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Bone Marrow Transplant ; : 1-9, 2020.
Article | WHO COVID | ID: covidwho-939434

ABSTRACT

The COVID-19 pandemic has serious implications also for patients with other diseases Here, we describe the effects of the pandemic on unrelated hematopoietic stem cell donation and transplantation from the perspective of DKMS, a large international donor registry Especially, we cover the development of PBSC and bone marrow collection figures, donor management including Health and Availability Check (HAC), transport and cryopreservation of stem cell products, donor recruitment and business continuity measures The total number of stem cell products provided declined by around 15% during the crisis with a particularly strong decrease in bone marrow products We modified donor management processes to ensure donor and product safety HAC instead of confirmatory typing was helpful especially in countries with strict lockdowns New transport modes were developed so that stem cell products could be safely delivered despite COVID-19-related travel restrictions Cryopreservation of stem cell products became the new temporary standard during the pandemic to minimize risks related to transport logistics and donor availability However, many products from unrelated donors will never be transfused DKMS discontinued public offline donor recruitment, leading to a 40% decline in new donors during the crisis Most DKMS employees worked from home to ensure business continuity during the crisis

2.
Int J Mol Sci ; 21(22)2020 Nov 11.
Article in English | MEDLINE | ID: covidwho-918209

ABSTRACT

Immune memory is a defining characteristic of adaptive immunity, but recent work has shown that the activation of innate immunity can also improve responsiveness in subsequent exposures. This has been coined "trained immunity" and diverges with the perception that the innate immune system is primitive, non-specific, and reacts to novel and recurrent antigen exposures similarly. The "exposome" is the cumulative exposures (diet, exercise, environmental exposure, vaccination, genetics, etc.) an individual has experienced and provides a mechanism for the establishment of immune training or immunotolerance. It is becoming increasingly clear that trained immunity constitutes a delicate balance between the dose, duration, and order of exposures. Upon innate stimuli, trained immunity or tolerance is shaped by epigenetic and metabolic changes that alter hematopoietic stem cell lineage commitment and responses to infection. Due to the immunomodulatory role of the exposome, understanding innate immune training is critical for understanding why some individuals exhibit protective phenotypes while closely related individuals may experience immunotolerant effects (e.g., the order of exposure can result in completely divergent immune responses). Research on the exposome and trained immunity may be leveraged to identify key factors for improving vaccination development, altering inflammatory disease development, and introducing potential new prophylactic treatments, especially for diseases such as COVID-19, which is currently a major health issue for the world. Furthermore, continued exposome research may prevent many deleterious effects caused by immunotolerance that frequently result in host morbidity or mortality.


Subject(s)
Betacoronavirus/immunology , Cell Lineage/immunology , Coronavirus Infections/immunology , Immunity, Innate/immunology , Immunologic Memory/immunology , Pneumonia, Viral/immunology , DNA Methylation/genetics , Dendritic Cells/immunology , Exposome , Histone Code/genetics , Humans , Immune Tolerance/immunology , Killer Cells, Natural/immunology , Macrophages/immunology , Pandemics
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