Microchimerism in transfused trauma patients is associated with diminished donor-specific lymphocyte response

Garth H Utter, John T Owings, Tzong Hae Lee, Teresa G. Paglieroni, William F. Reed, Robert C. Gosselin, Paul V. Holland, Michael P. Busch, Julie A. Dunn

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Blood transfusion can result in long-term survival of donor leukocyte subpopulations, or microchimerism, in the peripheral blood of injured patients. Neither injury severity nor the number of transfusions is associated with its occurrence. We sought to determine whether changes in general or antigen-specific lymphocyte activation may be associated with the subsequent development of microchimerism. Methods: We evaluated 63 transfused trauma patients, which we compared with 10 non-transfused trauma patients and 10 healthy control subjects. Of the 63 transfused patients, 31 were known to have evidence of microchimerism at hospital discharge with real-time quantitative PCR for non-recipient HLA DR alleles. We assessed lymphocyte response to phytohemagglutinin (PHA) using blood sampled upon arrival to the hospital (before transfusion) and at discharge. We performed one-way mixed leukocyte cultures (MLC) with pre-transfusion recipient specimens to assess recipient lymphocyte response to mitomycin-C treated donor cells and vice versa. Results: Lymphocyte response to PHA in microchimeric transfusion recipients was lower at admission (before transfusion) and discharge than in non-microchimeric recipients. Lymphocytes from microchimeric patients had less response to donor cells than did lymphocytes from non-microchimeric patients. Microchimeric patients also more frequently had diminished lymphocyte response to a single blood donor on MLC. Conclusions: Transfusion-associated microchimerism is correlated with diminished response to mitogen challenge as well as to specific alloantigenic challenges. This microchimerism is predated by diminished lymphocyte response to a specific blood donor in many instances. The blood donor associated with this diminished alloantigenic lymphocyte response may be the source of microchimeric cells present in the recipient.

Original languageEnglish (US)
Pages (from-to)925-932
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume58
Issue number5
DOIs
StatePublished - May 2005

Fingerprint

Chimerism
Tissue Donors
Lymphocytes
Wounds and Injuries
Blood Donors
Leukocytes
Phytohemagglutinins
Mitomycin
HLA-DR Antigens
Lymphocyte Activation
Mitogens
Blood Transfusion
Real-Time Polymerase Chain Reaction
Healthy Volunteers
Alleles
Antigens
Survival

Keywords

  • Blood transfusion
  • Compensatory anti-inflammatory response syndrome
  • Immunosuppression
  • Lymphocytes
  • Microchimerism
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Microchimerism in transfused trauma patients is associated with diminished donor-specific lymphocyte response. / Utter, Garth H; Owings, John T; Lee, Tzong Hae; Paglieroni, Teresa G.; Reed, William F.; Gosselin, Robert C.; Holland, Paul V.; Busch, Michael P.; Dunn, Julie A.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 58, No. 5, 05.2005, p. 925-932.

Research output: Contribution to journalArticle

Utter, Garth H ; Owings, John T ; Lee, Tzong Hae ; Paglieroni, Teresa G. ; Reed, William F. ; Gosselin, Robert C. ; Holland, Paul V. ; Busch, Michael P. ; Dunn, Julie A. / Microchimerism in transfused trauma patients is associated with diminished donor-specific lymphocyte response. In: Journal of Trauma - Injury, Infection and Critical Care. 2005 ; Vol. 58, No. 5. pp. 925-932.
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abstract = "Background: Blood transfusion can result in long-term survival of donor leukocyte subpopulations, or microchimerism, in the peripheral blood of injured patients. Neither injury severity nor the number of transfusions is associated with its occurrence. We sought to determine whether changes in general or antigen-specific lymphocyte activation may be associated with the subsequent development of microchimerism. Methods: We evaluated 63 transfused trauma patients, which we compared with 10 non-transfused trauma patients and 10 healthy control subjects. Of the 63 transfused patients, 31 were known to have evidence of microchimerism at hospital discharge with real-time quantitative PCR for non-recipient HLA DR alleles. We assessed lymphocyte response to phytohemagglutinin (PHA) using blood sampled upon arrival to the hospital (before transfusion) and at discharge. We performed one-way mixed leukocyte cultures (MLC) with pre-transfusion recipient specimens to assess recipient lymphocyte response to mitomycin-C treated donor cells and vice versa. Results: Lymphocyte response to PHA in microchimeric transfusion recipients was lower at admission (before transfusion) and discharge than in non-microchimeric recipients. Lymphocytes from microchimeric patients had less response to donor cells than did lymphocytes from non-microchimeric patients. Microchimeric patients also more frequently had diminished lymphocyte response to a single blood donor on MLC. Conclusions: Transfusion-associated microchimerism is correlated with diminished response to mitogen challenge as well as to specific alloantigenic challenges. This microchimerism is predated by diminished lymphocyte response to a specific blood donor in many instances. The blood donor associated with this diminished alloantigenic lymphocyte response may be the source of microchimeric cells present in the recipient.",
keywords = "Blood transfusion, Compensatory anti-inflammatory response syndrome, Immunosuppression, Lymphocytes, Microchimerism, Trauma",
author = "Utter, {Garth H} and Owings, {John T} and Lee, {Tzong Hae} and Paglieroni, {Teresa G.} and Reed, {William F.} and Gosselin, {Robert C.} and Holland, {Paul V.} and Busch, {Michael P.} and Dunn, {Julie A.}",
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T1 - Microchimerism in transfused trauma patients is associated with diminished donor-specific lymphocyte response

AU - Utter, Garth H

AU - Owings, John T

AU - Lee, Tzong Hae

AU - Paglieroni, Teresa G.

AU - Reed, William F.

AU - Gosselin, Robert C.

AU - Holland, Paul V.

AU - Busch, Michael P.

AU - Dunn, Julie A.

PY - 2005/5

Y1 - 2005/5

N2 - Background: Blood transfusion can result in long-term survival of donor leukocyte subpopulations, or microchimerism, in the peripheral blood of injured patients. Neither injury severity nor the number of transfusions is associated with its occurrence. We sought to determine whether changes in general or antigen-specific lymphocyte activation may be associated with the subsequent development of microchimerism. Methods: We evaluated 63 transfused trauma patients, which we compared with 10 non-transfused trauma patients and 10 healthy control subjects. Of the 63 transfused patients, 31 were known to have evidence of microchimerism at hospital discharge with real-time quantitative PCR for non-recipient HLA DR alleles. We assessed lymphocyte response to phytohemagglutinin (PHA) using blood sampled upon arrival to the hospital (before transfusion) and at discharge. We performed one-way mixed leukocyte cultures (MLC) with pre-transfusion recipient specimens to assess recipient lymphocyte response to mitomycin-C treated donor cells and vice versa. Results: Lymphocyte response to PHA in microchimeric transfusion recipients was lower at admission (before transfusion) and discharge than in non-microchimeric recipients. Lymphocytes from microchimeric patients had less response to donor cells than did lymphocytes from non-microchimeric patients. Microchimeric patients also more frequently had diminished lymphocyte response to a single blood donor on MLC. Conclusions: Transfusion-associated microchimerism is correlated with diminished response to mitogen challenge as well as to specific alloantigenic challenges. This microchimerism is predated by diminished lymphocyte response to a specific blood donor in many instances. The blood donor associated with this diminished alloantigenic lymphocyte response may be the source of microchimeric cells present in the recipient.

AB - Background: Blood transfusion can result in long-term survival of donor leukocyte subpopulations, or microchimerism, in the peripheral blood of injured patients. Neither injury severity nor the number of transfusions is associated with its occurrence. We sought to determine whether changes in general or antigen-specific lymphocyte activation may be associated with the subsequent development of microchimerism. Methods: We evaluated 63 transfused trauma patients, which we compared with 10 non-transfused trauma patients and 10 healthy control subjects. Of the 63 transfused patients, 31 were known to have evidence of microchimerism at hospital discharge with real-time quantitative PCR for non-recipient HLA DR alleles. We assessed lymphocyte response to phytohemagglutinin (PHA) using blood sampled upon arrival to the hospital (before transfusion) and at discharge. We performed one-way mixed leukocyte cultures (MLC) with pre-transfusion recipient specimens to assess recipient lymphocyte response to mitomycin-C treated donor cells and vice versa. Results: Lymphocyte response to PHA in microchimeric transfusion recipients was lower at admission (before transfusion) and discharge than in non-microchimeric recipients. Lymphocytes from microchimeric patients had less response to donor cells than did lymphocytes from non-microchimeric patients. Microchimeric patients also more frequently had diminished lymphocyte response to a single blood donor on MLC. Conclusions: Transfusion-associated microchimerism is correlated with diminished response to mitogen challenge as well as to specific alloantigenic challenges. This microchimerism is predated by diminished lymphocyte response to a specific blood donor in many instances. The blood donor associated with this diminished alloantigenic lymphocyte response may be the source of microchimeric cells present in the recipient.

KW - Blood transfusion

KW - Compensatory anti-inflammatory response syndrome

KW - Immunosuppression

KW - Lymphocytes

KW - Microchimerism

KW - Trauma

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