Journalartikel

Mechanism of transfusion-related acute lung injury induced by HLA class II antibodies


AutorenlisteSachs, Ulrich J. H.; Wasel, Wiebke; Bayat, Behnaz; Bohle, Rainer M.; Hattar, Katja; Berghoefer, Heike; Reil, Angelika; Bux, Juergen; Bein, Gregor; Santoso, Sentot; Weissmann, Norbert

Jahr der Veröffentlichung2011

Seiten669-677

ZeitschriftBlood

Bandnummer117

Heftnummer2

ISSN0006-4971

Open Access StatusBronze

DOI Linkhttps://doi.org/10.1182/blood-2010-05-286146

VerlagAmerican Society of Hematology (ASH Publications)


Abstract
Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-associated mortality in the United States and other countries. In most TRALI cases, human leukocyte antigen (HLA) class II antibodies are detected in implicated donors. However, the corresponding antigens are not present on the cellular key players in TRALI: neutrophils and endothelium. In this study, we identify monocytes as a primary target in HLA class II-induced TRALI. Monocytes become activated when incubated with matched HLA class II antibodies and are capable of activating neutrophils, which, in turn, can induce disturbance of an endothelial barrier. In an ex vivo rodent model, HLA class II antibody-dependent monocyte activation leads to severe pulmonary edema in a relevant period of time, whenever neutrophils are present and the endothelium is preactivated. Our data suggest that in most TRALI cases, monocytes are cellular key players, because HLA class II antibodies induce TRALI by a reaction cascade initiated by monocyte activation. Furthermore, our data support the previous assumption that TRALI pathogenesis follows a threshold model. Having identified the biologic mechanism of HLA class II antibody-induced TRALI, strategies to avoid plasma from immunized donors, such as women with a history of pregnancy, appear to be justified preventive measures. (Blood. 2011;117(2):669-677)



Zitierstile

Harvard-ZitierstilSachs, U., Wasel, W., Bayat, B., Bohle, R., Hattar, K., Berghoefer, H., et al. (2011) Mechanism of transfusion-related acute lung injury induced by HLA class II antibodies, Blood, 117(2), pp. 669-677. https://doi.org/10.1182/blood-2010-05-286146

APA-ZitierstilSachs, U., Wasel, W., Bayat, B., Bohle, R., Hattar, K., Berghoefer, H., Reil, A., Bux, J., Bein, G., Santoso, S., & Weissmann, N. (2011). Mechanism of transfusion-related acute lung injury induced by HLA class II antibodies. Blood. 117(2), 669-677. https://doi.org/10.1182/blood-2010-05-286146



Schlagwörter


BLOOD-DONORSDONOR ANTIBODIESHUMAN NEUTROPHILSINTERLEUKIN-8TRALIVIVO


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