title: Red cell ABO incompatibility and production of tumour necrosis factor-alpha.
abstract: Tumour necrosis factor-alpha (TNF) is a major mediator of diverse pathophysiological events similar to those of haemolytic transfusion reactions (HTR), such as fever, intravascular coagulation and organ failure. However, the possible role of TNF in HTR has not been investigated. We have constructed an in vitro whole blood model of HTR to examine whether TNF may be produced in red cell ABO incompatibility. TNF was observed in plasma, in a dose dependent manner, when ABO incompatible red cells were added, but not with compatible (group O) cells. Plasma TNF levels were maximal at 2 h, and declined to control levels by 24 h. Haemolysis of incompatible red cells was accompanied by TNF production. Immune haemolysis induced TNF gene expression by buffy coat leucocytes, as determined by Northern blot analysis. Heat inactivation of plasma abolished TNF production, whereas prior treatment with interferon-gamma augmented the response. These results demonstrate that a major cytokine is produced in response to red cell incompatibility, and suggest that TNF may play a role in the pathogenesis of haemolytic transfusion reactions.
authors.affiliation: Department of Pathology, University of Michigan Medical School, Ann Arbor.
authors.forename: R D
authors.initials: RD
authors.lastname: Davenport
authors.forename: R M
authors.initials: RM
authors.lastname: Strieter
authors.forename: S L
authors.initials: SL
authors.lastname: Kunkel
mesh_terms: D000017:ABO Blood-Group System / Q000502:physiology*; D001787:Blood Group Incompatibility / Q000097:blood*; D015152:Blotting, Northern; D002478:Cells, Cultured; D004912:Erythrocytes / Q000502:physiology; D015870:Gene Expression / Q000502:physiology; D006461:Hemolysis / Q000502:physiology; D006801:Humans; D007371:Interferon-gamma / Q000502:physiology; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D000017:ABO Blood-Group System; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma