Role of complement in alloimmunization and hyperhemolysis.
Role of complement in alloimmunization and hyperhemolysis.
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DOI：
10.1097/moh.0000000000000610
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发表时间：
2020-11
影响因子：
3.2
通讯作者：
Stowell SR
中科院分区：
文献类型：
--
作者：
Chonat S;Mener A;Verkerke H;Stowell SR
本综述的目的是总结补体在调节不相容红细胞（RBC）输血后靶异体抗原的清除，红细胞异体抗原暴露后异体抗体的形成以及镰状细胞性贫血患者高溶血的发展中的作用。最近的研究表明，补体可以加速异体抗体介导的靶异体抗原在不相容输血后从红细胞表面清除。补体也影响同种异体免疫反应过程中同种异体抗原的可用性，并作为红细胞同种异体抗原暴露后CD4 T细胞不依赖的同种异体抗体形成的独特介质。最后，替代补体激活似乎在镰状细胞性贫血患者急性溶血发作的发展中起关键作用，为预防镰状细胞性贫血患者的急性并发症提供了潜在的可药物靶点。最近的研究表明，补体可以调节多种与血液学相关的过程，从输血并发症到镰状细胞性贫血患者的基线溶血。随着补体在各种疾病过程中的作用得到更充分的了解，利用最近开发的补体调节药物的能力只会继续增强提供者对许多血液系统疾病进行有利干预的能力。
The purpose of this review is to summarize the role of complement in regulating the removal of a target alloantigen following an incompatible red blood cell (RBC) transfusion, the formation of alloantibodies following RBC alloantigen exposure, and the development of hyperhemolysis in patients with sickle cell anemia. Recent studies demonstrate that complement can accelerate alloantibody-mediated removal of target alloantigens from the RBC surface following incompatible transfusion. Complement also influences alloantigen availability during developing alloimmune responses and serves as a unique mediator of CD4 T cell-independent alloantibody formation following RBC alloantigen exposure. Finally, alternative complement activation appears to play a key role in the development of acute hemolytic episodes in patients with sickle cell anemia, providing a potential druggable target to prevent acute complications in patients with this disease Recent studies suggest that complement can regulate a wide variety of processes germane to hematology, from transfusion complications to baseline hemolysis in patients with sickle cell anemia. As the role of complement in various disease processes becomes more fully understood, the ability to leverage recently developed complement modulating drugs will only continue to enhance provider’s ability to favorable intervene on many hematological diseases.