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Alimentary Pharmacology & Therapeutics Apr 2003Coeliac disease is a chronic inflammatory condition associated with small intestinal injury that results in the malabsorption of different nutrients. The damaging factor... (Review)
Review
Coeliac disease is a chronic inflammatory condition associated with small intestinal injury that results in the malabsorption of different nutrients. The damaging factor is gluten present in wheat, barley and rye. The diagnosis relies on the clinical picture of the patient, serological markers for coeliac disease, characteristic findings of small intestinal biopsy and, eventually, clinical improvement on a gluten-free diet. Our strategies for the diagnosis of coeliac disease have changed dramatically within the last 10 years. The advent of serological markers with high sensitivity and specificity is changing our understanding of the disease and its prevalence. Treatment includes a life-long gluten-free diet to prevent the recurrence of symptoms and other potential consequences. Most coeliac disease remains under-diagnosed; the utilization of more accurate serological tests and a greater awareness of its many presentations will aid its identification.
Topics: Adult; Biopsy; Celiac Disease; Child; Histocompatibility Testing; Hordeum; Humans; Secale; Serologic Tests; Triticum
PubMed: 12694080
DOI: 10.1046/j.1365-2036.2003.01442.x -
Bone Marrow Transplantation Aug 2019We have developed banks of EBV and CMV-specific T-cell lines generated from healthy seropositive third party donors and characterized them as to their HLA type, virus... (Review)
Review
We have developed banks of EBV and CMV-specific T-cell lines generated from healthy seropositive third party donors and characterized them as to their HLA type, virus specificity, lack of alloreactivity, and HLA restriction. We here summarize results of studies employing these immediately accessible, broadly-applicable third party virus-specific T-cells for adoptive therapy of EBV lymphomas and CMV infections in allo-HCT recipients. We describe the characteristics contributing to their safety. We also discuss several distinctive advantages of banked third party virus-specific T-cells selected on the basis of their HLA restriction, particularly in the treatment of Rituximab-non-responsive EBV lymphomas and drug refractory CMV infections complicating HLA non-identical transplants.
Topics: Antigens, Viral; Histocompatibility Testing; Humans; Immunotherapy, Adoptive; T-Lymphocytes
PubMed: 31431697
DOI: 10.1038/s41409-019-0614-1 -
Assessment of human leukocyte antigen immunogenicity: current methods, challenges and opportunities.Current Opinion in Organ Transplantation Aug 2018Donor-recipient human leukocyte antigen (HLA) matching improves outcomes after solid-organ transplantation, but current assessment of HLA incompatibility is inadequate... (Review)
Review
PURPOSE OF REVIEW
Donor-recipient human leukocyte antigen (HLA) matching improves outcomes after solid-organ transplantation, but current assessment of HLA incompatibility is inadequate as it does not consider the relative immunogenicity of individual HLA mismatches. In this article, we review existing strategies for assessing HLA immunogenicity and discuss current challenges and future opportunities in this field.
RECENT FINDINGS
Current HLA immunogenicity algorithms focus primarily on the humoral component of the alloimmune response and aim to determine a measure of 'dissimilarity' between donor and recipient HLA. This can be achieved by deriving information from comparison of donor and recipient HLA at the amino acid sequence, structural and/or the physicochemical level, accounting for both B-cell and T-cell pathways of alloreactivity. Substantial evidence now supports the superiority of this molecular definition of HLA incompatibility, over conventional enumeration of HLA antigenic differences, for assessing the risk of humoral alloimmunity and for predicting graft outcomes after transplantation.
SUMMARY
Significant progress has been made in developing computational HLA immunogenicity algorithms that offer exciting opportunities for a more rational approach to determining the degree of donor-recipient HLA incompatibility and to defining HLA-related immunological risk. A number of challenges now need to be overcome to enable their implementation into clinical practice.
Topics: HLA Antigens; Histocompatibility; Histocompatibility Testing; Humans; Organ Transplantation; Tissue Donors; Transplantation Immunology
PubMed: 29870434
DOI: 10.1097/MOT.0000000000000544 -
Experimental and Clinical... Jun 2017Preformed donor-specific antibodies against human leukocyte antigen can induce antibody-mediated rejection after organ transplant. Hence, future transplant recipients... (Review)
Review
Preformed donor-specific antibodies against human leukocyte antigen can induce antibody-mediated rejection after organ transplant. Hence, future transplant recipients undergo pretransplant screening for preformed antibodies (ie, virtual crossmatch). Subsequently, prospective (analytic) crossmatching is performed using conventional, complement-dependent cytotoxicity assays and/or flow cytometry-based methods. The present article reviews factors that must be considered when unexpected, positive, prospective crossmatches are observed. First, the prozone effect caused by the interference of complement or immunoglobulin M must be abrogated by treating the serum with moderate heat, dilution, hypotonic dialysis, EDTA, or dithiothreitol. Second, the physician must check for the presence of potentially interfering autoantibodies (in a context of autoimmune disease or human immunodeficiency virus infection) or therapeutic antibodies (such as rituximab and antithymocyte globulin). In conclusion, knowledge of each assay's technical characteristics will enable the physician to reliably interpret any discrepancies. The reasons for an unexpected, positive, prospective crossmatch must be elucidated before transplant to ensure efficient organ allocation and optimize patient outcomes.
Topics: Donor Selection; False Positive Reactions; Graft Rejection; Graft Survival; HLA-A Antigens; Histocompatibility; Histocompatibility Testing; Humans; Isoantibodies; Organ Transplantation; Predictive Value of Tests; Reproducibility of Results; Risk Factors; Tissue Donors; Treatment Outcome
PubMed: 28447927
DOI: 10.6002/ect.2016.0346 -
Annales de Biologie Clinique 2014The Luminex technology has become an important tool for HLA antibody screening and identification. This is the most sensitive technology to detect HLA antibodies for... (Review)
Review
The Luminex technology has become an important tool for HLA antibody screening and identification. This is the most sensitive technology to detect HLA antibodies for transplant patients and patients on awaiting list, and it has ushered a new strategy to determine HLA compatibility between donor and recipient. Moreover, the clinical relevance of all detected anti-HLA antibodies is not well understood, because this technique was shown to be prone to many artefacts or interferences, leading to a complicated interpretation for biologists and clinicians. Our objective in this article is to provide a careful consideration about this solid phase assay, and to focus attention on raised questions about technical performance and interpretation of the results. We should keep in mind that our results could change the clinical management of sensitized patients, their aptitude to receive a graft, and their follow-up.
Topics: Blood Transfusion, Autologous; Data Interpretation, Statistical; Graft Rejection; HLA Antigens; Histocompatibility Testing; Humans; Isoantibodies; Serologic Tests; Solid Phase Extraction
PubMed: 24736137
DOI: 10.1684/abc.2014.0940 -
Pediatric Transplantation Nov 2011The detection of donor-specific antibodies after organ transplantation might provide an incisive way to monitor allo-specific immunity and predict graft outcome. Still,... (Review)
Review
The detection of donor-specific antibodies after organ transplantation might provide an incisive way to monitor allo-specific immunity and predict graft outcome. Still, the availability of new assays for these antibodies prompts us to pose some questions about results that might be observed. These questions include whether the antibodies detected in the blood are a sensitive measure of alloimmunity, whether the detected antibodies are truly specific for the donor and whether they are noxious for the graft. Here, we explain why answers to these questions might interest the basic scientist and clinician.
Topics: Animals; Antibodies; Graft Rejection; Graft Survival; Histocompatibility Testing; Humans; Immune System; Immunity, Humoral; Inflammation; Isoantibodies; Kidney Transplantation; Pediatrics; Perfusion; Phenotype; Transplantation; Transplantation, Heterologous; Transplantation, Homologous
PubMed: 22004543
DOI: 10.1111/j.1399-3046.2010.01436.x -
Ugeskrift For Laeger Nov 2020Allogeneic haematopoietic stem cell transplantation is a clinical example of precision medicine, as one individual donor is selected for one individual patient based on... (Review)
Review
Allogeneic haematopoietic stem cell transplantation is a clinical example of precision medicine, as one individual donor is selected for one individual patient based on genetic findings in the human leukocyte antigen (HLA) system. Unrelated donor search for Danish patients is based on an international collaboration between global registries hosting more than 37 million potential donors worldwide for patients in need. The implementation of next-generation sequencing technologies has been a revolution in donor registry typing due to more precise, detailed and cheaper HLA analyses, which is discussed in this review.
Topics: HLA Antigens; Hematopoietic Stem Cell Transplantation; Histocompatibility Testing; Humans; Registries; Tissue Donors; Unrelated Donors
PubMed: 33280644
DOI: No ID Found -
Transplant International : Official... Nov 2018Luminex single antigen bead assays revolutionized human leukocyte antigen (HLA) antibody detection owing to their superior sensitivity compared to conventional methods.... (Review)
Review
Luminex single antigen bead assays revolutionized human leukocyte antigen (HLA) antibody detection owing to their superior sensitivity compared to conventional methods. Nevertheless, the advent of higher sensitivity came at the expense of difficulty in clinical decision-making, since not all luminex detectable antibodies are clinically relevant. Therefore, new tools such as C1q/C3d assays and IgG subclass analysis emerged with the aim to discriminate the inert antibodies from the deleterious ones. Here, we provide an overview on the technical challenges related to these different HLA antibody detection systems and briefly refer to the recent literature regarding the clinical relevance of these assays, mainly in the field of kidney transplantation.
Topics: Complement C1q; Complement C3d; Decision Support Systems, Clinical; Graft Rejection; HLA Antigens; Histocompatibility Testing; Humans; Immunoglobulin G; Isoantibodies; Kidney Transplantation; Postoperative Period; Prognosis; Protein Binding; Risk
PubMed: 30091231
DOI: 10.1111/tri.13327 -
British Journal of Haematology Mar 2007Over the last 15 years, infrared (IR) spectroscopy has developed into a novel and powerful biomedical tool that has multiple applications in the field of haematology. By... (Review)
Review
Over the last 15 years, infrared (IR) spectroscopy has developed into a novel and powerful biomedical tool that has multiple applications in the field of haematology. By revealing subtle alterations in both the conformation and concentration of key macromolecules, such as DNA, protein and lipids, IR spectroscopy has been employed to investigate multiple aspects of leucocyte physiology. IR spectroscopy has been used, for example, to diagnose and prognose leukaemia; to characterise differentiation and apoptotic processes; to predict drug sensitivity and resistance in leukaemic patients undergoing chemotherapy; to monitor the response of leucocytes to chemotherapy and to perform human leucocyte antigen matching for bone marrow transplant patients. Such studies have provided insight into pathogenic mechanisms underlying specific leucocyte disorders, especially leukaemia. While it is likely to be some considerable time before IR spectroscopy is sufficiently developed to displace the established technologies, IR spectroscopy has the potential to become a valuable analytic tool in basic and clinical haematology.
Topics: Apoptosis; Cell Differentiation; Drug Resistance, Neoplasm; Histocompatibility Testing; Humans; Leukemia; Leukocytes; Prognosis; Spectrophotometry, Infrared
PubMed: 17338777
DOI: 10.1111/j.1365-2141.2006.06474.x -
Transfusion Medicine Reviews Oct 2007Antibodies to neutrophil and HLA antigens can cause pulmonary transfusion reactions, and in some cases acute lung injury. When evaluating cases of pulmonary transfusion... (Review)
Review
Antibodies to neutrophil and HLA antigens can cause pulmonary transfusion reactions, and in some cases acute lung injury. When evaluating cases of pulmonary transfusion reactions, it is often necessary to test donors for neutrophil and HLA antibodies and also type the recipient for neutrophil and HLA antigens. A variety of enzyme-linked immunosorbent assay (ELISA) and flow cytometry-based solid phase assays are available to test for HLA class I and class II antibodies, but not neutrophil antibodies. Screening for neutrophil antibodies requires the preparation of panels of fresh neutrophils and testing in agglutination, immunofluorescence, or flow cytometry assays. Genotyping of HLA class I and II antigens is performed with a variety of sequence-specific primers, sequenced-specific oligonucleotide probe, and sequence-based typing assays. Neutrophil-specific antigens HNA-1a, -1b, -1c, -4a, and -5a can be genotyped, but not HNA-2a or -3a. Phenotyping of HNA-2a can be performed with CD177 monoclonal antibodies, but the gene encoding HNA-3a has not been identified, and the genomic basis for the HNA-2a-negative phenotype is not known. In conclusion, patients and donors involved with pulmonary transfusion reactions can be quickly typed for HLA antigens and tested for HLA antibodies, but testing for neutrophil antibodies and antigens requires the use of a reference laboratory.
Topics: Antibodies; Blood Donors; HLA Antigens; Histocompatibility Testing; Humans; Lung Diseases; Models, Biological; Transfusion Reaction
PubMed: 17900489
DOI: 10.1016/j.tmrv.2007.05.003