IN VITRO در شرايط PH,ABO توليدشده در ناسازگاريهاي خوني ناشي از گروههاي TNF ارزيابي

Assessment of TNF Production During Transfusion of Incompatible ABO and Rh Blood Groups

In spite of advances in blood transfusion medicine, the pathophysiology of hemolytic transfusion reactions which can produce adverse consequences and death, are not exactly understood. In recent years the role of cytokines in this regard has been the scope of several investigations. Considering the similarity between clinical symptoms of hemolytic transfusion reactions and septic shock, and the key role of tumor necrosis factor (TNF) in septic shock, TNF secretion during or after hemolytic transfusion reactions and the biological importance of this cytokine is import. In this study two in vitro models, one for IgM (ABO incompatibility) and one for IgG (Rh incompatibility) were studied and the induction of TNF secretion by exposure of normal monocytes with sensitized RBCs was investigated. The secreated TNF was measured by bioassay using a TNF-sensitive cell line, L929. Our results showed that in both models, TNF was secreted in response to exposure of monocyte monolayer with antibody coated RBCs. The amount of TNF was significantly different with control wells in which the monocyte monolayer was exposed with unsensitized RBCs. on the other hand, TNF secretion in the IgM model (40960 U/ml) was greater compared with the IgG model (1280 U/ml) and the difference was statistically significant. This suggests that in both kinds of hemolytic reactions the attachment of antibodies to RBC surfaces and exposure of the reticuloendothelial system mononuclear phagocytes with sensitized RBCs results in considerable TNF production. The increases in serum TNF is responsible for at least some of the clinical symptoms seen in post-tranfusion reactions.