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Blood, Vol. 93 No. 5 (March 1), 1999:
pp. 1770-1777
Soluble HLA Class I, HLA Class II, and Fas Ligand in Blood
Components: A Possible Key to Explain the Immunomodulatory
Effects of Allogeneic Blood Transfusions
M. Ghio,
P. Contini,
C. Mazzei,
S. Brenci,
G. Barberis,
G. Filaci,
F. Indiveri, and
F. Puppo
From the Department of Internal Medicine, University of Genoa; and
the Blood Center, S. Corona Hospital, Pietra Ligure, Italy.
The immunomodulatory effect of allogeneic blood transfusions (ABT)
has been known for many years. However, a complete understanding of the
effects of ABT on the recipient's immune system has remained elusive.
Soluble HLA class I (sHLA-I), HLA class II (sHLA-II), and Fas ligand
(sFasL) molecules may play immunoregulatory roles. We determined by
double-determinant immunoenzymatic assay (DDIA) sHLA-I, sHLA-II, and
sFasL concentrations in different blood components. sHLA-I and sFasL
levels in red blood cells (RBCs) stored for up to 30 days and in
random-donor platelets are significantly (P < .001) higher
than in other blood components and their amount is proportionate to the
number of residual donor leukocytes and to the length of storage. Blood
components with high sHLA-I and sFasL levels play immunoregulatory
roles in vitro as in allogeneic mixed lymphocyte responses (MLR) and
antigen-specific cytotoxic T-cell (CTL) activity, and induce apoptosis
in Fas-positive cells. These data suggest that soluble molecules in
blood components are functional. If these results are paralleled in
vivo, they should be taken into account in transfusion practice. Blood
components that can cause immunosuppression should be chosen to induce
transplantation tolerance, whereas blood components that lack
immunosuppressive effects should be preferred to reduce the risk of
postoperative complications and cancer recurrence.
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