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M Marrari

Publications and source records attributed to M Marrari.

At least 19 recordsLinked to original sources
PubMed1997

Determination of HLA-A,B residue mismatch acceptability for kidneys transplanted into highly sensitized patients: a report of a collaborative study conducted during the 12th International Histocompatibility Workshop.

BACKGROUND: During the 12th International Histocompatibility Workshop, a collaborative study between 35 laboratories was conducted on a group of highly allosensitized patients who had received a kidney transplant from 1981 to 1995. The major goal of the study was to assess how serum screening against a large cell panel could determine donor HLA mismatch acceptability in relation to graft outcome. METHODS: Twenty laboratories participated in an extensive screening of 92 high panel-reactive antibody (PRA) sera from patients at 29 transplant centers worldwide; each patient had received a kidney allograft from an HLA-A,B mismatched unrelated donor. Screening was done by complement-dependent lymphocytotoxicity and antihuman globulin augmentation techniques using a common protocol and shared standardized reagents. After an extensive quality-control assessment, we selected data from 14 participants who had screened the sera against a combined panel of 535 HLA-typed cells. RESULTS: With the 2x2 table-based Multiscreen computer program, we could readily determine for virtually every patient the significant correlations between serum reactivity and the presence of panel cell markers, including private and public HLA-A,B epitopes and amino acid residues assigned from published sequencing data. Donor mismatch acceptability was assessed at the amino acid residue level. In the complement-dependent lymphocytotoxicity (n=49; PRA=84.1+/-12.1%) and antihuman globulin (n=60; PRA=92.5+/-5.8%) groups, the 3-month graft survivals were 28% and 30% lower for unacceptable residue mismatches. CONCLUSIONS: These studies underscore the importance of a comprehensive serum screening analysis in the selection of appropriately mismatched donors for highly sensitized transplant patients.

Antibody Specificity↗
PubMed1997

Multicenter evaluation of the flow cytometry T-cell crossmatch: results from the American Society of Histocompatibility and Immunogenetics-College of American Pathologists proficiency testing program.

BACKGROUND: The performance characteristics and interlaboratory comparisons of the T-cell flow cytometry crossmatch remain largely unknown. METHODS: This study was performed using data from the ASHI-CAP proficiency testing program. Four unknown sera and two unknown cells were sent to participating laboratories twice a year for 4 years. RESULTS: In one survey in which different crossmatch techniques were compared, flow cytometry was slightly more sensitive than the antiglobulin method and considerably more sensitive than direct cytotoxicity. However, the proportion of participants in any given survey detecting antibodies in all sera expected to be positive was 50-60% and has not changed over the years. Failure to detect antibodies correlated with low antibody concentration, diluting the unknown serum by the testing laboratory, and with the instrument used. False positive results with normal sera were infrequent. Fluorescence intensity values were not standardized and were highly variable, but when fluorescence units reported by individual laboratories were divided by their own positive-negative cutoff values, results from different centers were more comparable. In general, fluorescence-to-cutoff ratios >5 correlated with complement binding activity, whereas values <5 denoted concentrations below those required to fix complement. CONCLUSIONS: Flow cytometry, as used by most centers, is highly sensitive and allows relative antibody quantitation. Furthermore, the data define objective parameters that may help to standardize the test and improve its predictive value in clinical transplantation.

Antibodies↗
PubMed1994

Progress report on the ASHI/CAP Proficiency Survey Program in Histocompatibility Testing. I. HLA-A,B,C typing, antibody screening, and lymphocytotoxicity crossmatching. American Society for Histocompatibility and Immunogenetics. College of American Pathologists.

The Histocompatibility Survey Program was organized in 1982 as a joint project by the ASHI and CAP to evaluate laboratory performance in HLA typing, lymphocytotoxicity crossmatching, and antibody analysis. This report summarizes the experience with the HS surveys on HLA class I serology. During a 12-year period, the number of participating laboratories increased from 150 to 285 and HLA typing was done with 90 survey specimens representing 20 HLA-A and 35 HLA-B antigens. Most unsplit antigens were correctly identified in more than 90% of the laboratories. For many antigens, a high percentage of participants reported a split and there was generally a high consensus of a correct assignment. Nevertheless, several antigens were difficult to define, as shown by low consensus rates. During recent years, the assignments of Bw4/6 and HLA-C antigens have significantly improved. Lymphocytotoxicity crossmatching was analyzed for 138 cell-serum combinations tested by an average of 143 laboratories. Comparisons between four techniques (basic NIH, Amos modified, LI, and AHG) showed consistent results (greater than 90% crossmatch compatibility or incompatibility) for 71% of the cell-serum combinations. The crossmatch results with the remaining combinations were more variable for one or more of the crossmatch techniques. Serum antibody identification showed a continued improvement during recent years, and the average consensus for assigning acceptable antibody specificity reached 88%. A performance grading system based on a 90% consensus rate among participants is used to satisfy requirements for laboratory accreditation.

Cytotoxicity Tests, Immunologic↗
PubMed1994

Progress report on the ASHI/CAP Proficiency Survey Program in Histocompatibility Testing. II. HLA-DR, DQ serologic typing, antibody identification, and B-cell crossmatching. American Society for Histocompatibility of Immunogenetics. College of American Pathologists.

This report summarizes the 8-year experience of the DR survey program designed to evaluate the performance of histocompatibility laboratories in the serologic typing of cell specimens for HLA-DR and HLA-DQ polymorphisms and the HLA class II antibody identification and B-cell crossmatching of serum specimens. The number of participants increased from 45 in 1985 to 214 in 1992. Although the performance criteria are based on laboratory consensus, the availability of DNA typing since 1990 has enabled a critical assessment of the reliability of serologic HLA-DR, DQ typing. The survey results shows that unsplit HLA class II antigens DR1-DR8, DR52/53, and DQ1-3 are generally correctly identified in over 90% of the participating laboratories. DR9 and DR10 have not yet been tested and testing for DQ4 has not yet achieved this level on consensus. In contrast, the assignments of serologic subtypes of HLA-DR and HLA-DQ are less consistent and frequently unreliable. Although the B-cell crossmatches show generally high laboratory consensus rates, the serum screening results show frequently inconsistent results regarding HLA class-II-specific antibody identification.

Antibody Specificity↗
PubMed1991

Intravenous gamma globulin decreases platelet-associated IgG and improves transfusion responses in platelet refractory states.

In an attempt to improve platelet transfusion responses, intravenous immunoglobulin (IV-IgG) was administered to 19 patients who were refractory to random and best available HLA-matched platelets. A response to IV-IgG was defined as two or more successive transfusions of HLA-matched products that provided recoveries greater than 30%. Thirteen of 19 (68%) patients responded to therapy at a median time of 7 days after initiation of IV-IgG (range = 2-17). Baseline platelet associated IgG levels (PalgG) were elevated in both the responders (61.6 +/- 76.2) (mean +/- SD) and the non-responders (47.0 +/- 46.3 fg/plt). Post-therapy, PalgG levels remained unchanged in the nonresponders but were decreased significantly (p = 0.05) to 11.1 +/- 6.2 fg/plt in the responders. The latter levels were similar to those (11.6 +/- 8.2 fg/plt) measured in a series of 36 transfusion responsive patients. This apparent decline in PalgG was not explained by differences in lymphocytotoxic antibodies (LCT-Ab) after therapy. Moreover, a high degree of alloimmunization was associated with a poorer response to IgG. Only two of eight patients with LCT panel-reactive antibody (PRA) of greater than 85% were responders. By contrast, improved transfusion outcomes were seen uniformly in patients with PRA greater than or equal to 85%. Improved recoveries were obtained using LCT-Ab compatible but not incompatible platelets. The median increment (% predicted) with compatible platelets before therapy was 6.0 +/- 9.9 (SD). Post-IgG, median recoveries were 37.0 +/- 31.2 percent, P less than 0.001. These findings suggest that IV-IgG may alter destructive mechanisms that affect the survival of compatible platelets in refractory patients.

Antibodies↗
PubMed1990

A1, Cw7, B8, DR3 HLA antigen combination associated with rapid decline of T-helper lymphocytes in HIV-1 infection. A report from the Multicenter AIDS Cohort Study.

108 seropositive homosexual men were examined for associations between HLA phenotype and progression of human immunodeficiency virus type 1 (HIV-1) infection. Among men of predominantly European ethnic origin, 49 with very rapid 2-year declines in CD4+ lymphocyte counts showed significant differences in antigen frequencies from 59 men matched for ethnic background, study centre, and initial CD4+ cell count but with little or no decline in CD4+ cells. Relations of varying strength (odds ratios 6.1-10.3) were seen with several HLA antigens often linked in the A1-Cw7-B8-DR3 haplotype. The strongest relation was with the A1, Cw7, B8 combination (odds ratio 10.3). Associations between these antigen combinations and development of AIDS were weaker. The frequency of HLA A24 was also significantly higher in rapid than in slow decliners (odds ratio 4.3). These findings strengthen the suggested link between the product of a gene in the A1-Cw7-B8-DR3 haplotype and HIV-1-related disease.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Alloreactive T-cell recognition of two DQ beta allelic specificities associated with DQw1.

Two sets of alloreactive T-cell clones from different original mixed lymphocyte reactions (MLR) discriminate between two DQ beta allelic forms when these are expressed in association with the same DQ alpha form. From these results we concluded that it is possible to guide a DQ specific response of alloreactive T-cell clones by setting up an appropriate responder-stimulator combination in the original MLR; DQw1 is associated with two allelic forms of the DQ molecule recognized as lymphocyte activating determinants by alloreactive T-cell clones; alloreactive T cells recognize specific alpha-beta chain combination of the DQ molecule; the allelic forms that differentiate the alpha or the beta chains of the DQ molecule from each other can also be recognized at the molecular level by DQ alpha and DQ beta RFLP analysis.

Alleles↗
PubMed1987

Progress report on the ASHI/CAP Histocompatibility Survey Program, 1981-1986.

Two histocompatibility testing surveys were conducted over a five-year period by the American Society for Histocompatibility and Immunogenetics and the College of American Pathologists. More than 200 laboratories participated in the HS survey, which consisted of four shipments of cells and serum samples to be tested for ABO type, HLA-A and -B types, antibody identification, and lymphocytotoxicity crossmatching. About 100 laboratories participated in the DR survey, which consisted of four annual shipments to be tested for HLA-DR and -DQ types, antibody identification, and crossmatching. The results of the analysis of the HLA-typing results showed high consistency (generally greater than 90%) among laboratories in the definition of most recognized HLA antigens. In contrast, the HLA antibody screening was generally less consistent between laboratories. On the basis of 90% or greater consensus among participants, it was possible to develop a performance grading system.

ABO Blood-Group System↗
PubMed1986

HLA-DR associations in black type I diabetics in Nigeria. Further support for models of inheritance.

The distributions of HLA-A, -B, -(Bw4/Bw6), -C, -DR, -(DRw52/DRw53), and -DQ genes in 19 type I diabetics, 37 type II diabetics, and 13 nondiabetics of the Yoruba tribe in southwestern Nigeria were studied. Because no associations between type II diabetes and HLA were detected in the current study and such associations are not known to exist in most ethnoracial groups, type II diabetics plus nondiabetics were used as a group of controls for the group of type I diabetics. Trends toward associations between increased DR3 (53 versus 30% of controls) and decreased DR2 (21 versus 46% of controls) and type I diabetes were found (0.1 greater than P greater than 0.05). The strongest HLA association with type I diabetes in Caucasians is usually with DR4. The percent of DR4-positive type I diabetes (11%) was not significantly greater that that in the controls (4%). Because the strong HLA associations with type I diabetes in American Blacks are the same as in Caucasians (i.e., increased DR3 and DR4 and decreased DR2), the genetic contribution (i.e., the lack of an association with DR4) to susceptibility to type I diabetes in most Nigerian Blacks may be different from that in most Caucasians and American Blacks. Onset of diabetes in most of the type I subjects was after age 20, and type I diabetics were difficult to recruit for the study, in keeping with reports on the rarity of type I diabetes among Blacks in western Africa and reports of DR4, but not DR3, being correlated with an early age of onset in Caucasians.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Serological and cellular definition of a new HLA-DR associated determinant, MC1, and its association with rheumatoid arthritis.

A new serological HLA-DR associated determinant was defined by a cluster of six B cell alloantisera. This determinant, designated as MC1, was strongly associated with DR1 and DR4 and appeared unrelated to MB, MT, and SB. The antigen frequency of MC1 was 47% in Caucasoids and 43% in Blacks. Mixed leukocyte culture cloning yielded an alloreactive T cell clone with PLT specificity associated with MC1. We have also observed that certain alloreactive clones may also acquire expression of MC1 but not DR4 during long-term culture maintenance in the presence of DR4, MC1-positive feeder cells. Disease association studies showed a significantly increased frequency of MC1 in adult rheumatoid arthritis patients (93.5% vs 47.4% in normals; relative risk 16.1). These findings suggest that MC1 represents a novel HLA-D encoded determinant.

Alleles↗
PubMed1983

Bone marrow transplantation for severe aplastic anemia using a phenotypically HLA-identical, SB-compatible unrelated donor.

A three-year-old boy with severe aplastic anemia (HLA-A1,B8(Bw6), Cw7,DR3, MB2, MT2, SB4/A1,B8 (Bw6), Cw7,DR3,MB2,MT2,SB-) received a bone marrow transplant from a phenotypically HLA-identical, SB-compatible female unrelated donor. This donor was selected from eighteen HLA-A1,-B8,-blood donors after extended serotyping, mixed leukocyte culture testing and secondary proliferation assays with primed lymphocyte typing reagents specific for SB. Although patient cells proliferated well as responders in MLR, their stimulatory capability was greatly impaired. Because the patient had inherited the same serological HLA-D haplotype from each parent, it was concluded that a compatible unrelated donor must be homozygous for the same HLA-D antigens as the patient. This HLA-D homozygosity was demonstrated by the lack of MLR responses of both parents to stimulators from the donor. The SB typing results suggested SB compatibility because both the patient and the donor typed as SB4,-. Following bone marrow transplantation, there was rapid hematopoietic engraftment. The patient developed severe diarrhea caused by graft-versus-host disease of the gastrointestinal tract, which necessitated hyperalimentation. He is currently eighteen months posttransplant with full hematopoietic reconstitution and moderate chronic skin graft-versus-host disease.

Anemia, Aplastic↗
PubMed1983

Dissociation in expression of MB1/MT1 and DR1 alloantigens in mutants of a lymphoblastoid cell line.

Cytotoxicity tests with alloantisera were used to study the expression of HLA-D region antigens in HLA-DR-null mutants of a human lymphoblastoid cell line. The initial cell line contained just one copy of the MHC as a haplotype that included DR1 and MB1/MT1. Gamma ray mutagenesis of the single haplotype cells followed by selection with complement and an anti-DR monoclonal antibody were then used to isolate DR-null mutants. Two categories of mutants were identified with a panel of alloantisera. Expressions of DR1 and MB1/MT1 were simultaneously lost in four mutants. Nine mutants still expressed MB1/MT1 but had lost the expression of DR1. The dissociated loss of expression of MB1/MT1 and DR1 antigens is evidence for separate genetic control of these alloantigens. The methods used exemplify a versatile approach for conveniently inducing separations of closely linked loci of the MHC.

Cell Line↗
PubMed1982

Association of PLT specificity of alloreactive lymphocyte clones with HLA-DR, MB and MT determinants.

The HLA-D region encodes for several serologically defined systems, including DR, MB, and MT. The antigens of MB and MT are strongly associated with two or more DR specificities. The purpose of this study was to determine the role of MB and MT antigens in lymphocyte alloactivation. A soft agar colony assay was used to generate alloreactive lymphocyte clones primed in mixed leukocyte culture against a stimulator who typed as HLA-DR4,-;MB3,-;MT3,-. In secondary primed lymphocyte typing (PLT) assays, several clones were identified with PLT specificities strongly associated with DR4, MB3, or MT3. The data suggest that HLA-D controls different lymphocyte-activating determinants associated with the serologically defined DR, MB, or MT antigens.

Clone Cells↗
PubMed1982

Association between HLA-D region antigens and disease-free survival in childhood non-T, non-B acute lymphocytic leukemia.

The frequency of three serologically defined HLA-D region antigens--DR, MB, and MT--was determined in a group of 74 children with non-T, non-B acute lymphocytic leukemia (ALL). Statistically, there were no significant differences in the frequency of any antigen in these ALL patients as compared with a panel of 85 normal controls. However, significant differences in HLA-DR frequencies were observed between patients who relapsed or who remained disease-free during a 30-mo period of chemotherapy. An increased incidence of relapse was associated with DR5, while disease-free remission during chemotherapy was associated with DR7. Life table analysis also demonstrated that DR5 was significantly associated with a decrease in disease-free survival in these patients. These data suggest that HLA-associated genetic factors may influence the responses of ALL patients to chemotherapy.

Adolescent↗
PubMed1979

HLA-DR antigens in Black North-Americans and their association with HLA-D.

A random population of 108 Black North-Americans, 79 of whom had also been typed for HLA-D in Mixed Leukocyte Culture (MLC), were serologically tested for DRw with Seventh International Histocompatibility Workshop trays. Clusters of B cell alloantisera were identified which defined several DRw antigens. Although the clusters for DRw1, DRw2, DRw3 and DRw7 showed similarities with the clusters derived during the Seventh International Histocompatibility Workshop, distinct differences were observed which should be taken into account for the assignment of the DRw antigens in Blacks. DRw6 was defined by a cluster of sera which also reacted with DRw1 and DRw2 cells. The tails of these sera were used to assign DRw6, but this was only possible with DRw1 and DRw2 negative cells. It was not possible to identify serum clusters specific for DRw4 or WIA8. The associations between DRw and the corresponding Dw specificities were reasonably good for DRw1, DRw2 and DRw7, but weaker for DRw3 and DRw5. The cumulative gene frequencies for DRw1, DRw2, DRw3, DRw5, DRw6 and DRw7 was 0.86. The frequencies of these six DRw antigens fitted into a Hardy-Weinberg distribution, suggesting that DRw in Blacks is controlled by a single gene with multiple alleles.

Black People↗