PMID- 21030555
OWN - NLM
STAT- MEDLINE
DCOM- 20110223
LR  - 20210206
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Linking)
VI  - 117
IP  - 2
DP  - 2011 Jan 13
TI  - Mechanism of transfusion-related acute lung injury induced by HLA class II 
      antibodies.
PG  - 669-77
LID - 10.1182/blood-2010-05-286146 [doi]
AB  - 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.
FAU - Sachs, Ulrich J H
AU  - Sachs UJ
AD  - Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig 
      University, Giessen, Germany. ulrich.sachs@med.uni-giessen.de
FAU - Wasel, Wiebke
AU  - Wasel W
FAU - Bayat, Behnaz
AU  - Bayat B
FAU - Bohle, Rainer M
AU  - Bohle RM
FAU - Hattar, Katja
AU  - Hattar K
FAU - Berghofer, Heike
AU  - Berghofer H
FAU - Reil, Angelika
AU  - Reil A
FAU - Bux, Jurgen
AU  - Bux J
FAU - Bein, Gregor
AU  - Bein G
FAU - Santoso, Sentot
AU  - Santoso S
FAU - Weissmann, Norbert
AU  - Weissmann N
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20101028
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Histocompatibility Antigens Class II)
RN  - 0 (Isoantibodies)
RN  - 0 (Isoantigens)
SB  - IM
CIN - Blood. 2011 Jan 13;117(2):378-9. PMID: 21233322
MH  - Acute Lung Injury/blood/*immunology
MH  - Animals
MH  - Capillary Permeability/immunology
MH  - Cell Separation
MH  - Female
MH  - Flow Cytometry
MH  - Histocompatibility Antigens Class II/*immunology
MH  - Humans
MH  - Isoantibodies/blood/immunology
MH  - Isoantigens/immunology
MH  - Male
MH  - Monocytes/*immunology
MH  - Neutrophil Activation/immunology
MH  - Neutrophils/immunology
MH  - Rats
MH  - *Transfusion Reaction
EDAT- 2010/10/30 06:00
MHDA- 2011/02/24 06:00
CRDT- 2010/10/30 06:00
PHST- 2010/10/30 06:00 [entrez]
PHST- 2010/10/30 06:00 [pubmed]
PHST- 2011/02/24 06:00 [medline]
AID - S0006-4971(20)59216-1 [pii]
AID - 10.1182/blood-2010-05-286146 [doi]
PST - ppublish
SO  - Blood. 2011 Jan 13;117(2):669-77. doi: 10.1182/blood-2010-05-286146. Epub 2010 
      Oct 28.