title: The IgE-dependent pathway in allergic transfusion reactions: involvement of donor blood allergens other than plasma proteins.
abstract: On transfusion, several plasma proteins can cause anaphylaxis in patients deficient in the corresponding plasma proteins. However, little is known about other allergens, which are encountered much more infrequently. Although it has been speculated that an allergen-independent pathway underlying allergic transfusion reactions (ATRs) is elicited by biological response modifiers accumulated in blood components during storage, the exact mechanisms remain unresolved. Furthermore, it is difficult even to determine whether ATRs are induced via allergen-dependent or allergen-independent pathways. To distinguish these two pathways in ATR cases, we established a basophil activation test, in which the basophil-activating ability of supernatants of residual transfused blood of ATR cases to whole blood basophils was assessed in the presence or absence of dasatinib, an inhibitor of IgE-mediated basophil activation. Three of 37 supernatants from the platelet concentrates with ATRs activated panel blood basophils in the absence, but not in the presence, of dasatinib. The basophil activation was inhibited by treatment of anti-fish collagen I MoAb in one case, suggesting that the involvement of fish allergens may have been present in donor plasma. We concluded that unknown non-plasma proteins, some of which had epitopes similar to fish antigens, in blood component may be involved in ATRs via an allergen/IgE-dependent pathway.
authors.affiliation: Japanese Red Cross Kinki Block Blood Center, 7-5-17, Saitoasagi, Ibaraki, Osaka, 567-0085, Japan.
authors.forename: Nobuki
authors.initials: N
authors.lastname: Matsuyama
authors.forename: Kazuta
authors.initials: K
authors.lastname: Yasui
authors.forename: Etsuko
authors.initials: E
authors.lastname: Amakishi
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hayashi
authors.forename: Ayumu
authors.initials: A
authors.lastname: Kuroishi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishii
authors.forename: Harumichi
authors.initials: H
authors.lastname: Matsukura
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Tani
authors.forename: Rika A
authors.initials: RA
authors.lastname: Furuta
authors.forename: Fumiya
authors.initials: F
authors.lastname: Hirayama
mesh_terms: D000485:Allergens / Q000276:immunology*; D001491:Basophils / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D001789:Blood Group Antigens / Q000276:immunology; D001798:Blood Proteins / Q000276:immunology; D000069439:Dasatinib / Q000494:pharmacology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis / Q000276:immunology*; D017713:Platelet Transfusion / Q000009:adverse effects; D047428:Protein Kinase Inhibitors / Q000494:pharmacology; D065227:Transfusion Reaction / Q000175:diagnosis / Q000276:immunology*
chemical_list: D000485:Allergens; D001789:Blood Group Antigens; D001798:Blood Proteins; D047428:Protein Kinase Inhibitors; D000069439:Dasatinib
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