| HLA alloimmunization against platelet transfusions: pathophysiology, significance, prevention and management. | |
| | |
MedLine Citation:
|
PMID: 22385314 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Approximately five decades ago, alloimmunization to human leukocyte antigens (HLA) and platelet refractoriness were recognized as potentially serious complications of platelet transfusions. The mechanisms that result in stimulating immunity against blood products are still incompletely understood but are related to both the composition of the donor product transfused and the immune status of the recipient. Based on murine studies of platelet immunity, platelets are inherently immunogenic and there are at least two independent levels of immunoregulation against platelet transfusions. The first level resides within the recipient and is related to antigen processing/presentation events and CD8+ T cell-mediated immunosuppression. The second level relates to the donor product and includes donor antigen presenting cells (APC) levels as well as age-induced changes in donor APC and/or platelets. Implementation of pre-storage leukoreduction of cellular blood components led to a marked reduction in platelet alloimmunization and its dreaded complication, platelet refractoriness. Platelet refractoriness is usually managed by transfusion of matched platelets, selected according to one of the many published methods. It is unclear which of these methods is superior, and given the difficulty of obtaining a perfectly matched product, perhaps the most logical approach is to use a combination of selection strategies. This review discusses the various aspects of platelet alloimmunization and the clinical consequences that may result. It highlights how animal studies have shed light on the immune mechanisms responsible for allogeneic platelet immunity and immunomodulation and reviews relevant literature on clinical and laboratory manifestations of immune platelet refractoriness. |
| | |
Authors:
|
Katerina Pavenski; John Freedman; J W Semple |
Related Documents
:
|
16566544 - The use of hydrogen peroxide for achieving dermal hemostasis after burn excision in a p... 18328494 - Edge-modification of laponite with dimethyl-octylmethoxysilane. 16805694 - Anorganic bovine matrix/p-15 "flow" in the treatment of periodontal defects: case serie... 21839494 - Influence of renal function and platelet turnover on the antiplatelet effect of aspirin. 21299394 - Changes of platelet antioxidative enzymes during oxidative stress: the protective effec... 1309464 - Influence of mineral dust surface chemistry on eicosanoid production by the alveolar ma... |
Publication Detail:
|
Type: JOURNAL ARTICLE |
Journal Detail:
|
Title: Tissue antigens Volume: 79 ISSN: 1399-0039 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
|
Created Date: 2012-3-5 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0331072 Medline TA: Tissue Antigens Country: - |
Other Details:
|
Languages: ENG Pagination: 237-245 Citation Subset: - |
Copyright Information:
|
© 2012 John Wiley & Sons A/S. |
Affiliation:
|
Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada The Toronto Platelet Immunobiology Group, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada Department of Medicine, University of Toronto, Toronto, Ontario, Canada Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada Research and Development, Canadian Blood Services, Toronto, Ontario, Canada. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The mother and the motherland: Their internal representations among immigrant and non-immigrant adol...
Next Document: Drug delivery in multiple indication (multipurpose) prevention technologies: systems to prevent HIV-...