1. Silent red blood cell autoantibodies: Are they naturally occurring or an effect of tolerance loss for a subsequent autoimmune process?
- Author
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María de Los Ángeles Romero-Tlalolini, Sorely Adelina Sosa-Luis, William de Jesús Ríos-Ríos, Honorio Torres-Aguilar, and Sergio R. Aguilar-Ruiz
- Subjects
0301 basic medicine ,Erythrocytes ,Immunology ,Autoimmunity ,medicine.disease_cause ,Autoantigens ,Autoimmune Diseases ,Immune tolerance ,Blood cell ,03 medical and health sciences ,0302 clinical medicine ,Autoimmune Process ,ABO blood group system ,Immune Tolerance ,medicine ,Humans ,Immunology and Allergy ,Autoantibodies ,030203 arthritis & rheumatology ,biology ,business.industry ,Autoantibody ,Immune dysregulation ,Molecular mimicry ,030104 developmental biology ,medicine.anatomical_structure ,biology.protein ,Anemia, Hemolytic, Autoimmune ,Disease Susceptibility ,Antibody ,business - Abstract
Unexpected anti-red blood cell (RBC) alloantibodies are routinely investigated in immunohematology and blood banking since their existence in pregnant women may induce haemolytic disease of the foetus and newborn, and their presence in donors may induce haemolytic transfusion reactions or hyperacute rejection in solid organ transplantation. Unexpected anti-RBC alloantibodies may target antigens of the most blood types excluding the expected antibodies targeting the ABO antigens. Their incidence in humans was originally linked to alloimmunization events such as blood transfusions, transplants, or pregnancies. But later, many findings revealed their existence in pathogenic processes such as malignancies, infections, and autoimmune diseases; and usually (but not always) associated to autoimmune haemolytic anaemia (AIHA). Nevertheless, unexpected anti-RBC autoantibodies are also occasionally found in healthy individuals in the absence of AIHA and with no history of alloimmunization or the associated pathologic processes. Hence, they are generally known as non-clinically significant, are excluded for typification and called "silent red blood cell autoantibodies (SRBCAA)". This review highlights evidence related to genetic predisposition, molecular mimicry, immune dysregulation, and immune tolerance loss surrounding the existence of anti-RBC antibodies, describing the presence of SRBCAA as possible early witnesses of the development of autoimmune diseases.
- Published
- 2020
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