The Role of Complement in Transfusion-Related Acute Lung Injury.
C5Ar
C5a
Complement
NETs
TRALI
Transfusion-related acute lung injury
Journal
Transfusion medicine reviews
ISSN: 1532-9496
Titre abrégé: Transfus Med Rev
Pays: United States
ID NLM: 8709027
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
04
07
2019
revised:
05
09
2019
accepted:
06
09
2019
pubmed:
5
11
2019
medline:
20
9
2020
entrez:
3
11
2019
Statut:
ppublish
Résumé
Transfusion-related acute lung injury (TRALI) is a life-threatening complication of acute respiratory distress occurring within 6 hours of blood transfusion. TRALI is one of the leading causes of transfusion-related fatalities and specific therapies are unavailable. Neutrophils are recognized as the major pathogenic cells, whereas T regulatory cells and dendritic cells appear to be important for protection against TRALI. The pathogenesis, however, is complex and incompletely understood. It is frequently postulated that the complement system plays an important role in the TRALI pathogenesis. In this article, we assess the evidence regarding the involvement of complement in TRALI from both human and animal studies. We hypothesize about the potential connection between the complement system and neutrophils in TRALI. Additionally, we draw parallels between TRALI and other acute pulmonary disorders of acute lung injury and acute respiratory distress syndrome regarding the involvement of complement. We conclude that, even though a role for complement in the TRALI pathogenesis seems plausible, studies investigating the role of complement in TRALI are remarkably limited in number and also present conflicting findings. Different types of TRALI animal models, diverse experimental conditions, and the composition of the gastrointestinal microbiota may perhaps all be factors which contribute to these discrepancies. More systematic studies are warranted to shed light on the contribution of the complement cascade in TRALI. The underlying clinical condition of the patient, which influences the susceptibility to TRALI, as well as the transfusion factor (antibody-mediated vs non-antibody-mediated), will be important to take into consideration when researching the contribution of complement. This should significantly increase our understanding of the role of complement in TRALI and may potentially result in promising new treatment strategies.
Identifiants
pubmed: 31676221
pii: S0887-7963(19)30130-0
doi: 10.1016/j.tmrv.2019.09.002
pmc: PMC7127679
pii:
doi:
Substances chimiques
Complement System Proteins
9007-36-7
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
236-242Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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