A synergistic effect of albumin and fibrinogen on immunoglobulin-induced red blood cell aggregation
A synergistic effect of albumin and fibrinogen on immunoglobulin-induced red blood cell aggregation
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DOI：
10.1152/ajpheart.00128.2003
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发表时间：
2003-12-01
影响因子：
4.8
通讯作者：
Berliner, S
中科院分区：
文献类型：
--
作者：
Ben-Ami, R;Barshtein, G;Berliner, S
免疫球蛋白 (Ig) 的治疗性给药有可能引发血栓事件。这种现象可以用红细胞 (RBC) 聚集来解释，而 Ig 可以增强红细胞聚集。血浆白蛋白和纤维蛋白原对 Ig 诱导的红细胞聚集的贡献尚不清楚。我们检查了三种情况下的红细胞聚集情况：1）接受 Ig 治疗性输注的患者； 2)接受体外补充Ig血浆的患者； 3) 患者接受含不同浓度白蛋白、Ig 和纤维蛋白原的标准缓冲液中的红细胞悬浮液。 Ig输注增强了血浆白蛋白水平正常或高的患者的红细胞聚集，但血浆白蛋白浓度较低的患者的聚集减少。在体外，仅当悬浮液中所有三种成分（纤维蛋白原、白蛋白和 Ig）都以正常浓度或高于正常浓度存在时，红细胞聚集才会显着增加，而当悬浮液中不存在任何一种成分时，红细胞聚集不受影响。我们的结果表明纤维蛋白原、Ig 和白蛋白之间存在三向相互作用，协同诱导血浆中红细胞聚集。了解这些相互作用可能有助于预测与红细胞聚集相关的临床重要现象，例如 Ig 输注的血栓并发症。
Therapeutic administration of immunoglobulins (Ig) has the potential to precipitate thrombotic events. This phenomenon may be explained by red blood cell (RBC) aggregation, which can be potentiated by Ig. The contribution of plasma albumin and fibrinogen to Ig-induced RBC aggregation is unclear. We examined RBC aggregation in three settings: 1) patients receiving therapeutic infusions of Ig; 2) patients receiving plasma supplemented in vitro with Ig; and 3) patients receiving RBC suspensions in standard buffer with varying concentrations of albumin, Ig, and fibrinogen. Ig infusion augmented aggregation of RBCs from patients with normal or high plasma levels of albumin but decreased aggregation in those with lower plasma albumin concentrations. In vitro, RBC aggregation was significantly increased only when all three components, fibrinogen, albumin, and Ig, were present at or above normal concentrations in the suspension but was unaffected when any one of the components was absent from the suspension. Our results suggest a three-way interaction among fibrinogen, Ig, and albumin that synergistically induces RBC aggregation in plasma. Understanding these interactions may help predict clinically important phenomena related to RBC aggregation, such as thrombotic complications of Ig infusion.