Transfusion-associated graft-versus-host disease: A concise review

Transfusion-associated graft-versushost disease (TA-GVHD) represents a rare fatal event observed in immunocompromised patients and immunocompetent individuals. The main clinical features of this transfusion reaction are pancitopenia and multiorgan failure (skin, liver, gut). The possible pathogenesis includes donor T lymphocyte proliferation in blood, their engraftment and host tissue attack. The purpose of this narrative review was analyzing the international guidelines for irradiation of cellular blood components to prevent TA-GVHD. A literature search was conducted using PubMed articles published between January 2000 to July 2018. American, Australian, British and Japanese transfusion guidelines have been compared regarding clinical indications. The contribution of manuscripts has been focused on recipients of Haematopoietic Stem Cell Transplantation, severe cellular immunodeficient patients, fetuses and neonates, immunocompentent individuals. Furthermore, 348 cases of TA-GVHD in the last five decades have been documented according to a recent systematic review. The standard of care to prevent this complication is gamma or x irradiation of cellular blood products. New treatments with pathogen inactivation appear safe and effective against proliferating white blood cells and T cells. Further clinical and biological studies are necessary to better characterize immunocompetence of T cells and select alternative preventive strategies

Divergent northern and southern populations and demographic history of the pearl oyster in the western Pacific revealed with genomic SNPs

In the open ocean without terrain boundaries, marine invertebrates with pelagic larvae can migrate long distances using ocean currents, suggesting reduced genetic diversification. Contrary to this assumption, however, genetic differentiation is often observed in marine invertebrates. In the present study, we sought to explain how population structure is established in the western Pacific Ocean, where the strong Kuroshio Current maintains high levels of gene flow from south to north, presumably promoting genetic homogeneity. We determined the population structure of the pearl oyster, Pinctada fucata, in the Indo-Pacific Ocean using genome-wide genotyping data from multiple sampling localities. Cluster analysis showed that the western Pacific population is distinct from that of the Indian Ocean, and that it is divided into northern (Japanese mainland) and southern (Nansei Islands, China, and Cambodia) populations. Genetic differentiation of P. fucata can be explained by geographic barriers in the Indian Ocean and a local lagoon, and by environmental gradients of sea surface temperature (SST) and oxygen concentration in the western Pacific. A genome scan showed evidence of adaptive evolution in genomic loci, possibly associated with changes in environmental factors, including SST and oxygen concentration. Furthermore, Bayesian simulation demonstrated that the past population expansion and division are congruent with ocean warming after the last glacial period. It is highly likely that the environmental gradient forms a genetic barrier that diversifies P. fucata populations in the western Pacific. This hypothesis helps to explain genetic differentiation and possible speciation of marine invertebrates

Seasonal Variations of the Activity of Antioxidant Defense Enzymes in the Red Mullet (Mullus barbatus l.) from the Adriatic Sea

This study investigated seasonal variations of antioxidant defense enzyme activities: total, manganese, copper zinc containing superoxide dismutase (Tot SOD, Mn SOD, CuZn SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase (GR) and biotransformation phase II enzyme glutathione-S-transferase (GST) activity in the liver and white muscle of red mullet (Mullus barbatus). The investigations were performed in winter and spring at two localities: Near Bar (NB) and Estuary of the River Bojana (EB) in the Southern Adriatic Sea. At both sites, Mn SOD, GSH-Px, GR and GST activities decreased in the liver in spring. In the white muscle, activities of Mn SOD, GSH-Px, GR and GST in NB decreased in spring. GR decreased in spring in EB, while CAT activity was higher in spring at both sites. The results of Principal Component Analysis (PCA) based on correlations indicated a clear separation of various sampling periods for both investigated tissues and a marked difference between two seasons. Our study is the first report on antioxidant defense enzyme activities in the red mullet in the Southern Adriatic Sea. It indicates that seasonal variations of antioxidant defense enzyme activities should be used in further biomonitoring studies in fish species

Transfusion-Associated Graftversus-Host Disease: A Brief Comment on Blood Safety

Dear Editor, A recent paper from Dr Elliot published in Transfusion, entitled ‘Missed irradiation of cellular blood components from vulnerable patients: Insight from 10 years of SHOT data’ updates on Transfusion-associated graft-versus-host disease and blood safety [...]</jats:p

Alloantibody Identification: The Importance of Temperature, Strength Reaction and Enzymes&mdash;A Practical Approach

Red blood cell (RBC) alloimmunization and antibodies formation against non-self antigens on red cells may occur after blood transfusion, pregnancies or other exposures. The RBC alloimmunization rate varies from 2% to 6% according to recent studies. The antibody screen is performed to identify or confirm the presence of antibodies in patient&rsquo;s serum or plasma, as a preoperative or pretransfusion test. The antibody identification process and major crossmatch are critical steps of risk management in transfusion medicine. The aim of this article is to describe a flow chart of the antibody identification. I report three educational examples of case studies associated with the negative direct antiglobulin test and clinically significant single and multiple alloantibodies using the gel method, Anti-M, Anti-c and Anti-E, Anti-Jka and Anti-s. Furthermore, I provide a critical analysis of the current literature on the topic. The flow chart of the antibody identification may simplify the process and possibly reduce errors in routine workflow

From bivalves to birds: Oxidative stress and longevity

1. The oxidative stress theory of ageing predicts that animals living longer will have less cumulative oxidative damage together with structural characteristics that make them more resistant to oxidative damage itself.2. Although a general relationship between body size, metabolism and longevity does not exist in marine invertebrates, they are generally characterized by low rates of metabolism and reactive oxygen species (ROS) formation associated with lower antioxidant enzyme activities compared to vertebrates.3. Birds and mammals have very similar size-affected metabolic rates and their metabolic intensity explains only some of the variation in maximum lifespan potential (MLSP).Within each class, smaller animals have higher rates of metabolism and ROS production and membranes that are more susceptible to oxidative damage and autocatalytic propagation of free radicals than larger ones.4. Although the high variation in life-history strategies is accompanied by substantial variation in MLSP, there is a consistent positive correlation between rates of ROS formation and antioxidant levels among most animals examined so far for these traits. The consensus of these studies is that ROS and antioxidant levels are inversely related to MLSP.5. The lack of a clear stoichiometric relation between variables contributing to oxidative stress limits our capacity to infer longevity consequences from measures of pro-oxidant or antioxidant status among or within species<br /

Transfusion-Associated Graftversus-Host Disease: A Brief Comment on Blood Safety

Dear Editor, A recent paper from Dr Elliot published in Transfusion, entitled ‘Missed irradiation of cellular blood components from vulnerable patients: Insight from 10 years of SHOT data’ updates on Transfusion-associated graft-versus-host disease and blood safety [...

Ruxolitinib in myelofibrosis: to be or not to be an immune disruptor

Palma Manduzio Department of Haematology and Oncology, Haematology With BMT, IRCCS, Casa Sollievo della Sofferenza, Foggia, Italy Abstract: Primary myelofibrosis (PMF) is a myeloproliferative neoplasm classified according to the 2016 revision of World Health Organization Classification of Tumors and Haematopoietic and Lymphoid Tissue. Ruxolitinib is an oral inhibitor of Janus kinase approved in the USA for the treatment of intermediate or high-risk PMF and approved in Europe for the treatment of splenomegaly and constitutional symptoms of the disease. More recently, case reports described serious opportunistic infections in this neoplasm treated with ruxolitinib. Research studies demonstrated the immunological derangement of this compound mainly based on T, dendritic, and natural killer cell defects. The purpose of this review of the literature was to analyze the relationship among ruxolitinib, immune system and bacterial, viral, fungal, and protozoan infections. A&nbsp;literature search was conducted using PubMed articles published between January&nbsp;2010 and November 2016. The efficacy of drug in patients with PMF was demonstrated in two phase III studies, Controlled MyeloFibrosis Study with ORal Jak inhibitor Treatment (COMFORT-I and COMFORT-II). Grade 3 and 4 neutropenia were recognized in 7.1% and 2% of patients in the ruxolitinib and placebo arm of COMFORT-I. Grade 3 or 4 neutropenia or leukopenia were observed in 8.9% and 6.3% of ruxolitinib treated patients of 5-year follow-up of COMFORT-II. In addition, leukocyte subpopulations, lymphocyte functions, or antibody deficiency were not documented in either of the studies. The complex interactions between ruxolitinib, bone marrow, immune system, and infections in PMF need further investigation, robust data from a randomized clinical trial, registry, or large case-series. Keywords: myelofibrosis, JAK/STAT pathway, immune system, infections, inflammatio