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Biomedical subjects

V Moalic

Publications and source records attributed to V Moalic.

3 recordsLinked to original sources

[Graft vs host disease].

Graft vs host disease is a serious immunological complication of allogeneic haematopoietic cell transplantation, leading to a significant morbidity and mortality. It occurs when donor T lymphocyte react to foreign host cells. The physiopathology is a more complex process implicating host tissues damage caused by the conditioning regimen, cytokines, cellular effectors implicated in the immune response such as donor lymphocytes T, antigen presenting cells and mechanisms of apoptosis. This review focuses on the physiopathological basis, risk factors, clinical aspects; prevention and current management strategies to treat graft vs host disease. Recent developments in our understanding of this bone marrow transplantation complication have profoundly influenced the practice of allogeneic haematopoietic cell transplantation. There is a growing realisation of the importance of a graft vs leukaemia effect, strategy, which has encouraged the development of less conditioning regimens. Segregation between graft vs host effect and graft vs leukaemia effect is a key challenge, and could lead to new efficient and specific immunotherapy.

Acute Disease↗

[HLA typing, analysis methods, and clinical applications].

The polygenic HLA system is a well known region of the human genome. Its main function is to present antigenic peptides to the immune system and thereby regulate induction of immune responses. Extensive genetic polymorphisms characterize some HLA genes. Initially, genetic variations were analyzed by a serological typing technique (microlymphocytotoxicity). The introduction of polymerase chain reaction (PCR) in the mid-1980s led the development of a variety of methods that use molecular biology. An international nomenclature, regularly updated, governs the names of HLA antigens defined by serology as well as of HLA alleles. Knowledge of the specific polymorphisms of individuals is essential in organ and stem cell transplantation and highly useful in disease association studies.

Adolescent↗

[Transfusion related acute lung injury (TRALI): an unrecognised pathology].

Transfusion related acute lung injury (TRALI) is a rare but potentially severe complication of blood transfusion, manifested by pulmonary oedema, fever and hypotension. The signs and symptoms are often attributed to other clinical aspects of a patient's condition, and therefore, TRALI may go unrecognised. It has been estimated to be the third cause of transfusion related mortality, so it should be better diagnosed. Cases are related to multiple blood units, such as white blood cells, red blood cells, fresh frozen plasma, platelets or intravenous immunoglobulins. Physiopathology of TRALI is poorly understood, and still controversial. It is often due to an immunological conflict between transfused plasma antibodies and recipients' blood cells. These antibodies are either HLA (class I or II) or granulocyte-specific. They appear to act as mediators, which result in granulocytes aggregation, activation and micro vascular pulmonary injury. Lipids or cytokines in blood units are also involved as TRALI priming agents. Diagnosis is based on antibody screening in blood components and on specific-antigen detection in the recipient. The screening of anti-HLA or anti-granulocytes is recommended as part of prevention for female donors who had been pregnant. Preventative measures should also include leucoreduction and measures to decrease the amount of priming agents in blood components. In this article, we summarise what is known about TRALI, and we focus attention on unanswered questions and controversial issues related to TRALI.

Diagnosis, Differential↗