A significant increase of HLA-DR3 and DR2 in systemic lupus erythematosus among blacks.

We found a highly significant increase in the incidence of HLA-DR3 and DR2 antigens in black patients with systemic lupus erythematosus (SLE). HLA-DR3 was found in 62% of patients and 20% of controls (p less than 0.0001), and DR2 in 41% of patients and 18% of controls (p less than 0.001). The relative risk (RR), conferred by DR3 was 6.41, and that by DR2 was 3.03. Further, 84% of the patients had DR3 and/or DR2; the combined RR for SLE with these antigens was 9.0. A significant proportion of the patients (57%) developed lymphocytotoxic antibodies; of these, 19% had HLA specific antibodies.

Cryopreservation of human granulocytes: study of granulocyte function and ultrastructure.

Human granulocytes can be cryopreserved with dimethyl sulfoxide (DMSO) at--80 degrees C. However, the percent recovery of functional cells has been unsatisfactory to date. Throughout this study we have been able to prepare relatively pure granulocytes approximately equal to 85%), cryopreserve them with 5%--10% DMSO with and without serum, and store them at--80 degrees C for up to 4 mo. The parameters studied were absolute cell counts and viability determination, myeloperoxidase activity, phagocytosis, candidacidal activity, bactericidal activity, nitroblue tetrazolium reduction, chemiluminescence, and cell morphology by transmission and scanning electron microscopy. Based on our investigation, granulocytes cryopreserved without serum showed an intact membrane of superior integrity as compared with those preserved with serum. At least 50% of the cells recovered were functional after 2 mo of storage, but there was a progressive loss of viability and function on prolonged storage. The property of phagocytosis was the best preserved after storage for 4 mo, whereas myeloperoxidase activity, killing activity, nitroblue tetrazolium reduction, and chemiluminescence were maintained less efficiently. Morphological studies of cryopreserved granulocytes revealed that the nuclear, cytoplasmic, and cell surface architectures were altered by storage. Depletion of nuclear and cytoplasmic material, as well as changes in configuration, were also noted.

The HLA antigens and ABO blood groups in an American Black population with mitral valve prolapse.

A total of 42 American Black patients with mitral valve prolapse and 194 healthy individuals of similar ethnic background were tested for the distribution of various HLA antigens and ABO blood groups. The most significant result was an increased frequency of Bw35 in patients (74%) as compared with controls (39%), with a P value of less than 0.0001; the relative risk was 4.45.

Microaggregate counts in frozen-preserved erythrocytes: effects of washing in three blood processors and filtration.

Since microaggregates have been implicated in posttransfusion pulmonary insufficiency, their elimination has become an active concern in blood transfusion. Various types of filters, as well as frozen-preserved erythrocytes, have been used to provide blood relatively low in microaggregates. We have counted particles in frozen-stored blood before deglycerolization, after washing in each of three cell processing systems, and after filtration through a 40-micrometer filter. Washing frozen erythrocytes reduced the total particle counts by an average of 89%. Slight differences were found among the three blood processors with respect to particle removal. Passing washed blood through a 40-micrometer filter did not result in significant further reduction in particle counts. Hence, the use of such filters in a frozen-preserved blood system is not warranted.

The use of frozen, thawed erythrocytes in blood banking: a report of 28 months' experience in a large transfusion service.

A program of component therapy using largely frozen erythrocytes was initiated at Cook County Hospital in July 1973. Use of the three existing washing systems for routine preparation of frozen erythrocytes has shown that there are differences in the levels of free hemoglobin, hematocrit, and residual glycerol in the washed products. Adenosine triphosphate, 2,3-diphosphoglycerate, and extracellular potassium and sodium were found to be within acceptable limits. Some expired units were cultured and were found to be positive for Staphylococcus and Corynebacterium. The source of contamination has not been determined. Frozen blood, when available, has been given to all patients, regardless of age or clinical condition. The incidence of transfusion reactions has decreased from 0.57% prior to the inception of the component therapy program to 0.11% since that time. Two cases of possible posttransfusion hepatitis occurred in patients who had received non-frozen blood, and in three patients who received non-frozen erythrocytes and/or components as well as frozen blood. Although the goal of the program was the use of frozen erythrocytes exclusively, only 64% use was achieved, as sufficient quantities of blood for freezing were not available at all times.

Incidence of HBsAg, anti-HBs and subtypes ad and ay in a general hospital: correlation with clinical data and its significance as a public health problem.

During a period of four months, 9,418 individuals, comprising new hospital admissions, new employees and blood donors, were tested for HbsAg and 1,212 for anti-HBs. A high incidence of positivity for both was found in the different groups under investigation. Subtyping was carried out on acutely ill patients and carriers. Sbtype ay was common in acutely ill patients and among addicts and subtype ad in nonhepatitis patients and healthy carriers. The significance of these findings and possible measures for prevention of spread of the infection are discussed.

Hemolytic disease of the newborn due to anti-N.

A Negro woman of phenotype M+, N-, S-, s-, U+, who produced anti-N, is described. The antibody in her serum caused hemolytic disease of the newborn in her M+, N+ infant.

Viable lymphocytes in frozen washed blood.

Samples of glycerolized, frozen, packed cells, were washed by each of three systems and then were cultrued for viable lymphocytes using the short-term culture method. Of the 39 samples, 17 (43.6%) showed definite evidence of growth of lymphocytes. Of the 17, 11(64.7%) were washed by Elutramatic, two (11.8%) by Haemonetics, and four (23.5%) by IBM. The 4 C prefreeze (two to five days) as well as the -80 C (21 To 40 days) storage times were the same for both positive and negative specimens. In all samples, clumps of distorted granulocytes with pyknotic nuclei were seen in addition to a number of well-preserved mononucleated white cells. In the 17 specimens which showed growth, incorporation of 3H-thymidine was seen only in the PHA-induced blast cells; typical mitotic figures were seen in some cultures. These observations demonstrate that lymphocytes remain viable in frozen blood stored at -80 C up to 40 days. The significant difference in removal of viable lymphocytes noted in specimens washed by different instruments requires further evaluation.