[The immunomodulatory effect of blood transfusions and intravenous immunoglobulins: the role of the soluble molecules of the Class-I major histocompatibility complex and of the Fas ligand].
Allogeneic blood transfusions may have immunomodulatory effects including improved allograft acceptance and increased risk for cancer recurrence or post-operative bacterial infections. These effects are associated with the presence of leukocytes in transfused blood and are reduced by pre-storage leuko-reduction. However, the precise mechanism of this effect has not yet been elucidated. We report that the concentrations of soluble major histocompatibility complex class I and soluble Fas-ligand molecules are significantly higher in supernatants of blood components containing elevated numbers of residual donor leukocytes, such as red blood cells and random-donor platelets, than in other blood components. Elevated amounts of soluble Fas-ligand molecules are also found in some intravenous immunoglobulin preparations. Soluble molecules detected in blood components and in immunoglobulin preparations are biologically active in vitro. In fact, they inhibit mixed lymphocyte responses and cytotoxic T cell activity in allogeneic and autologous combinations and induce apoptosis in Fas-positive cells. These results should be taken into account in clinical practice to select the blood component or the immunoglobulin preparation in order to induce or prevent an immunosuppressive effect in the recipient.
Ghio
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M
U.O. di Medicina Interna ad Orientamento Immunologico, DIMI, Università degli Studi di Genova.
Contini
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Puppo
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Indiveri
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D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D001803:Blood Transfusion; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000276:immunology*; D007962:Leukocytes / Q000276:immunology; D008024:Ligands; D008285:Major Histocompatibility Complex / Q000276:immunology*; D012995:Solubility; D019014:fas Receptor / Q000276:immunology*
D000276:Adjuvants, Immunologic; D006680:HLA Antigens; D016756:Immunoglobulins, Intravenous; D008024:Ligands; D019014:fas Receptor