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Biomedical subjects

E G Reisner

Publications and source records attributed to E G Reisner.

At least 19 recordsLinked to original sources
PubMed1997

Ethical issues in umbilical cord blood banking. Working Group on Ethical Issues in Umbilical Cord Blood Banking.

OBJECTIVE: Banking umbilical cord blood (UCB) to be used as a source of stem cells for transplantation is associated with a set of ethical issues. An examination of these issues is needed to inform public policy and to raise the awareness of prospective parents, clinicians, and investigators. PARTICIPANTS: Individuals with expertise in anthropology, blood banking, bone marrow transplantation, ethics, law, obstetrics, pediatrics, and the social sciences were invited to join the Working Group on Ethical Issues in Umbilical Cord Blood Banking. EVIDENCE: Members were assigned topics to present to the Working Group. Following independent reviews, background materials were sent to the Working Group. CONSENSUS PROCESS: Individual presentations of topics at a 2-day meeting were followed by extensive group discussions in which consensus emerged. A writing committee then drafted a document that was circulated to the entire Working Group. After 3 rounds of comments over several months, all but 1 member of the Working Group agreed with the presentation of our conclusions. CONCLUSIONS: (1) Umbilical cord blood technology is promising although it has several investigational aspects; (2) during this investigational phase, secure linkage should be maintained of stored UCB to the identity of the donor; (3) UCB banking for autologous use is associated with even greater uncertainty than banking for allogeneic use; (4) marketing practices for UCB banking in the private sector need close attention; (5) more data are needed to ensure that recruitment for banking and use of UCB are equitable; and (6) the process of obtaining informed consent for collection of UCB should begin before labor and delivery.

Biomedical Research↗
PubMed1995

Ethical aspects of banking placental blood for transplantation.

Transplantation of blood cells harvested from the umbilical cord immediately after birth has been effective in repopulating the bone marrow. These placental blood transplantations may be safer than conventional bone marrow transplantations and may suspend the need to harvest bone marrow, a process fraught with difficulties. Further understanding and advancement of this emerging technology require developing large banks of placental blood. In this article, we examine some of the ethical issues associated with placental blood banking, including (1) questions about ownership of the tissue, (2) the necessity and nature of obtaining informed consent from parents for harvesting placental blood and the information-gathering process associated with it, (3) obligations to notify parents and children of the results of medical testing for infectious diseases and genetic information, (4) matters of privacy and confidentiality related to such information, and (5) the need for fair and equitable harvesting of and access to placental blood.

Blood Banks↗
PubMed1988

Tests of genetic markers on aborted fetal material.

Women who conceive as a result of rape often elect to abort the fetus. We describe twelve cases where genetic markers were tested on the aborted fetal material to provide evidence of the genetic constitution of the rapist. Two cases are presented in detail, and the problems encountered with the testing are discussed.

Abortion, Induced↗
PubMed1987

Alloantibody responses in multiply transfused sickle cell patients.

Fifty-six adult and 15 pediatric black patients with sickle cell disease were studied to determine their antibody responses to repeated transfusions of red cells. Red cell antibodies were determined retrospectively; anti-lymphocyte antibodies (class I and II) were determined on the single, most recently drawn blood sample. All adults were HLA-A, B, C, DR and DQ typed. Ten percent of the individuals with less than 50 transfusions, but greater than 50% with 100 transfusions or more, had red cell antibodies. The percentage of patients producing anti-red cell antibodies increased consistently with the number of transfusions (p = 0.0062). Women were more likely to become sensitized to red cell antigens than men (p = 0.008), and nulliparous women more likely than multiparous women. Children were also sensitized to red cell antigens (20%), and to a high degree to lymphocyte antigens (73%). No HLA association was found with increased propensity to red cell sensitization. A weak association of HLA DR5 and DR7 with failure to become sensitized to lymphocyte alloantigens was observed, but did not reach statistical significance. Our results suggest that, while genetic factors influencing transfusion response almost certainly exist, other factors such as number of transfusions, age, sex and parity need to be examined to provide accurate projections of risk in chronic transfusion.

Age Factors↗
PubMed1985

The effect of differences in gene frequency on probability of paternity.

Knowledge of gene frequencies in populations is required for the calculation of probability of paternity. The question remains open as to the degree of accuracy of gene frequency estimates required to give accurate probability of paternity figures. This is of special concern in the HLA system, which has haplotype frequencies known to vary in populations. This paper presents computer simulation data comparing probability of paternity calculations using HLA data from California and North Carolina. Comparisons were made between geographic regions, and between blacks and whites within a geographic region. It was found that when the absolute probability of paternity is high, the average differences induced were small, but at lower probabilities the changes can be large. Differences were most pronounced between black and white populations. Examples of individual cases are given to illustrate the huge differences that can be induced in some cases by changing gene frequency.

Child↗
PubMed1984

Three new phenotypes of human red cell acid phosphatase: ACP1FA, ACP1GA, and ACP1GB.

Three new phenotypes of human erythrocyte acid phosphatase (ACP1) have been detected and found to be unique by direct comparison with previously identified ACP1 variants. One of these new electrophoretic variants, labeled as ACP1FA, has been detected in the Hispanic population of California. The electrophoretic variants identified as ACP1GA and ACP1GB have been detected in a black family in North Carolina. A family study has shown that ACP1G is transmitted as an allele of ACP1.

Acid Phosphatase↗
PubMed1984

The use of radiolabeled and fluorescein-labeled antiglobulins in assays to predict platelet transfusion outcome.

We used both radiolabeled and fluorescein-labeled antiglobulins in assays to detect antibodies against platelets in multiply transfused patients to determine the value of these tests in predicting the outcome of platelet transfusion in such patients. In 15 allosensitized patients, we studied 68 single-donor platelet transfusions, 43 (63%) of which had a poor outcome, defined as a corrected count increment (CCI), less than 10,000. The results obtained with either test were significantly correlated with the CCI following transfusion (p less than 0.001), but the assay using the radiolabeled antiglobulin had slightly better sensitivity, specificity, and predictive value. When the assays were used in combination, there was again significant correlation with the CCI of the transfusion, p less than 0.001. When both assays predicted failure of the transfusions, 31/31 (100%) such transfusions resulted in a CCI of less than 10,000, and when both assays predicted success of the transfusions, 14/15 (93%) such transfusions resulted in a CCI of greater than 10,000. Both assays are useful in predicting the outcome of the platelet transfusions; when the assay results were concordant, almost total predictive accuracy was obtained.

Adolescent↗
PubMed1983

HLA-B15 association with erythema multiforme.

Erythema multiforme (EM) is a cutaneous reaction pattern which follows numerous infections, drugs, neoplastic and inflammatory disorders in some individuals. We undertook a prospective study of thirty-eight HLA specificities of the -A, -B, and -C series in 16 Caucasian patients with EM and in 140 local Caucasian controls. Seven of 16 patients (44%) with EM and 5 of 9 patients (55%) with EM following herpes simplex infections possessed the HLA-B15 antigen, compared to 7% of local controls and 11.6% of the 1980 WHO Workshop Caucasian controls. Both associations were highly significant (p = 0.0125 and p = 0.02) when corrected for 38 HLA antigens. This is the first reported HLA association for erythema multiforme, a disease which may be a host-specific immune response to various antigens, determined in part by genes linked to HLA-B15.

Erythema Multiforme↗
PubMed1983

Studies of random Black and White populations in North Carolina: hla antigen profile.

As HLA testing is becoming a major vehicle for parentage determination with non-excluded, alleged fathers being compared to their racial peers, it is important to ensure that the population data used accurately reflect the genetic profile of the region from which the alleged fathers are drawn. This paper presents data on the HLA profile of Black and White residents of North Carolina. Significant differences were observed for certain antigens when the North Carolina data were compared to nationally derived population tables. Differences were observed for B7 (increase) and Bw16 (decrease) in Whites and A10 (decrease), B7 (increase) and Bw42 (decrease) in Blacks. Internal controls comparing the testing from the two participating centers showed complete agreement for White persons, but a significant difference for B5 between the two Black populations.

Adult↗
PubMed1983

A feasibility study of human leukocyte antigen (HLA) typing for dried bloodstains.

This paper constitutes a feasibility report on the use of the human leukocyte antigen (HLA) system for the typing of dried bloodstains. Antigens tested include the HLA-A2, A3, A10, B7, B8, and B14 alleles. An aging study conducted on A3 positive bloodstains showed that HLA-A3 could be reliably detected on bloodstains stored up to 30 days at 22 degrees C. Unlike most earlier reports on HLA typing of bloodstains, no cross-reactivity problems were detected with the antisera used in this study. In addition to the successful typing of bloodstains, we were also able to type fresh, neat seminal and saliva stains in the A2 and A10 antigenic systems.

Blood Grouping and Crossmatching↗
PubMed1982

Description of monoclonal antibody defining an HLA allotypic determinant that includes specificities within the B5 cross-reacting group.

The selection and characterization of a cloned murine monoclonal antibody (4D12) that defines an HLA allotypic determinant is described. Antibody 4D12 immunoprecipitates HLA heavy and light chains. From studies on 4D12 reactivity with a large panel of well-characterized target cells, antibody 4D12 defines a public HLA determinant that includes specificities within but not identical to the B5 cross-reacting group. Antibody 4D12 should be useful in the study of HLA-B5--related supratypic antigens.

Animals↗
PubMed1981

Problems arising from the use of the HLA system in paternity testing.

Characterization of the HLA antigens present on lymphocytes has become an important procedure in paternity testing. This paper presents data on two cases in which the HLA antigens exhibited by the mother, child and alleged father were consistent with paternity but where the other genetic markers clearly showed exclusion of paternity. The use of HLA data alone to calculate probability of paternity in these two cases produced misleading figures. Caution must be exercised in using HLA results to calculate the probability of paternity, especially when there is reason to believe that the alleged and natural fathers are relatives.

Female↗
PubMed1980

Complement sensitivity of paroxysmal nocturnal hemoglobinuria bone marrow cells.

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired disorder in which erythrocytes, granulocytes, and platelets are defective, as shown by increased susceptibility of RBCs, WBCs, and platelets to complement-mediated lysis in vitro. The purpose of this study is to determine the sensitivity to complement lysis of PNH and non-PNH erythroid and myeloid precursors using the release of 59Fe and myeloperoxidase as specific markers to monitor the lytic action of complement on erythroid and myeloid cell precursors, respectively. Erythroid cell precursors in four of four PNH patients demonstrated increased sensitivity to complement-mediated lysis. Myeloid cell precursors in four of five PNH patients also exhibited increased sensitivity to complement and antibody. In addition, CFU-c growth was below normal in the marrow of seven PNH patients. These findings support the hypothesis that the defect in PNH occurs at the level of the hematopoietic stem cell.

Adult↗
PubMed1976

Isoelectric focusing of an anti-HL-A2 antiserum cross-reacting with W28.

The cytotoxicity activity of an anti-HL-A2 antiserum cross-reactive with W28 appeared in three distinct peaks after the serum was subjected to isoelectric focusing. The pH at which the peaks formed was reproducible using pH 5-8 or pH 3.5-10 gradients. Anti-HL-A2 activity occurred in each peak, but the cross-reactive anti-W28 cytotoxicity appeared to be largely confined to the second and third peaks. The first peak was exclusively IgG, the second contained IgG and IgM, and the third contained IgG, IgA, and IgM.

Cross Reactions↗