Effect of circulating immune complex on the efficacy of platelet transfusion / 中国输血杂志

【Objective】 To analyze the efficacy of ABO-matched platelet transfusions and ABO-mismatched platelet transfusions in patients with hematonosis and to explore the effect of circulating immune complexes (CIC) on the efficacy. 【Methods】 A total of 1 510 platelet transfusions involving 757 patients in our hospital from January 2013 to June 2018 were retrospectively analyzed. The patients were divided into ABO-matched group and ABO-mismatched group. The 12-hour percent platelet recovery (PPR) was used to evaluate the effect of platelet transfusion between the groups. TEG was used to evaluate the efficacy of the transfusions, and CIC value was measured before and after platelet transfusion. The effect of A-B/CIC (or AB-O/CIC) on platelet function was tested. 【Results】 1)The results showed that platelet transfusion was effective(PPR>30%) in both ABO-matched group[PPR=(66.5±52.8)%] and ABO-mismatched group[PPR=(47.7%±51.6)%], and there was no increase in the report of hemolytic transfusion reaction of ABO-mismatched group. The efficacy of ABO-matched platelet transfusions was significantly better than that of ABO-mismatched group(P 0.05. 2) In the experiment of simulating platelet transfusion in patients, no difference in MA value of TEG was noticed between ABO-mismatched groups and ABO-matched groups (all P>0.05). 3) There was no difference in CIC value before and after platelet transfusions (P>0.05) in the ABO-matched group, while CIC value decreased significantly in all ABO-mismatched groups (all P < 0.05). 4) The MA values (mm)of AB, A and O blood group platelets mixed with A-B/CIC and AB-O/CIC were 36.1 vs 31.1, 37.8 vs 35.0 and 43.1 vs 45.7, with the MA value (mm) in control group at 49.2 vs 49.5, respectively. 【Conclusion】 Platelet transfusion was effective in both ABO-matched group and ABO-mismatched group, and the efficacy of ABO-matched group was significantly better compared with the ABO-mismatched group. There was no increase in the safety risk of ABO-mismatched platelet transfusion with major mismatches/minor matches. CIC can inhibit the function of platelets and combine more with ABO-matched platelets than with ABO-mismatched platelets, therefore, CCI is an important influencing factor on the efficacy of platelet transfusions.

Galactose base level of N-sugar chain and clinical significance in immunoglobulin of schizophrenia / 中华检验医学杂志

Objective To investigate the correlation among serum galactose immunoglobulin of quantitative change, total IgG and CIC(circulating immune complexes)levels in patients with schizophrenia.Methods Test the number changed of PVL affinity type Ig in 80 patients with schizophrenia and 80 controls′serum with the PVL affinity ELISA method.The specimens without central nervous system organic disease,heart,liver,kidney diseases, and autoimmune diseases are collected from March to June 2015 in Hospital 261 of PLA′s hospitalized patients.The total of cases is 80.The cases of male are 52,and the cases of female are 28.The age is from 19 to 60,and the average of age is(27.2 ±6.2).Control group is selected from health checkers from the same petiod.The cases of male are 52,and the cases of female are 28.The age is from 19 to 61,and the average of age is(27.8 ±5.4).The relationships among serum PVL-Ig,total IgG and CIC levels in patient group and control group were investigated by rectilinear correlation analysis.Results The serum PVL-IgG level(3.128 ±0.531)(A value)in schizophrenia was significantly higher than control group(2.672 ±0.492)(A value),(t=3.846,P<0.01).PVL-IgM(0.351 ±0.082)(A value)and PVL-IgA(1.287 ±0.205)(A value)compared with the control group(0.362 ±0.073,1.203 ± 0.216)(A value), there was no difference(t=0.241,0.6013;P>0.05).There was positive correlation between serum PVL-IgG and CIC in patients(r=0.423 1,P<0.01).There was no significant correlation with IgG,IgM and IgA.Conclusions People with schizophrenia have an excess of PVL-IgG expression,which maybe participated in the pathological process of immunological injury.PVL-IgG may be one of the molecular mechanisms of patients′CIC stranded or cleared of obstacles.

Evaluation of circulating immune complexes and serum immunoglobulins in oral cancer patients - A follow up study.

Background: High serum immunoglobulins and circulating immune complexes (IgG, IgM, IgA and CIC) values in patients with cancer have been used as tumor markers. Hence, the aim of the study was to estimate these immunological markers in pre- and post-treatment phases with a follow-up of 3-24 months and to understand the prognostic significance of the same in patients with oral cancer. Materials and Methods: The malignancy group consisted of 56 patients with different stages (AJCC TNM) of oral cancer and 20 healthy control group. Samples were selected at random and subjected for sequential analysis of serum biochemical markers (IgG, IgA, IgM and CIC-circulating immune complexes levels) in the pre- and post-treatment period. Statistical method employed was the paired t test. Results: We observed significant elevated levels of all the immunological markers ( P < 0.01) when compared with the control group. Sequential analysis of these markers revealed significant reduction in immunological markers in stage I and II patients. On the contrary, stage III and IV patients showed remarkably elevated levels of IgA and CIC one year after initial treatment. Conclusions : All these immunological markers are indicative of tumor burden and Serum levels of CIC and IgA might be employed as prognostic indicators in oral cancer.

Clinical Significance of Serum C1q-Circulating Immune Complexes in Patients with Lupus Nephritis / 대한류마티스학회지

OBJECTIVE: The purpose of this study was to evaluate whether serum C1q-circulating immune complexes (C1q-CIC) serve as a predictive marker for renal flares in patients with lupus nephritis. METHODS: Twenty-five patients with lupus nephritis and 24 healthy controls were enrolled. Patients with lupus nephritis had their serum C1q-CIC titers and other serologic parameters such as serum C3, C4, anti-dsDNA antibody, and erythrocyte sedimentation rate measured simultaneously. The systemic lupus erythematosus disease activity index (SLEDAI) was also checked. RESULTS: Serum C1q-CIC titers were higher in patients with lupus nephritis than in healthy controls (109.33+/-53.79 microg/mL vs. 75.28+/-22.91 microg/mL, p=0.008). A statistically significant association was found between serum C1q-CIC titers and C3 (p=0.011), C4 (p=0.027), and anti-dsDNA antibody (p=0.014). SLEDAI was also correlated with serum C1q-CIC titers (p=0.022). CONCLUSION: Serum C1q-CIC appears to be related to renal disease activity in patients with lupus nephritis. These results suggest that serum C1q-CIC is a predictive marker for renal flares in patients with lupus nephritis.

Expression of CD35 on erythrocyte membrane and changes of serum inflammatory cytokines in children with recurrent respiratory tract infection before and after zinc treatment / 中华临床感染病杂志

Objective To investigate the expression of CD35 on erythrocyte membrane and the changes of serum inflammatory cytokines in children with recurrent respiratory tract infection (RRTI) and their relation to zinc therapy. Methods One hundred and sixteen RRTI children including 82 cases of upper respiratory tract infection and 34 cases of lower respiratory tract infection were enrolled in the study;40 children with acute respiratory infection and 50 healthy children were randomly selected as the controls. The expression of CD35 on erythrocyte membrane, positive rate of circulating immune complex (CIC), IL-6, IL-8 and TNF-α were detected. Sixty-eight RRTI children with hypozincemia were randomly divided into zinc treatment group ( n = 38) and control group ( n = 30). The above parameters were detected at the end of the treatment and 12 weeks after the treatment. Results The expression of CD35 on erythrocyte membrane was significantly lower in RRTI children ( upper respiratory group and lower respiratory group) than that in healthy controls ( t=6.17 and 6.46, P <0.01 ). CIC-pesitive rate and the contents of IL-6, IL-8 and TNF-α were increased in RRTI children, especially in those with lower respiratory tract infections. Compared with the children of acute respiratory infections, the expression of CD35on erythrocyte memhrane was much lower in RRTI children in the remission stage ( t = 20. 307, P < 0.01 ). The above parameters were improved in RRTI children who received zinc treatment. Conclusions Down-regulation of CD35, insufficient elimination of CIC, excessive production of serum IL-6, IL-8 and TNF-α were observed in RRTI children, which might be the immunopathologic mechanism of the repeated infection. These indexes can be improved after zinc treatment.

Circulating immune complexes and cell-mediated immunity in patients with hepatitis B virus associated liver diseases

The prevalence of circulating immune complexes (CIC), their role and their relationship to cell-mediated immunity in patients with hepatitis B virus associated liver disease are still controversial. This study was designed to investigate the prevalence of CIC and their relationship to viral markers, to subsets of peripheral blood T lymphocytes and to suppressor cell activity in patients with hepatitis B virus associated liver diseases. CIC were positive in 29.3% of 41 healthy HBsAg carriers, 37.8% of 88 patients with hepatitis B virus associated liver diseases, and 15% of 41 healthy subjects by the platelet aggregation test (PAT). The prevalence of CIC in patients with acute hepatitis (40.0%) and in those with cirrhosis (61.5%) was significantly higher than in normal controls (p less than 0.05, p less than 0.005 respectively). There was no correlation between the titer of CIC and serum HBsAg titer or the status of HBeAg, and no significant decrease in the peripheral blood lymphocyte CD4/CD8 ratio in healthy HBsAg carriers (1.39 +/- 0.31) and in patients with liver diseases (1.40 +/- 0.54) compared to the normal controls (1.48 +/- 0.31). Concanavalin A induced suppressor cell activity on IgG producing cells was impaired in healthy HBsAg carriers (34.9%) (p less than 0.005) and in patients with liver diseases (25.3%) (p less than 0.0001), and this change was prominent in patients with chronic active hepatitis and cirrhosis (p less than 0.0001). And there was a significant reverse correlation between concanavalin A induced suppressor cell activity on IgG-producing cells and the titer of CIC in PAT positive patients with hepatitis B virus associated liver diseases. In conclusion, it was suggested that defective suppressor cell function may lead to an increased B cell activation and such activity may account for the presence of CIC.

The Leukocyte Inhibitory Factor and Circulating Immune Complex in Leprosy Patients

To investigate leukocyte inhibitory factor(LlF) production and circulating immune complexes (CIC) in leprosy, peripheral blood mononuclear cells (PBMC) from 61 patients and sera from 6O patients were tested. The results indicate that there is a defect in LlF production in the lepromatous (LL) or borderline lepromatous (BL) types compared to the tubrculoid (TT) type (mean migration index=66.O +/- 16.O in LL 61.1 +/- 15.3 in BL, 51.9 +/- 11.2 in TT) (p < 0.05). The number of patients with positive CIC was higher among the LL patents (30%) than the TT patients (20%). There was also positive correlation between the bacterial index (Bl) and the CIC level (r=0.46, p < 0.05). The correlation between CIC and LIF in LL patients and the possibility (p=0.06) that the inuease m CIC may account for the decrease in LIF production in LL patients and vice versa are discussed.

Immediate Effects of Methylprednisolone Pulse Therapy on the Immune Response

To study the immediate effects of high-dose intravenous methylprednisolone pulse therapy on the immune mechanisms in the absence of other immunosuppressive agents, we treated ten patients with active systemic lupus erythematosus, six with renal and three with central nervous system involvement with three daily 1 gram intravenous doses of methylprednisolone and measured the immune response before and just after discontinuation of the drugs. After the treatment, the mean seum IgG, IgA and IgM levels were essentially unchanged. Likewise, serum C3 and C4 levels were not changed significantly. In nine of ten patients, methylprednisolone pulse therapy reduced the levels of circulating immune complexes (p < 0.05). Thus the immediate clinical improvements with methylprednisolone pulse therapy are suggested to be the result of depression of the circulating immune complex levels.

Circulating Immune Complexes in Diabetics

Circulating immune complexes (ClC) were detected by platelet aggregation test (PAT) in 40.0% of 45 diabetics and by polyethylene glycol precipitation-complement consumption test (PEG-CC test) in 30.6% of 36 diabetics as compared to 5% and 10% of 20 normal control subjects for each test. The prevalence of CIC in diabetics was significantly higher than in the normal controls (P < 0.05%). There were no correlations between the presence of ClC detected by PAT and the duration of the disease, insulin treatment, or diabetic complications. Thus multiple factors must contribute to the increase of ClC in diabetics. The role of these various factors needs to be studied.

Circulating Igm—specific immune complexes activating complement in patients with rheumat IC heart disease / 中国免疫学杂志

Circulating IgM-specific immune complexes activating complement(IgM/C_3—CIC)weredetected in 64 cases of rheumatic heart disease by a complement types capture ELISA method.Itwas found that the positive rates of the specific immune cmplexes in patients with rheumatic ac-tivity(51.9%)were significantly higher than in patients without rheumatic activity(78.4%).Morever,the rates were closely related to antibody to streptolysin O and C reactive protein.butnot to sex、age、disease'time、IgM、IgG、IgA、C_3、C_4、C_5.These results suggest that immune modu-lation disorder is an essential factor of causing these relationships above,and circulating IgM— specific immune complexes activating complement pay an important role in rheumatic activity.

CIRCULATING SPECIFIC IgA IMMUNE COMPLEXES ACTIVATING COMPLEMENT IN HEALTHY PERSONS / 中国免疫学杂志

plexes activating complement of 404 cases of healthy persons.It was found that there were thisimmune complexes in every case except umbilical blood,the amount of this immune complexeswere related to age and sex,but not to ABO blood types,which was similar to the relationshipbetween serum IgA and age and sex.These results suggests that the amount of circulating spe-cific IgA immune complexes activating complement in healthy persons depend chiefly on the levelof serum IgA,detecting this immune complexes may approach some characterizations on normalimmune response,and age and sex should be considered when normal value of the specific im-mune complexes is determined

Circulating Immune Complexes in Patients with Leprosy

The occurrence of immune complexes in the serum from rats infected with M. leprae-murium and 38 patients with leprosy were studied by the polyethylene glycol precipitation complement consumption (PEG-CC) test and the results were compared in the various forms of the disease. Circulating immune complexes (CIC) were significantly increased in the sera from rats infected with M. lepraemurium compared to normal control rats (P < 0.005). There were no significant differences between the the level of CIC in the sera from lepromatous leprosy patients and that from tuberculoid leprosy patients, but in the sera from patients with erythema nodosum leprosum (ENL) the level of CIC was significantly increased (P < 0.005). And although we couldn't find a corre1ation between the level of CIC and bacterial indices in lepromatous leprosy patients, CIC tends to de-crease after negative conversion of their bacterial indices. These findings suggested that the detection of CIC can be of some practical interest in the early diagnosis of ENL and can be a valuable assessment in following the therapy after negative conversion of their bacterial indices.

Circulating immune complexes in rodent and simian malaria.

The circulating immune complexes have been detected in the sera of albino rats infected with Plasmodium berghei and rhesus monkeys infected with P. knowlesi by (i) quantitative cryoprecipitation assay and (ii) polyethylene glycol assay. In the rodent model, the levels of circulating immune complexes increased during infection and decreased considerably in the post-infection period. In the simian system, high levels were detected during peak parasitaemia. Polyethylene glycol precipitate obtained from the sera during acute P. knowlesi infection when analysed by Immunoelectrophoresis was found to contain (i) monkey IgG, (ii) four other components of monkey plasma, (iii) two components of normal monkey erythrocytes and (iv) antigen(s) of P. knowlesi.

Assessment of three simple techniques for the screening of circulating immune complexes: Correlation with a parameter of complement consumption.

The sera of 36 normal controls, 45 patients with various diseases and 11 pregnant women were screened for circulating immune complexes using three relatively simple and inexpensive techniques. These included inhibition of agglutination of IgG coated latex particles with a serum having rheumatoid factor activity, polyethylene glycol precipitation and anti-complementary activity test. The circulating immune complexes were detected in a significantly higher proportion of patients as compared to normal controls. In the patients, the presence of circulating immune complexes did not always correlate with clinically detectable immunoinflammatory tissue damage indicating that pathogenic as well as nonpathogenic immune complexes were being detected by the above mentioned techniques. The alpha-1- antitrypsin/C3 ratio, however, correlated well with clinically apparent immunoinflammation.