of a powerful immunosuppression and of a suitable antiinfectious prevention. The results obtained with the incompatible donors are nowadays excellent and totally comparable to the obtained ones using living compatible donors. 

Long-term outcome of ABO-incompatible living donor kidney transplantation based on antigen-specific desensitization. An observational comparative analysis.

BACKGROUND: ABO-incompatible living donor kidney transplantation based on specific conditioning has been successfully adopted by transplant centres worldwide. Excellent short-term results have been reported in small cohorts. However, long-term data and comparative analyses are still sparse. We report on the outcome of 40 consecutive ABO-incompatible living donor kidney transplant recipients and compare their clinical course to a control group of 43 ABO-compatible living donor transplant patients transplanted during the same time period. METHODS: This is an observational single-centre analysis of 40 consecutive patients undergoing ABO-incompatible kidney grafting between April 2004 and April 2009, using a protocol of rituximab, antigen-specific immunoadsorption, intravenous immunoglobulin, basiliximab induction and oral triple immunosuppression with tacrolimus, mycophenolic acid and prednisone. Forty-three ABO-compatible kidney transplant recipients served as controls. The control group had also received basiliximab induction and an identical initial maintenance immunosuppression. The two groups were observed for an average of 39 and 19 months, respectively. RESULTS: There was a significantly higher incidence of lymphoceles requiring surgical revisions in the ABO-incompatible group. However, this surgical complication did not affect patient or graft survival. Mean serum creatinine, estimated glomerular filtration rate and proteinuria did not differ between the two groups. Furthermore, ABO-incompatible and ABO-compatible patients had the same incidence of humoral and cellular rejections. Despite a more aggressive induction therapy, no differences in infectious or malignant complications were observed. CONCLUSIONS: ABO-incompatible living donor kidney transplantation utilizing a combination of rituximab and antigen-specific immunoadsorption yielded results identical to ABO-compatible transplantation despite a significantly higher number of human leukocyte antigen mismatches.

Analysis of Bordetella pertussis agglutinin titers during an outbreak of pertussis at a university in Japan.

In 2007, a large outbreak of pertussis occurred at a university in Japan. Initially, a student, suffering from nocturnal cough and post-tussive vomiting for 3 weeks was diagnosed with pertussis. During the subsequent outbreak, 361 university students and staff members presented with a primary complaint of a cough. In the present study, we analyzed bacterial agglutinin titers against two Bordetella pertussis strains, Yamaguchi (epidemic strain) and Tohama (vaccine strain), in 310 patients with a cough and evaluated its diagnostic accuracy for adolescent and adult pertussis. These serological analyses showed a significant difference (P<0.001) in the levels of Yamaguchi agglutinin titer, but not in those of Tohama agglutinin titer, between patient and healthy adult groups. Therefore, the bacterial agglutination assay against strain Yamaguchi may be a useful tool for diagnosis of adolescent and adult pertussis, especially in young adults, when an agglutinin titer cutoff value of >or=160x is used in combination with clinical symptoms and other clinical laboratory tests.

El donante incompatible en trasplante renal de donante vivo / Incompatible living donors in kidney tranplantation

El trasplante renal es la mejor opción de tratamiento de la insuficiencia renal crónica y la escasez de donantes de cadáver ha ocasionado la potenciación de los programas de donante vivo. Dado que una proporción no desdeñable de las parejas donante-receptor son incompatibles entre sí, ya sea por incompatibilidad de grupo sanguíneo o por prueba cruzada positiva, uno de los retos más importantes de la última década ha sido la solución de dicho problema. Para ello se han iniciado los programas de trasplante cruzado o intercambio de donantes en sus distintas combinaciones y se han consolidado con unos excelentes resultados el trasplante ABO incompatible y el trasplante con prueba cruzada previa positiva. Para eliminar los títulos de anticuerpos anti-HLA y las isoaglutininas disponemos de diferentes recursos, entre los que cabe destacar la plasmaféresis, la inmunoadsorción, la infusión de inmunoglobulinas, el uso de Rituximab® y la esplenectomía. Todos ellos requieren del uso concomitante de una inmunosupresión potente y de una adecuada profilaxis antiinfecciosa. Los resultados obtenidos con los donantes incompatibles son hoy en día excelentes y totalmente equiparables a los obtenidos con el trasplante de donante vivo compatible (AU)

Renal transplant is the best option of treatment of chronic kidney disease and the shortage of cadaveric donors has caused the rapid increase of living donor programs. Provided that an important proportion of the donor-recipient pairs are incompatible between them, ABO incompatibility or positive cross-match test, one of the most important challenges of last decade, has been the solution of the above mentioned problem. For it there have begun the crossed-over transplant programs (also called donors' exchange programs) in his different combinations and these kind of transplants has been consolidated by an excellent results. To eliminate the titles of anti-HLA antibodies and the isoaglutinines we have different resources, beeing the most importants plasmapheresis, the immunoadsortion, immunoglobulin infusion, Rituximab use and splenectomy. They need all of them of the concomitant use of a powerful immunosuppression and of a suitable antiinfectious prevention. The results obtained with the incompatible donors are nowadays excellent and totally comparable to the obtained ones using living compatible donors (AU)

Purification and partial characterization of an agglutinin from Octopus maya serum.

A 66-kDa lectin (OmA) was purified from the serum of the Yucatan peninsula endemic octopus (Octopus maya) by a single step affinity chromatography on glutaraldehyde-fixed stroma from rat erythrocytes. OmA corresponds to 0.8% of the total circulating protein in the hemolymph; it is composed of three equal subunits of 22kDa each, and 7.4% of linked carbohydrates. The amino acids' composition indicated that agglutinin contained mainly aspartic and glutamic acids, and cysteine and methionine were identified in minor proportion. OmA agglutinates mainly rat, guinea pig, and rabbit erythrocytes, and this activity is partially inhibited by galactosamine, melobiose, galacturonic acid, mannose, and methyl alpha and beta galactosides. Hemagglutinating activity is not dependent on divalent cations, such as Ca(2+), Mg(2+), or Mn(2+). The OmA subunits showed no identity for any lectin in databases but partial identity with the type A hemocyanin from Octopus dolfleini hemolymph; the main similarities are related to tyrosinase domains and copper A and B sites that conform to the oxygen-binding site of hemocyanin.