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Blood Transfusion = Trasfusione Del... Jun 2024Transfusion medicine is facing new challenges from therapies which interfere with pre-transfusional tests, such as monoclonal antibodies targeting blood-cell antigens....
BACKGROUND
Transfusion medicine is facing new challenges from therapies which interfere with pre-transfusional tests, such as monoclonal antibodies targeting blood-cell antigens. Anti-CD38 monoclonal antibodies, widely used to treat multiple myeloma, cause panreactivity of indirect antiglobulin test; this can be resolved by treating cells with dithiothreitol to disrupt the CD38 disulphide bonds expressed on red blood cell surfaces. Interference mitigation strategy with dithiothreitol, however, has some drawbacks: it entails losing the traceability of results and the denaturation of blood group systems sensitive to reducing agents; it takes time to perform and quality controls are lost.
MATERIALS AND METHODS
Panels were treated with 0.2 mol/L dithiothreitol and stored for 30 days with a commercial preservative solution. On day 30, we measured the hemolysis indices and ability to eliminate daratumumab and isatuximab interference in the treated cells using indirect antiglobulin test. We also tested the stability of erythrocyte antigenic structure by screening 42 samples with known antibodies; tests were repeated on day 1, 7, 15 and 30. All indirect antiglobulin testing was performed on gel card.
RESULTS
After 30 days from treatment, panels preserved in preservative solution showed hemolysis indices comparable to untreated panels: all cases of interference by anti-CD38 in pre-transfusional tests were successfully mitigated. All antibodies were detected after 30 days, except for KEL system antibodies, as expected, although there was a detectability of anti-Kell antibodies in high titer samples (the first detection in dithiothreitol-treated cells since 1983).
DISCUSSION
We propose the Extended Lifetime Protocol; a simple card-based method which is cheap and traceable, that combines the strengths of anti-CD38 mitigation strategies. It makes it possible to treat and store, at the same time, a sufficient volume of red blood cells, that can be used for the following 30 days, to avoid any delay in transfusional requests.
PubMed: 38949853
DOI: 10.2450/BloodTransfus.779 -
Pharmeuropa Bio & Scientific Notes 2024The level of anti-D antibodies in human immunoglobulin products for intravenous administration (IVIG) is controlled by the direct haemagglutination method prescribed by...
Determination of procoagulant activity in human normal immunoglobulin preparations for therapeutic use by FXIa chromogenic assay: Evaluation of test kit sensitivity, reference standard performance and product formulation effects on the FXIa assay.
The level of anti-D antibodies in human immunoglobulin products for intravenous administration (IVIG) is controlled by the direct haemagglutination method prescribed by the European Pharmacopoeia (Ph. Eur.) that requires 2 control reference reagents. The World Health Organization (WHO) positive control International Reference Reagent (IRR; 02/228) with a nominal titre of 8 defines the highest acceptable titre, while the negative control preparation (02/226) has a nominal titre of <2. Working reference preparations (04/132 and 04/140) were subsequently established as Biological Reference Preparations (BRPs) for the Ph. Eur., and for distribution by the United States Food and Drug Administration (US FDA) and the National Institute for Biological Standards and Control (NIBSC). Due to diminishing stocks of these working reference preparations across the 3 institutions, a joint international study was organised to establish harmonised replacement batches. Sixteen laboratories contributed data to the study to evaluate positive and negative candidate replacement batches (13/148 and 12/300, respectively) against the WHO positive and negative control IRRs and the current working reference preparations (BRPs). The results show that the candidate reference preparations (13/148 and 12/300) are indistinguishable from the corresponding IRRs and current BRPs. The candidate preparations 13/148 and 12/300 were adopted by the Ph. Eur. Commission as Immunoglobulin (anti-D antibodies test) BRP batch 2 and Immunoglobulin (anti-D antibodies test negative control) BRP batch 2 with nominal haemagglutination titres of 8 and <2, respectively. The same materials were also adopted as NIBSC and US FDA reference preparations, thus ensuring full harmonisation.
Topics: Humans; Reference Standards; Immunoglobulins, Intravenous; Rho(D) Immune Globulin; Chemistry, Pharmaceutical
PubMed: 38949845
DOI: No ID Found -
JAMA Neurology Jul 2024
PubMed: 38949818
DOI: 10.1001/jamaneurol.2024.2008 -
Neurological Sciences : Official... Jun 2024Here we described an 18-year-old woman who were initially misdiagnosed as psychiatric disorders in a psychiatric institution. She was transferred to our neurological...
Here we described an 18-year-old woman who were initially misdiagnosed as psychiatric disorders in a psychiatric institution. She was transferred to our neurological ward because of impaired consciousness. Neuronal antibody testing confirmed the diagnosis of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Cerebral magnetic resonance imaging (MRI) revealed a concomitant disorder named reversible splenial lesion syndrome (RESLES). After administration of combined immunotherapy, the patient recovered completely 3 months after discharge. To our knowledge, co-occurrence of RESLES and anti-NMDAR encephalitis was only described in two patients with teratoma and we provide another case without teratoma. We highlight that anti-NMDAR antibodies can be added to the multiple causes of RESLES. It is therefore imperative for clinicians to detect anti-neuronal antibodies in patients with RESLES to avoid missed diagnosis.
PubMed: 38949742
DOI: 10.1007/s10072-024-07646-x -
Annals of the American Thoracic Society Jul 2024
Topics: Humans; Antibodies, Monoclonal, Humanized; Dermatitis, Atopic; Clinical Trials as Topic
PubMed: 38949603
DOI: 10.1513/AnnalsATS.202403-268LE -
Journal of the American Chemical Society Jul 2024Advanced in vitro diagnosis technologies are highly desirable in early detection, prognosis, and progression monitoring of diseases. Here, we engineer a multiplex...
Advanced in vitro diagnosis technologies are highly desirable in early detection, prognosis, and progression monitoring of diseases. Here, we engineer a multiplex protein biosensing strategy based on the tunable liquid confinement self-assembly of multi-material heterochains, which show improved sensitivity, throughput, and accuracy compared to standard ELISA kits. By controlling the material combination and the number of ligand nanoparticles (NPs), we observe robust near-field enhancement as well as both strong electromagnetic resonance in polymer-semiconductor heterochains. In particular, their optical signals show a linear response to the coordination number of the semiconductor NPs in a wide range. Accordingly, a visible nanophotonic biosensor is developed by functionalizing antibodies on central polymer chains that can identify target proteins attached to semiconductor NPs. This allows for the specific detection of multiple protein biomarkers from healthy people and pancreatic cancer patients in one step with an ultralow detection limit (1 pg/mL). Furthermore, rapid and high-throughput quantification of protein expression levels in diverse clinical samples such as buffer, urine, and serum is achieved by combining a neural network algorithm, with an average accuracy of 97.3%. This work demonstrates that the heterochain-based biosensor is an exemplary candidate for constructing next-generation diagnostic tools and suitable for many clinical settings.
PubMed: 38949598
DOI: 10.1021/jacs.4c04460 -
Polish Archives of Internal Medicine Jul 2024There is little data on the development of dermal lesions in patients with inflammatory bowel disease (IBD) treated with anti - tumor necrosis factor-α (anti-TNF-α),...
Dermal lesions associated with anti-tumor necrosis factor-α therapy in patients with inflammatory bowel disease: findings from an inflammatory bowel disease tertiary center in Poland.
INTRODUCTION
There is little data on the development of dermal lesions in patients with inflammatory bowel disease (IBD) treated with anti - tumor necrosis factor-α (anti-TNF-α), while their characteristics, clinical course, and impact on treatment are of great concern.
OBJECTIVES
The aim of this study is to assess the prevalence, risk factors, and clinical sequelae of dermal lesions in IBD patients treated with anti-TNF-α antibodies.
PATIENTS AND METHODS
This retrospective, single-center study evaluated 541 IBD patients treated with anti-TNF-α drugs and compared them with 688 IBD anti-TNF-α-naïve patients.
RESULTS
A significant higher prevalence of dermal lesions was noted during the anti-TNF-α therapy of 30.9% patients versus 16.4% (P <0.001). Risk factors for dermal lesions were higher body mass index (BMI), Crohn's disease located in the small intestine, and longer duration of therapy. Some types of dermal lesions were associated with anti-TNF-α therapy: infusion reactions and injection site reactions, cutaneous infection, psorasiform reactions, and lupus-like symptoms. Dermal lesions (alopecia, lupus-like symptoms, melanoma, and psoriasis) occurred in 5.9% of patients who discontinued or changed anti-TNF-α therapy.
CONCLUSIONS
We observed a higher prevalence of dermal lesions in patients with IBD undergoing anti-TNF-α therapy, although the development of such lesions rarely necessitated a change in or discontinuation of treatment. Patients with IBD should undergo regular dermatological follow-up, which may improve the detection of dermal lesions. Moreover, biological therapy in IBD patients requires close collaboration with an experienced dermatologist.
PubMed: 38949562
DOI: 10.20452/pamw.16789 -
Advances in Neonatal Care : Official... Jun 2024Acquired human cytomegalovirus (CMV) is a noteworthy disease in infants. This case study will highlight the influence of early diagnosis of CMV retinitis (CMVR) on avoid...
BACKGROUND
Acquired human cytomegalovirus (CMV) is a noteworthy disease in infants. This case study will highlight the influence of early diagnosis of CMV retinitis (CMVR) on avoid visual impairment.
CLINICAL FINDINGS
We describe a preterm female infant with a birth weight of 2060 gr that was admitted for tracheostomy placement due to hypoxic-ischemic encephalopathy. There were no signs of CMV infection or sepsis in laboratory results upon admission such as serology (IgG, IgM antibodies), Toxoplasma gondii, Rubella virus, Herpes simplex virus, CMVR and urine polymerase chain reaction (PCR).
PRIMARY DIAGNOSIS
Incidentally, upon screening for retinopathy of prematurity, diffuse occlusive vasculitis was detected in the retinal image on the 112th day of life.
INTERVENTION
Intravenous and intraocular ganciclovir were administered for 4 weeks.
OUTCOMES
In the follow-up visit 6 weeks after discharge from the hospital, visual impairment was detected on both sides.
PRACTICE RECOMMENDATIONS
This is a report of a case of acquired CMVR, a silent finding, as an uncommon complication in preterm neonates during the hospital stay. This diagnosis should be taken into consideration in preterm infants, since early diagnosis and treatment are crucial to avoid visual impairment.
PubMed: 38949554
DOI: 10.1097/ANC.0000000000001174 -
Hepatitis B immunisation and immune status of nurses in a regional hospital in central South Africa.South African Family Practice :... Jun 2024The hepatitis B virus (HBV) is one of the most important biological occupational hazards for healthcare workers. A high percentage of HBV infections are attributable...
BACKGROUND
The hepatitis B virus (HBV) is one of the most important biological occupational hazards for healthcare workers. A high percentage of HBV infections are attributable to percutaneous occupational exposure. This study aimed to describe the HBV immunisation and current immune status of all the nurses employed in a regional hospital in central South Africa.
METHODS
A descriptive record review included all the nurses (N = 388) employed in a regional hospital in central South Africa from 01 January 2018 to 31 January 2020. A total of 289 health records were included in the study. Data were analysed using descriptive statistics. Logistic regression analysis was used to establish factors associated with full immunisation.
RESULTS
Most nurses were females (87.9%), working in medical (27.0%) wards. Only 20.4% of nurses received one dose of vaccine, while 51.2% received the three prescribed doses. However, 91.2% of nurses did not receive the vaccine at the correct intervals. Most of the tested nurses (71.0%) were immune. Immunisation status was significantly associated with religion (p 0.001) and schedule (p = 0.003). Nurses who were non-Christians were 35.9% less likely to be fully vaccinated compared to Christians.
CONCLUSION
Half of the nursing staff received three doses as prescribed. All nurses should receive the vaccine against HBV and their immune status monitored to minimise the risk of an infection. It is therefore recommended that proof of immunity should be a requirement.Contribution: This study found a high percentage of nurses with HBV antibodies, which will ensure workplace safety.
Topics: Humans; Female; South Africa; Male; Hepatitis B; Hepatitis B Vaccines; Adult; Middle Aged; Nursing Staff, Hospital; Vaccination; Occupational Exposure; Nurses
PubMed: 38949452
DOI: 10.4102/safp.v66i1.5871 -
The Onderstepoort Journal of Veterinary... Jun 2024Wild animals, sharing pathogens with domestic animals, play a crucial role in the epidemiology of infectious diseases. Sampling from wild animals poses significant...
Wild animals, sharing pathogens with domestic animals, play a crucial role in the epidemiology of infectious diseases. Sampling from wild animals poses significant challenges, yet it is vital for inclusion in disease surveillance and monitoring programmes. Often, mass surveillance involves serological screenings using enzyme-linked immunosorbent assay (ELISA) tests, typically validated only for domestic animals. This study assessed the diagnostic specificity of commercially available ELISA tests on 342 wild ruminant serum samples and 100 from wild boars. We evaluated three tests for foot-and-mouth disease: two for Peste des petits ruminants, two for Rift Valley fever and one for Capripox virus. Diagnostic specificity was calculated using the formula True Negative/(False Positive + True Negative). Cohen's kappa coefficient measured agreement between tests. Results showed high specificity and agreement across all tests. Specificity for foot-and-mouth disease (FMD) ranged from 93.89% for Prionics to 100% for IDEXX, with IDvet showing 99.6%. The highest agreement was between FMD IDvet and IDEXX at 97.1%. Rift Valley fever (RVF) tests, Ingezim and IDvet, achieved specificities of 100% and 98.83%, respectively. The optimal specificity was attained by retesting single reactors and inactivating the complement.Contribution: Commercially available ELISA kits are specific for foot-and-mouth disease and similar transboundary animal diseases and can be used for highly specific wild animal testing.
Topics: Animals; Enzyme-Linked Immunosorbent Assay; Animals, Wild; Sensitivity and Specificity; Foot-and-Mouth Disease; Rift Valley Fever; Sus scrofa; Ruminants; Antibodies, Viral
PubMed: 38949427
DOI: 10.4102/ojvr.v91i1.2164