The treatment of blood components with ultraviolet-B irradiation
The treatment of blood components with ultraviolet-B irradiation
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DOI：
10.1111/j.1423-0410.1998.tb05395.x
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发表时间：
1998-01-01
期刊：
影响因子：
2.7
通讯作者：
Pamphilon, DH
中科院分区：
文献类型：
--
作者：
Pamphilon, DH
血液学疾病导致骨髓衰竭的患者接受多次输血产品，并经常产生针对白细胞和血小板上发现的I类人类白细胞抗原的同种异体抗体。对人类白细胞抗原的同种异体免疫可能导致对未选择的血小板的进一步输注无效。现在人们意识到，在血小板悬液中发现的表达HLAI1类抗原的白细胞是诱导同种异体免疫所必需的；在动物研究中，纯血小板悬液不会诱导同种异体抗体的形成，血液产品的过滤大大降低了同种异体免疫和难治性的发生率。[1]紫外线照射已被证明降低了淋巴细胞对同种异体抗原和有丝分裂原的增殖反应，研究人员已经证明，照射浓缩血小板(PC)可以使血小板本身保持可接受的功能，而PC中含有的剩余白细胞的增殖反应被取消。因此，UV-B辐射可作为减少或防止血小板输注后同种异体免疫的手段来替代白血球耗竭。本文简要讨论了紫外线辐射的物理效应和生物活性。它描述了UV-B辐射的体外效应，特别是对白细胞和血小板的影响，并回顾了临床数据，其中研究了UV-B辐射的PC以评估其止血效果以及对同种异体免疫和耐受性的影响。
Patients with haematological disorders resulting in bone marrow failure receive multiple transfusions of blood products and frequently develop alloantibodies against the class I HLA antigens found on both leucocytes and platelets. Alloimmunisation to HLA may lead to refractoriness to further transfusions of unselected platelets. It is now appreciated that the leucocytes expressing HLA class I1 antigens, found in platelet suspensions, are required to induce alloimmunisation; pure platelet suspensions do not induce the formation of alloantibodies in animal studies and filtration of blood products significantly reduces the incidence of alloimmunisation and refractoriness.[1] UV irradiation has been shown to reduce the proliferative responses of lymphocytes to alloantigens and mitogens and investigators have shown that it is possible to irradiate platelet concentrates (PCs) so that the platelets themselves retain acceptable function whilst the proliferative responses of residual leucocytes contained within PCs were abolished. UV-B irradiation might therefore be employed as an alternative to leucodepletion as a means of reducing or preventing alloimmunisation following platelet transfusions. This brief paper discusses the physical effects and biological activity of UV-irradiation. It describes the in vitro effects of UV-B irradiation in particular on leucocytes and platelets and reviews clinical data where PCs irradiated with UV-B have been studied to evaluate their haemostatic efficacy and impact on alloimmunisation and refractoriness.