Spotlight on pathogenesis of TRALI: HNA-3a (CTL2) antibodies

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TRANSFUSION MEDICINE Brief report Donor antibodies to HNA-3a implicated in TRALI reactions prime neutrophils and cause PMN-mediated damage to human pulmonary microvascular endothelial cells in a two-event in vitro model

Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortality. Antibodies to HNA-3a are commonly implicated in TRALI. We hypothesized that HNA-3a antibodies prime neutrophils (PMNs) and cause PMN-mediated cytotoxicity through a two-event pathogenesis. Isolated HNA3a or HNA-3a PMNs were incubated with plasma containing HNA-3a antibodies implicated in TRALI, ...

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Identification of the HNA-3a antigen.

Among the 5 HNA systems, HNA-3 was the only one that had yet to be characterized. This effort was critical because antibodies directed to HNA-3a are responsible for causing numerous cases of transfusion-related acute lung injury (TRALI), especially fatal TRALI.2-4 Antibodies to HNA-3a cause neutrophil (PMN) agglutination, priming of the PMN oxidase, and PMN-mediated killing of pulmonary endothe...

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Regular Article TRANSFUSION MEDICINE Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo

• TRALI may be induced by antibodies to HLA or HNA antigens or lipids, which accumulate during storage. • Prestorage experimental filtration of RBCs removes HLA and HNA antibodies, decreases lipid priming activity, and mitigates TRALI in an animal model. Transfusion-related acute lung injury (TRALI) remains a significant cause of transfusionrelated mortality with red cell transfusion. We hypoth...

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HNA antibody-mediated neutrophil aggregation is dependent on serine protease activity.

BACKGROUND AND OBJECTIVES Transfusion-related acute lung injury (TRALI) is often caused by antibodies against human neutrophil alloantigen-2 (HNA-2) and HNA-3a. Neutrophil aggregation is considered as a major cause of TRALI, but little is known about how HNA antibodies initiate this process. We explored mechanisms involved in neutrophil aggregation induced by HNA-2 and HNA-3a antibodies. MATE...

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Experimental prestorage filtration removes antibodies and decreases lipids in RBC supernatants mitigating TRALI in vivo.

Transfusion-related acute lung injury (TRALI) remains a significant cause of transfusion-related mortality with red cell transfusion. We hypothesize that prestorage filtration may reduce proinflammatory activity in the red blood cell (RBC) supernatant and prevent TRALI. Filters were manufactured for both small volumes and RBC units. Plasma containing antibodies to human lymphocyte antigen (HLA)...

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ژورنال

عنوان ژورنال: Blood

سال: 2014

ISSN: 0006-4971,1528-0020

DOI: 10.1182/blood-2014-05-538181