Multifactorial aspects of antibody-mediated blood cell destruction

摘要: The research described in this thesis focuses on diseases of antibody-mediated blood cell destruction via FcγRs phagocytes, particular regarding platelets fetal or neonatal alloimmune thrombocytopenia (FNAIT) and red cells (RBC) hemolytic disease the fetus newborn (HDFN). Diagnostically, for HDFN laboratory tests are place order to predict risk severe RBC thereby initiate appropriate treatments. This test is sensitive, but has relatively low specificity. For FNAIT, no diagnostic currently available platelet destruction. FNAIT it been suggested that decrease numbers determined by antibody titer, correlation does not appear be strict. indicates other factors, besides antibody-titer involved as such C-reactive protein (CRP) anti-platelet IgG-fucosylation identified. CRP, which bound after platelet-oxidation, enhanced both vitro vivo was found elevated immune thrombocytopenic patients. CRP levels dropped IVIg-treatment, accompanied normalization counts decreased clinical bleeding severity. A Fc-fucosylation observed anti- antibodies (and total IgG), resulted increased binding affinity FcγRIIIa/b, phagocytosis, correlated with also an adverse scenario. data need validated larger patient cohorts, monitoring promising potential. lowered anti-RBC (anti-D) pregnancy, hemolysis a small pilot-study, however more needed. anti-D Fc-fucose occurred male hyperimmunized donors (although lesser extent than pregnant women), indicating regulation fucosylation strictly dependent upon pregnancy setting. implications antibody-fucosylation immunoprophylaxis, derived from donors, discussed.