Pub Date : 2024-11-30DOI: 10.1016/j.transci.2024.104040
Marcela Mafra, Maria Meritxell Roca Mora, Everton Castanha, Amanda Godoi, Andrés Valenzuela S
Background: Cryoprecipitate-poor plasma (CPP) has been suggested as a promising alternative to the standard fresh frozen plasma (FFP) in plasma exchange therapy (TPE) for thrombotic thrombocytopenic purpura (TTP) given its lower concentrations of von Willebrand Factor (VWF). However, its efficacy and safety remain a topic of debate.
Study design and methods: We conducted a systematic review and meta-analysis comparing CPP to FFP during TPE in patients with TTP. PubMed, Embase, and Cochrane Central were systematically searched for studies reporting outcomes of all-cause mortality, relapse rate, response to treatment, and the mean number of TPE sessions. Sensitivity analyses restricted to randomized controlled trials (RCTs) were performed. Review Manager v5.4 and RStudio v4.1.2 were used for statistical analysis. The protocol was prospectively registered in PROSPERO (ID CRD42023440665).
Results: Eight studies, including three RCTs and five non-randomized studies, met the eligibility criteria. A total of 290 patients with TTP were included, of whom 144 (49.7 %) received CPP and 146 (50.3 %) received FFP. Use of CPP was associated with lower mortality (RR 0.41; 95 % CI 0.23-0.72; p = 0.002; I²=0 %), while the subgroup analysis restricted to RCTs showed no statistical difference between groups (p = 0.36). No significant differences were found in relapse rate, response to treatment, or mean number of TPE sessions between groups.
Conclusion: Our findings show that the use of CPP is not inferior to FFP in TPE. Given the limited population, future clinical trials are needed to elucidate its benefits compared to FFP in patients with TTP.
{"title":"Comparing cryoprecipitate-poor plasma to fresh frozen plasma as replacement therapy in thrombotic thrombocytopenic purpura: An updated meta-analysis.","authors":"Marcela Mafra, Maria Meritxell Roca Mora, Everton Castanha, Amanda Godoi, Andrés Valenzuela S","doi":"10.1016/j.transci.2024.104040","DOIUrl":"https://doi.org/10.1016/j.transci.2024.104040","url":null,"abstract":"<p><strong>Background: </strong>Cryoprecipitate-poor plasma (CPP) has been suggested as a promising alternative to the standard fresh frozen plasma (FFP) in plasma exchange therapy (TPE) for thrombotic thrombocytopenic purpura (TTP) given its lower concentrations of von Willebrand Factor (VWF). However, its efficacy and safety remain a topic of debate.</p><p><strong>Study design and methods: </strong>We conducted a systematic review and meta-analysis comparing CPP to FFP during TPE in patients with TTP. PubMed, Embase, and Cochrane Central were systematically searched for studies reporting outcomes of all-cause mortality, relapse rate, response to treatment, and the mean number of TPE sessions. Sensitivity analyses restricted to randomized controlled trials (RCTs) were performed. Review Manager v5.4 and RStudio v4.1.2 were used for statistical analysis. The protocol was prospectively registered in PROSPERO (ID CRD42023440665).</p><p><strong>Results: </strong>Eight studies, including three RCTs and five non-randomized studies, met the eligibility criteria. A total of 290 patients with TTP were included, of whom 144 (49.7 %) received CPP and 146 (50.3 %) received FFP. Use of CPP was associated with lower mortality (RR 0.41; 95 % CI 0.23-0.72; p = 0.002; I²=0 %), while the subgroup analysis restricted to RCTs showed no statistical difference between groups (p = 0.36). No significant differences were found in relapse rate, response to treatment, or mean number of TPE sessions between groups.</p><p><strong>Conclusion: </strong>Our findings show that the use of CPP is not inferior to FFP in TPE. Given the limited population, future clinical trials are needed to elucidate its benefits compared to FFP in patients with TTP.</p>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 1","pages":"104040"},"PeriodicalIF":1.4,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-25DOI: 10.1016/j.transci.2024.104038
Shijie Huang , Fei Han , Qishuo Zhang , WeiHao Hu , Kai Gao , Yang Xie
Tetanus, a severe illness caused by Clostridium tetani, entails symptoms such as muscle spasms and tissue necrosis due to the production of tetanus toxin and hemolysin, posing a grave risk to life. Plasma exchange is infrequently used in tetanus treatment due to limited reported cases, guidelines, the relative rarity of tetanus cases, the high cost and technical complexity of the treatment, and the need to carefully balance risks and benefits. In this case study, a 57-year-old male with a recent foot injury presented with classical tetanus symptoms, including lockjaw, neck stiffness, and lower limb hypertonicity. Upon admission, his condition deteriorated rapidly, leading to cardiac arrest. Following successful resuscitation, he was admitted to the ICU. The patient underwent plasma exchange due to persistent symptoms, ultimately showing partial functional recovery and being discharged for rehabilitation. Clinical evidence supports plasma exchange's ability to eliminate macromolecules, autoantibodies, immune complexes, cytokines, and inflammatory mediators from the body. Despite its uncommon use in tetanus infections, our patient's treatment with plasma exchange facilitated toxin removal and alleviated persistent symptoms. This case contributes to expanding our understanding and offers a novel therapeutic option for severe tetanus cases.
{"title":"Case report: Plasma exchange treatment in a patient with severe tetanus","authors":"Shijie Huang , Fei Han , Qishuo Zhang , WeiHao Hu , Kai Gao , Yang Xie","doi":"10.1016/j.transci.2024.104038","DOIUrl":"10.1016/j.transci.2024.104038","url":null,"abstract":"<div><div>Tetanus, a severe illness caused by Clostridium tetani, entails symptoms such as muscle spasms and tissue necrosis due to the production of tetanus toxin and hemolysin, posing a grave risk to life. Plasma exchange is infrequently used in tetanus treatment due to limited reported cases, guidelines, the relative rarity of tetanus cases, the high cost and technical complexity of the treatment, and the need to carefully balance risks and benefits. In this case study, a 57-year-old male with a recent foot injury presented with classical tetanus symptoms, including lockjaw, neck stiffness, and lower limb hypertonicity. Upon admission, his condition deteriorated rapidly, leading to cardiac arrest. Following successful resuscitation, he was admitted to the ICU. The patient underwent plasma exchange due to persistent symptoms, ultimately showing partial functional recovery and being discharged for rehabilitation. Clinical evidence supports plasma exchange's ability to eliminate macromolecules, autoantibodies, immune complexes, cytokines, and inflammatory mediators from the body. Despite its uncommon use in tetanus infections, our patient's treatment with plasma exchange facilitated toxin removal and alleviated persistent symptoms. This case contributes to expanding our understanding and offers a novel therapeutic option for severe tetanus cases.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 1","pages":"Article 104038"},"PeriodicalIF":1.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-23DOI: 10.1016/j.transci.2024.104036
Saira Bano , Inshal Jawed , Muhammad umair abdul qadir , Syed Ali Farhan Abbas Rizvi , Vikash Kumar Karmani , Farah Alam , Abdul Haseeb , Hina Khan , Agha Muhammad Wali Mirza , Naheed Akhtar , Abu Huraira Bin Gulzar , Khabab Abbasher Hussien Mohamed Ahmed
Introduction
Systemic sclerosis (SSc) is an autoimmune disorder with fibrosis in multiple organs, autoantibodies, and microvascular abnormalities. Its origin is unclear, but it may result from circulatory damage, collagen metabolism disruption, and modifications in immunoregulation. The disease affects various organs and has high morbidity and mortality rates. SSc-related complications are managed using immunosuppressive medications that target autoantibodies. The main objective of this study was to assess the safety and efficacy of plasma therapy/plasmapheresis in managing SSc.
Methods
This systematic review followed PRISMA and IMRAD guidelines, using PICO framework for study selection based on MeSH terms and Boolean operators. It included cross-sectional, randomized control trials, and clinical studies on plasma therapy for SSc. Standardized protocols were used for data extraction and risk of bias assessment.
Discussion
Plasma therapy is a growing treatment option for managing SSc with reported benefits, especially in early stages and specific organ complications. However, further investigation and standardized protocols are needed. This review explores the potential of plasma therapy in improving the quality of life for SSc patients and in combination with other treatments.
Result
The review analyzed 15 articles, including research papers, controlled trials, and case reports. Plasma therapy, involving Plasmapheresis and therapeutic plasma exchange (TPE), improved symptoms of SSc like Raynaud phenomenon, vasculitis, muscle dysfunction, and digital ulcers. However, outcomes varied among studies, and some advanced cases showed limited benefits.
Conclusion
Plasma therapy can be an effective way of managing the symptoms of systemic sclerosis with low incidence of adverse events. However, the exact mechanism behind this treatment is still unclear. Therefore, additional studies are required.
{"title":"Evaluating the safety and efficacy of plasma therapy/plasmapheresis for systemic sclerosis – A comprehensive systematic review","authors":"Saira Bano , Inshal Jawed , Muhammad umair abdul qadir , Syed Ali Farhan Abbas Rizvi , Vikash Kumar Karmani , Farah Alam , Abdul Haseeb , Hina Khan , Agha Muhammad Wali Mirza , Naheed Akhtar , Abu Huraira Bin Gulzar , Khabab Abbasher Hussien Mohamed Ahmed","doi":"10.1016/j.transci.2024.104036","DOIUrl":"10.1016/j.transci.2024.104036","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic sclerosis (SSc) is an autoimmune disorder with fibrosis in multiple organs, autoantibodies, and microvascular abnormalities. Its origin is unclear, but it may result from circulatory damage, collagen metabolism disruption, and modifications in immunoregulation. The disease affects various organs and has high morbidity and mortality rates. SSc-related complications are managed using immunosuppressive medications that target autoantibodies. The main objective of this study was to assess the safety and efficacy of plasma therapy/plasmapheresis in managing SSc.</div></div><div><h3>Methods</h3><div>This systematic review followed PRISMA and IMRAD guidelines, using PICO framework for study selection based on MeSH terms and Boolean operators. It included cross-sectional, randomized control trials, and clinical studies on plasma therapy for SSc. Standardized protocols were used for data extraction and risk of bias assessment.</div></div><div><h3>Discussion</h3><div>Plasma therapy is a growing treatment option for managing SSc with reported benefits, especially in early stages and specific organ complications. However, further investigation and standardized protocols are needed. This review explores the potential of plasma therapy in improving the quality of life for SSc patients and in combination with other treatments.</div></div><div><h3>Result</h3><div>The review analyzed 15 articles, including research papers, controlled trials, and case reports. Plasma therapy, involving Plasmapheresis and therapeutic plasma exchange (TPE), improved symptoms of SSc like Raynaud phenomenon, vasculitis, muscle dysfunction, and digital ulcers. However, outcomes varied among studies, and some advanced cases showed limited benefits.</div></div><div><h3>Conclusion</h3><div>Plasma therapy can be an effective way of managing the symptoms of systemic sclerosis with low incidence of adverse events. However, the exact mechanism behind this treatment is still unclear. Therefore, additional studies are required.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 1","pages":"Article 104036"},"PeriodicalIF":1.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-22DOI: 10.1016/j.transci.2024.104037
Giustina De Silvestro , Liviana Catalano , Giuseppe Marano , Vanessa Piccinini , Simonetta Pupella , Angelo Ostuni , Vincenzo De Angelis
The Italian Registry of Therapeutic Apheresis (IRTA) collects clinical data on patients undergoing therapeutic apheresis procedures throughout the national territory, with the main objective of improving the quality and safety of the care provided to the patient. Given the importance of centralizing the collection and analysis of information on therapeutic apheresis, the National Blood Center (NBC), at the request of the Italian Scientific Society of Hemapheresis and Cellular Manipulation (SIdEM), has included IRTA in the Information System of Transfusion Services (SISTRA), which is the information system of the Ministry of Health for the exchange of data on blood and its derivatives between the Italian Regions and the NBC. This manuscript reports IRTA activity data for 2023 maintaining the general approach introduced in previous manuscripts to facilitate comparison with already published activity data (2020–2022). For each therapeutic apheresis procedure (more than 15) we reported the number of procedures, the number of patients treated, and adverse effects. Furthermore, for each pathology belonging to more than 8 specialized clinical areas we reported the number of procedures, the number of patients treated, the number of patients at first diagnosis and the outcome of the patients. More than 36000 procedures in more than 8500 patients were included in the 2023 database. The aim of the IRTA 2023 activity data is to provide an updated snapshot of the use of therapeutic apheresis in the treatment of human diseases in Italy and a strategic resource for institutions and scientific societies.
{"title":"The Italian registry of therapeutic apheresis in SISTRA: Year of activity 2023","authors":"Giustina De Silvestro , Liviana Catalano , Giuseppe Marano , Vanessa Piccinini , Simonetta Pupella , Angelo Ostuni , Vincenzo De Angelis","doi":"10.1016/j.transci.2024.104037","DOIUrl":"10.1016/j.transci.2024.104037","url":null,"abstract":"<div><div>The Italian Registry of Therapeutic Apheresis (IRTA) collects clinical data on patients undergoing therapeutic apheresis procedures throughout the national territory, with the main objective of improving the quality and safety of the care provided to the patient. Given the importance of centralizing the collection and analysis of information on therapeutic apheresis, the National Blood Center (NBC), at the request of the Italian Scientific Society of Hemapheresis and Cellular Manipulation (SIdEM), has included IRTA in the Information System of Transfusion Services (SISTRA), which is the information system of the Ministry of Health for the exchange of data on blood and its derivatives between the Italian Regions and the NBC. This manuscript reports IRTA activity data for 2023 maintaining the general approach introduced in previous manuscripts to facilitate comparison with already published activity data (2020–2022). For each therapeutic apheresis procedure (more than 15) we reported the number of procedures, the number of patients treated, and adverse effects. Furthermore, for each pathology belonging to more than 8 specialized clinical areas we reported the number of procedures, the number of patients treated, the number of patients at first diagnosis and the outcome of the patients. More than 36000 procedures in more than 8500 patients were included in the 2023 database. The aim of the IRTA 2023 activity data is to provide an updated snapshot of the use of therapeutic apheresis in the treatment of human diseases in Italy and a strategic resource for institutions and scientific societies.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 1","pages":"Article 104037"},"PeriodicalIF":1.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Therapeutic plasma exchange (TPE) is generally well tolerated but Anticoagulant Citrate Dextrose Solution A (ACD-A) can cause citrate mediated hypocalcaemia so, adding calcium gluconate to the replacement fluid is effective in preventing this complication. We aimed to compare the effect of different concentrations of 10 % calcium gluconate (9.3 mg of elemental calcium/100 ml Vs 18.6 mg of elemental calcium/100 ml) added to 5 % Human Serum Albumin (HSA) on intraprocedural and post procedural ionised calcium (iCa2+) levels in patients with neurological conditions undergoing TPE.
Material and methods
This study comprised of 100 TPE procedures divided into two groups of 50 each. In group 1, 5 ml of 10 % calcium gluconate was added in 500 ml of 5 % HSA (9.3 mg of elemental calcium/100 ml) and in group 2, 10 ml of 10 % calcium gluconate was added (18.6 mg of elemental calcium/100 ml) in 5 % of HSA. Ionised calcium was noted-pre, intra and post-procedure and compared within the groups along with other procedural parameters and adverse events if any.
Results
We observed that mean intraprocedural ionised calcium levels were comparable (p = 0.579) in both the groups, but post-procedural iCa2+ levels significantly decreased (p = 0.003) in group-1 as compared to group-2. Symptomatic hypocalcaemia was seen in 14 % of patients group 1 compared to 2 % in group-2. Vasovagal reactions were 8 % in group-1 % and 2 % in group-2.
Conclusion
Prophylactic addition of 18.6 mg of elemental calcium/100 ml of 5 % HSA is safe to maintain levels of iCa2+ throughout the procedure with lower chances of adverse events related to hypocalcaemia.
{"title":"Comparison of different concentrations of calcium gluconate added in replacement fluid to maintain ionised calcium levels during therapeutic plasma exchange procedures","authors":"Nippun Prinja , Rekha Hans , Aarushi Sahni , Sangeeta Kumari , Preeti Paul , Divjot Singh Lamba , Aastha Takkar , Karthik Vinay Mahesh , Ratti Ram Sharma","doi":"10.1016/j.transci.2024.104039","DOIUrl":"10.1016/j.transci.2024.104039","url":null,"abstract":"<div><h3>Introduction</h3><div>Therapeutic plasma exchange (TPE) is generally well tolerated but Anticoagulant Citrate Dextrose Solution A (ACD-A) can cause citrate mediated hypocalcaemia so, adding calcium gluconate to the replacement fluid is effective in preventing this complication. We aimed to compare the effect of different concentrations of 10 % calcium gluconate (9.3 mg of elemental calcium/100 ml Vs 18.6 mg of elemental calcium/100 ml) added to 5 % Human Serum Albumin (HSA) on intraprocedural and post procedural ionised calcium (iCa2+) levels in patients with neurological conditions undergoing TPE.</div></div><div><h3>Material and methods</h3><div>This study comprised of 100 TPE procedures divided into two groups of 50 each. In group 1, 5 ml of 10 % calcium gluconate was added in 500 ml of 5 % HSA (9.3 mg of elemental calcium/100 ml) and in group 2, 10 ml of 10 % calcium gluconate was added (18.6 mg of elemental calcium/100 ml) in 5 % of HSA. Ionised calcium was noted-pre, intra and post-procedure and compared within the groups along with other procedural parameters and adverse events if any.</div></div><div><h3>Results</h3><div>We observed that mean intraprocedural ionised calcium levels were comparable (p = 0.579) in both the groups, but post-procedural iCa2+ levels significantly decreased (p = 0.003) in group-1 as compared to group-2. Symptomatic hypocalcaemia was seen in 14 % of patients group 1 compared to 2 % in group-2. Vasovagal reactions were 8 % in group-1 % and 2 % in group-2.</div></div><div><h3>Conclusion</h3><div>Prophylactic addition of 18.6 mg of elemental calcium/100 ml of 5 % HSA is safe to maintain levels of iCa2+ throughout the procedure with lower chances of adverse events related to hypocalcaemia.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 1","pages":"Article 104039"},"PeriodicalIF":1.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.transci.2024.104028
Benoit Jauniaux , Laura Burke , Nicola Snook , Marina Karakantza , Maria Kerr , Michelle Wilson , Alexandre Zougman , Mark Bellamy , Rosamonde E. Banks , Joanna Moore
Background & aims
Therapeutic plasma exchange (PEX) has shown potential in improving transplant-free survival in acute liver failure (ALF) however the mechanism of action is not understood. This exploratory study aimed to elucidate the circulating proteomic changes associated with PEX in ALF to provide insight into mechanisms underlying the benefit of this therapy.
Methods
Consecutive patients admitted with ALF between June 2019 and August 2020 were enrolled. Patients received either standard medical treatment (n = 5) or PEX (n = 5). Plasma samples were collected at multiple time points and analysed using the Olink Proximity Extension Assay. Comparative analyses included healthy controls and Octaplas batches.
Results
Biomarker results were available for 54 samples: Octaplas batches (n = 7), healthy controls (n = 6), ALF-standard medical treatment (n = 8), and ALF-PEX (n = 33). Proteomic analysis of 177 biomarkers revealed marked baseline differences between ALF and healthy controls, with ALF patients exhibiting lower levels of proteins secreted by the liver and higher levels of inflammatory cytokines and growth factors. Longitudinal analysis showed several distinct patterns with PEX. Proteins including carboxylesterase-1, hepatocyte growth factor, fetuin B, IL-6 and IL-10 showed differential expression patterns longitudinally, indicating some of the potential underlying mechanisms and therapeutic effects of PEX.
Conclusions
PEX in ALF patients leads to dynamic proteomic changes, reflecting its multifaceted role in modulating inflammation, liver regeneration and replacing essential proteins. These findings provide insight into some of the changes in circulating blood proteins and underlying mechanisms of PEX.
{"title":"Mechanistic insights from a pilot exploratory study of the dynamic proteomic changes during plasma exchange in patients with acute liver failure","authors":"Benoit Jauniaux , Laura Burke , Nicola Snook , Marina Karakantza , Maria Kerr , Michelle Wilson , Alexandre Zougman , Mark Bellamy , Rosamonde E. Banks , Joanna Moore","doi":"10.1016/j.transci.2024.104028","DOIUrl":"10.1016/j.transci.2024.104028","url":null,"abstract":"<div><h3>Background & aims</h3><div>Therapeutic plasma exchange (PEX) has shown potential in improving transplant-free survival in acute liver failure (ALF) however the mechanism of action is not understood. This exploratory study aimed to elucidate the circulating proteomic changes associated with PEX in ALF to provide insight into mechanisms underlying the benefit of this therapy.</div></div><div><h3>Methods</h3><div>Consecutive patients admitted with ALF between June 2019 and August 2020 were enrolled. Patients received either standard medical treatment (n = 5) or PEX (n = 5). Plasma samples were collected at multiple time points and analysed using the Olink Proximity Extension Assay. Comparative analyses included healthy controls and Octaplas batches.</div></div><div><h3>Results</h3><div>Biomarker results were available for 54 samples: Octaplas batches (n = 7), healthy controls (n = 6), ALF-standard medical treatment (n = 8), and ALF-PEX (n = 33). Proteomic analysis of 177 biomarkers revealed marked baseline differences between ALF and healthy controls, with ALF patients exhibiting lower levels of proteins secreted by the liver and higher levels of inflammatory cytokines and growth factors. Longitudinal analysis showed several distinct patterns with PEX. Proteins including carboxylesterase-1, hepatocyte growth factor, fetuin B, IL-6 and IL-10 showed differential expression patterns longitudinally, indicating some of the potential underlying mechanisms and therapeutic effects of PEX.</div></div><div><h3>Conclusions</h3><div>PEX in ALF patients leads to dynamic proteomic changes, reflecting its multifaceted role in modulating inflammation, liver regeneration and replacing essential proteins. These findings provide insight into some of the changes in circulating blood proteins and underlying mechanisms of PEX.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 1","pages":"Article 104028"},"PeriodicalIF":1.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.transci.2024.104025
Jerard Seghatchian
{"title":"Editorial commentary: The latest viewpoint on a statistical analysis of total analytical errors in diagnostic tools used for quantitative testing of medical devices in transfusion medicine & insights on the development of autoantibody isotypes to the Annexin A1 protein of the neutrophil in association with COVID-19-induced hyperinflammatory processes","authors":"Jerard Seghatchian","doi":"10.1016/j.transci.2024.104025","DOIUrl":"10.1016/j.transci.2024.104025","url":null,"abstract":"","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104025"},"PeriodicalIF":1.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.transci.2024.104027
Jean Amiral , Rémy Ferol , Matthias H. Busch , Sjoerd A.M.E.G. Timmermans , Chris Reutelingsperger , Pieter van Paassen
Annexin A1, a protein released by neutrophils, is a potent regulator of inflammation in the intact form, but loses this activity when cleaved. The presence of autoantibodies to this protein can impact its function. An immunoassay, developed to measure autoantibodies to Annexin A1 in plasma or serum, has been developed and performances are reported. The cut-off for the positive range is determined from the mean value and standard deviations measured in a healthy group. Anti-Annexin A1 autoantibodies were then tested in hospitalized COVID-19 patients, at baseline or at any time during hospitalization. Sixty-one out of 379 patients tested positive for at least one isotype, IgG, IgA, or IgM. Few patients presented with only 1 isotype (2 G, 12 A, 16 M), but the combination of 2 isotypes was observed in many of them, and 3 expressed the 3 isotypes all together. Some association was noted between the presence of these autoantibodies and the development of thrombosis or admission in Intensive Care Units. The specific clinical complication risk associated to each isotype is yet to be established as our study was mainly transversal. Complementary studies are required to better evaluate the diagnostic or prognostic values of the anti-Annexin A1 autoantibodies, which have already been reported in various clinical situations. They could potentially reduce the anti-inflammatory regulation potential of Annexin A1, a mechanism which could contribute to disease evolution and worsening.
{"title":"Laboratory measurement of autoantibodies to Annexin A1: Review and measurements in health and COVID-19","authors":"Jean Amiral , Rémy Ferol , Matthias H. Busch , Sjoerd A.M.E.G. Timmermans , Chris Reutelingsperger , Pieter van Paassen","doi":"10.1016/j.transci.2024.104027","DOIUrl":"10.1016/j.transci.2024.104027","url":null,"abstract":"<div><div>Annexin A1, a protein released by neutrophils, is a potent regulator of inflammation in the intact form, but loses this activity when cleaved. The presence of autoantibodies to this protein can impact its function. An immunoassay, developed to measure autoantibodies to Annexin A1 in plasma or serum, has been developed and performances are reported. The cut-off for the positive range is determined from the mean value and standard deviations measured in a healthy group. Anti-Annexin A1 autoantibodies were then tested in hospitalized COVID-19 patients, at baseline or at any time during hospitalization. Sixty-one out of 379 patients tested positive for at least one isotype, IgG, IgA, or IgM. Few patients presented with only 1 isotype (2 G, 12 A, 16 M), but the combination of 2 isotypes was observed in many of them, and 3 expressed the 3 isotypes all together. Some association was noted between the presence of these autoantibodies and the development of thrombosis or admission in Intensive Care Units. The specific clinical complication risk associated to each isotype is yet to be established as our study was mainly transversal. Complementary studies are required to better evaluate the diagnostic or prognostic values of the anti-Annexin A1 autoantibodies, which have already been reported in various clinical situations. They could potentially reduce the anti-inflammatory regulation potential of Annexin A1, a mechanism which could contribute to disease evolution and worsening.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104027"},"PeriodicalIF":1.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-26DOI: 10.1016/j.transci.2024.104026
Paulo Pereira
The performance assessment of quantitative measurements is predominantly based on evaluating Total Analytical Error (TAE). This evaluation encompasses several key objectives critical to ensuring accurate, reliable, and clinically relevant test results. Traditional parametric methods often fall short due to data normality assumptions in the performance assessment of in vitro diagnostic medical devices (IVD-MDs). This study presents a non-parametric approach to estimating and evaluating the TAE in transfusion medicine, aiming to enhance the reliability and patient safety of IVD-MDs. A protocol to estimate TAE over diverse data distributions is suggested, employing a robust statistical definition and comparative measurement procedures. Results from 200 samples indicate that non-parametric methods provided a more accurate reflection of TAE. The findings assert that non-parametric TAE estimation is vital for ensuring the 'fitness for purpose' of clinical tests in transfusion medicine, directly impacting post-transfusion outcomes and patient care. The study concludes that adopting non-parametric methods in transfusion services can significantly improve test accuracy, aligning with the highest laboratory practice standards.
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Pub Date : 2024-10-23DOI: 10.1016/j.transci.2024.104023
Gail Rock
{"title":"People, places and things: The new WAA board","authors":"Gail Rock","doi":"10.1016/j.transci.2024.104023","DOIUrl":"10.1016/j.transci.2024.104023","url":null,"abstract":"","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"63 6","pages":"Article 104023"},"PeriodicalIF":1.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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