The Vatican and the Cairo conference on population and development.
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Catholicism↗
Biomedical subjects
J Poole
Publications and source records attributed to J Poole.
Molecular basis of reduced or absent expression of decay-accelerating factor in Cromer blood group phenotypes.
The human erythrocyte blood group system Cromer consists of high-incidence and low-incidence antigens that reside on decay-accelerating factor (DAF; CD55), a glycosyl-phosphatidylinositol-anchored membrane protein that regulates complement activation on cell surfaces. In the Cromer phenotypes Dr(a-) and Inab there is reduced or absent expression of DAF, respectively. This study investigated the molecular basis of the reduced DAF expression by polymerase chain reaction amplification of genomic DNA and RNA/cDNA obtained from Epstein-Barr virus-transformed lymphoblastoid cell lines. Sequence analysis of the Inab propositus showed a single nucleotide substitution in exon 2 of the DAF gene and at the corresponding position in the cDNA, G314-->A resulting in Trp53-->Stop. This truncation near the amino terminus explains the complete absence of surface DAF in the Inab phenotype. A similar analysis was performed for two Dr(a-) individuals, including KZ, who was previously reported to be Inab phenotype but is now shown by immunochemical and serologic methods to be Dr(a-) phenotype. A single nucleotide change was found in exon 5 of the DAF gene, C649-->T resulting in Ser165-->Leu, which we had previously shown to lead to loss of the Dra epitope. However, two species of cDNA were found, one encoding full-length DAF with the single amino acid change and the more abundant species having a 44-nucleotide deletion. The 44 nucleotide deletion includes the single polymorphic site, which creates a cryptic branch point in the Dr(a-) allele that leads to use of a downstream cryptic acceptor splice site. This shifts the reading frame and leads to a premature stop codon that precludes membrane anchoring. Thus, the single point mutation in the Dr(a-) phenotype results in a novel use of alternative splicing and provides a molecular explanation for both the antigenicity and the reduced DAF expression seen in this phenotype.
Amino Acid Sequence↗
A novel form of congenital dyserythropoietic anemia associated with deficiency of erythroid CD44 and a unique blood group phenotype [In(a-b-), Co(a-b-)].
We have used a panel of well-characterized monoclonal antibodies (MoAbs) to examine the blood cells of a patient with a novel form of congenital dyserythropoietic anemia (CDA) characterized by intra-erythroblastic and intra-erythrocytic membranous inclusions. Twelve antibodies defining three nonoverlapping epitope groups on the extracellular domain of CD44 all failed to react with the red blood cells (RBCs) of the patient. A rabbit antibody to the cytoplasmic domain of CD44 from normal RBCs failed to react with the patient's RBC ghosts. In contrast, the patient's lymphocytes, granulocytes, and monocytes showed apparently normal CD44 expression. Bone marrow preparations stained with CD44 antibodies and visualized with 125I antimouse Ig (F(ab')2) followed by autoradiography showed positive staining of lymphocytes and myeloid cells but not of most orthotolidine-positive erythroblasts. The patient's RBCs also gave weaker than normal reactions with MoAbs of anti-LWab specificity while MoAbs to glycophorins A, B, and C, Rh polypeptides, CD47, CD55, CD58, CD59, acetylcholinesterase, and Lutheran and Kell glycoproteins all gave normal reactions. Agglutination tests with human blood grouping sera demonstrated that the RBCs of the patient have the unique phenotype In(a-b-), Co(a-b-) and that they also lack the high incidence RBC antigen AnWj. The phenotype In(a-b-) would be expected because these antigens are known to be expressed on CD44. There is also some evidence associating the AnWj antigen with CD44. However, the CO blood group locus is on chromosome 7p whereas that for CD44 is on chromosome 11p. Quantitative binding assays using 125I-labeled Fab fragments of CD44 antibodies did not show any evidence for reduced levels of CD44 on RBCs from the parents of the patient or from her unaffected sister. The parents and sister had the common Colton blood group phenotype [Co(a+b-)]. Neither deficiency of CD44 nor absence of Colton antigens are general features of CDA because erythrocytes from patients with CDA I, CDA II, CDA III, and two other unclassified CDAs had normal expression of CD44 and normal Colton blood group phenotypes. Further analysis of the defect(s) present in the patient's erythroid cells may provide useful information regarding membrane assembly and the regulation of differentiation in normal erythroid cells.
Anemia, Dyserythropoietic, Congenital↗
Transient loss of proteins carrying Kell and Lutheran red cell antigens during consecutive relapses of autoimmune thrombocytopenia.
A patient is described in whom two consecutive relapses of autoimmune thrombocytopenic purpura (AITP) were associated with loss of red cell antigens of the Kell and Lutheran blood group systems respectively. During the second relapse the glycoprotein CD44 and to a lesser extent the LW antigen were also depressed. Both relapses were associated with concomitant production of IgG antibody recognizing high-frequency determinants on the corresponding antigen-carrying protein. Blocking of antigen sites by these antibodies was not the cause of reduced antigen expression, because immunoblotting studies showed absence of Kell protein during the first relapse, and Lutheran protein during the second. On both occasions the red cell changes reverted to normal with disappearance of the antibody as the AITP entered remission. There was no evidence of clonal lymphocyte expansion as demonstrated using immunoglobulin JH and T cell receptor beta chain probes.
Adult↗
The prevention of industrial accidents.
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Accidents, Occupational↗
ERIK, a low-frequency red cell antigen of the MNS blood group system associated with Sta.
A new low-frequency red cell antigen, ERIK (MNS37), is associated with the Sta antigen of the MNS system. Four ERIK+ propositi have been identified: all are St(a+). Thirteen other St(a+) samples, including one of the Mz type, and over 200 St(a-) samples were ERIK-. In two of the propositi ERIK is associated with an abnormal trypsin-resistant M antigen; in the others it is associated with N, which is shown to be expressed weakly in one family. Immunoblotting with an antibody to an epitope common to glycophorin A (GPA) and glycophorin B (GPB) gave identical results with St(a+) ERIK+ and St(a+) ERIK- cells, revealing GPA, GPB, an abnormal structure GPSta and aggregates of these components. In the propositi with trypsin-resistant M, GPSta carries the unusual M antigen, whereas in the M-N+ERIK+ individual analysed by immunoblotting GPSta carries N. Immunoblotting with anti-Sta and anti-ERIK showed that Sta is located on GPSta but that ERIK is located on GPA, presumably the GPA molecule encoded by the GYPA gene contiguous to the gene encoding GPSta.
Adult↗
Sewage workers and hepatitis A.
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Health Education↗
HELLP syndrome and coagulopathies of pregnancy.
The critically ill obstetric patient presents many unique management problems to the health care provider. Both the mother and her fetus can be profoundly affected by disease processes. One such challenging management problem in the obstetric population is the development of an underlying coagulopathy. Coagulopathies during pregnancy present diverse clinical pictures. The coagulopathy may be unaffected by the pregnancy or there may be a dynamic relationship between the pregnancy and the pathologic state. With the well-being of the mother and her fetus dependent upon management decisions, each must be considered in the management plan.
Blood Coagulation Disorders↗
Time for the Vatican to bend.
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Abortion, Illegal↗
CD10 antigen density in childhood common acute lymphoblastic leukaemia: comparisons of race and sex.
During the 25 month period from July 1989 until August 1991, 58 children with FAB defined acute lymphoblastic leukaemia (ALL) were referred for immunophenotypic analysis. Of these, 42 children with a common/pre-B phenotype (CD19/CD10-positive) were studied specifically to assess CD10 antigen density. A pattern of segregation was found between males and females and between black and white children. Black males, who are the worst prognostic group, had the lowest CD10 density, while white females, known to constitute the best prognostic group, had significantly higher CD10 antigen density than the other groups. Black females and white males occupied intermediate positions with respect to CD10 antigen density. A two way analysis of variance showed that although sex had contributed significantly to this variation (p = 0.0038), the contribution of race was marginal (p = 0.0530). It is hypothesized that low CD10 antigen density patterns in males and in Blacks could be causally related to poor prognosis.
Black People↗
The Miltenberger subsystem: is it obsolescent?
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Amino Acid Sequence↗
Autoimmune hemolytic anemia associated with anti-Sc1.
A case of autoimmune hemolytic anemia (AIHA) in a young child is described. The hemolysis was resistant to steroid therapy but responded to splenectomy and intravenous immunoglobulin. The autoantibody was shown to be anti-Sc1 by both serologic and immunoblotting techniques. This seems to be the first report of an autoanti-Sc1 detected by immunoblotting and the first example of AIHA in a child caused by autoanti-Sc1.
Anemia, Hemolytic, Autoimmune↗
Failure to find an association of blood group P1 with thyroid-associated ophthalmopathy.
OBJECTIVE: Genetic factors have been proposed to account for the development of ophthalmopathy in a proportion of patients with Graves' disease. The aim of this study was to confirm the previously reported association between blood group P1 and thyroid-associated ophthalmopathy. DESIGN: A prospective study of sequential Caucasian patients. PATIENTS: We studied 169 patients with Graves' disease, 84 of whom had grade 3, 4 or 6 ophthalmopathy and 85 had no eye signs. MEASUREMENTS: Blood group P1 was measured by a standard serological technique. RESULTS: The frequency of the P1 blood group was 74.1% in the patients without eye signs and 77.4% in those with ophthalmopathy (chi 2 = 0.25, P > 0.1). By Woolf's method there was no significant difference in the test for heterogeneity of estimates between the present and the previously reported series of Graves' patients. Combining the results (n = 279), the pooled relative risk for ophthalmopathy with blood group P1 did not differ significantly from 1.0 (chi 2 = 2.33, P > 0.1). CONCLUSIONS: The presence of blood group P1 in patients with Graves' disease does not appear to be associated with an increased risk of developing thyroid-associated ophthalmopathy.
Graves Disease↗
TSEN: a novel MNS-related blood group antigen.
We report an antibody (anti-TSEN) that recognizes an antigen (TSEN) at the unique amino acid sequence that results from the junction of GPA58 to GPB27 if the GPB carries the S antigen. Red cells from several unrelated donors that possess this specific GP(A-B) hybrid molecule were agglutinated by anti-TSEN. Since a synthetic peptide with the amino acid sequence at this junction (Pro-Glu-Glu-Glu-Thr-Gly-Glu-Met-Gly-Gln-Leu-Val-His-Arg) specifically inhibited anti-TSEN, it must detect an antigen within this novel amino acid sequence. The TSEN antigen has been provisionally assigned the MNS blood group system number 002.033 on behalf of the ISBT Working Party on Terminology for Red Cell Surface Antigens.
Adult↗
MINY: a novel MNS-related blood group antigen.
We report an antibody (anti-MINY) that recognises a novel low-incidence MNS-related blood group antigen. Anti-MINY agglutinates all Hil-positive red cells tested (Mi.III, Mi.V, Mi.VI, GP.Kipp, GP.Mor and AG) and Hil-negative TSEN-positive red cells (Mi.IV, JR, JL, Oca. and Rag.). All MINY-positive red cells possess glycophorin A-B hybrid molecules. The MINY antigen occurs at the unique amino acid sequence which results from the junction of glycophorin A58 to glycophorin B27 regardless of whether the glycophorin B gene encodes methionine or threonine at amino acid residue 29 of normal glycophorin B. The MINY antigen has been provisionally assigned the MNS blood group system number 002.034 on behalf of the ISBT Working Party on Terminology for Red Cell Surface Antigens.
Amino Acid Sequence↗
Legal and professional issues in critical care obstetrics.
The practice of critical care obstetrics is a challenging specialty that presents unique problems and issues in providing perinatal care. With the emergence of critical care obstetrics comes increased accountability and expanded responsibilities. This article addresses the legal and professional issues related to critical care obstetrics.
Critical Care↗
Pulmonary embolism.
A major cause of maternal morbidity and mortality during pregnancy and the puerperium is thromboembolic disease. Pregnancy is a hypercoagulative state that predisposes the gravida to thrombus formation. Once a thrombus forms in the venous system of the lower extremities, it can travel to the pulmonary arterial bed, which can lead to hypoxemia or death. Maternal mortality associated with pulmonary embolism (PE) is approximately 14%. Most gravidas who have PE during or after pregnancy have no history of thromboembolic disease at the time of insult.
Adult↗