فصلنامه خون
سال هفدهم شماره 2 (پیاپی 68، تابستان 1399)

Use of kits with high sensitivity and specificity to determine the prevalence of antibodies against hepatitis B virus (anti-HBc) core antigen is important. The aim of this study was to determine the prevalence of hepatitis B virus antibody in HBsAg negative blood donors using two anti-HBc enzyme immunoassay kits (DIA.PRO and SIEMENS). 

In this Cross-sectional study, a number of 4313 samples of HBsAg negative blood donors were collected. All samples were tested for the detection of anti-HBc (Total, IgM & IgG) by ELISA using Diapro and Siemens kits. Anti-HBc assay was performed by both kits in duplicate. Statistical analysis of data was performed using SPSS Ver. 22.0; chi-square tests were also performed. 

The study population consisted of 227 (5.3%) women and 4086 (94.7%) men. 498 (11.5%) and 384 (8.9%) samples reacted with Diapro and Siemens kits for Anti-HBc, respectively. All positive samples of both kits in duplicate test showed the same results as the previously reported results. 114 cases of reactive kits of DIA.PRO kit were negative in re-testing with SIEMENS kit. Significant differences were observed between the reactive results of the two kits (p = 0.00005).  The kappa coefficient for the reactive results of the two kits was 85%. 

Conclusions:

 Considering the significant difference between the results of the two kits, it is recommended to perform anti-HBc testing with anti-HBs and /or anti-HBe to determine the prevalence of anti-HBc in blood donors with past HBV infection.

Blood transfusion related alloimmunization is common among patients receiving regular blood transfusion, especially thalassemia patients. In this study we aimed to find the prevalence of alloimmunization among patients of thalassemia. 

In this desciptional study, we screened 305 thalassemia patients (53.8% female and  46.2% male, age 4-38) referring to Imam Khomeini Hospital during 2017-2018 for presence of antibodies against blood group antigens. Then for those patients of positive antibody screening result we identified the antibody in each patient. 

Seven out of 305 patients in this study had positive antibody screening results. The most prevalent alloantibodies were detected to be anti-K (6 patients, 85.7%) and anti-E (2 patients, 28.57%). Also, 2 out of 7 patients with positive antibody results presented dual antibody of anti-K and anti-E. 

Conclusions : 

According to the results, anti-K and anti-E are the most likely antibodies presenting in patients of thalassemia with positive antibody screening results. This point is important to bear in mind in providing special blood supplies for thalassemics who are in need of regular blood transfusion. Prior to treatment of multitransfused patients like thalassemia the phenotyping of patients for important blood groups of Kell and Rh should be considered.

Platelets release microparticles containing cellular components, including microRNAs, during storage. Assessment of these microRNAs is one of the markers for evaluation of platelet storage lesions. The aim of the present study was to evaluate the level of changes in the expression of mir-223, mir-92a and mir-222 during storage in platelets prepared by platelet rich plasma method. 

In this experimental study, 5 platelet concentrates prepared by PRP method were collected from blood donors and stored at 22°C for 5 days with agitation. Changes in the expression levels of mir-223, mir-92a and mir-222 were determined using qRT- PCR method on days zero, three and five of storage. The results were analyzed using paired-sample-T test using GenEX version 7 software.

It was found that the expression of miR-223 gradually increased during the third and fifth days compared to the day 0 of platelet concentrate storage (p < 0.05). The expression of mir-92a also significantly increased on the third and the fifth days compared to day 0 of storage (p < 0.05). However, the expression of mir-222 gradually decreased over the fifth day of storage (p < 0.05). 

Conclusions:  

This study showed that the determination of miRNAs in the platelet-derived microparticles with common markers such as platelet count, MPV determination, platelet volume determination, leukocyte count, swirling assay, and pH measurement can be useful tools for identifying cellular damage associated with platelet storage lesion and maybe potential indicators for evaluating the quality and viability of platelets stored in vitro conditions.

Acute myeloid leukemia is a heterozygous hematologic malignancy that is manifested by the     accumulation of hematopoietics stem cells in peripheral blood and bone marrow. Anticancer effects and  cryotoxic activity of curcumin have been proven frequently in many cancers. Sorafenib is known as an inhibitor of angiogenesis which prevent cells’ survival. In the present study, the effects of curcumin and sorafenib and their combination were evaluated on AML cells. 

In this experimental study, U937 and KG-1 cells were treated with different concentration of curcumin and sorafenib and their combination.  MTT assay was applied to assess the viability of cells.  Percentage of apoptotic cells was evaluated by annexin PI staining. Also Real Time PCR was performed to investigte the level of  AKT mRNA expression. 

Our data showed that the percentage of apoptotic cells significantly increased in response to treatment with  curcumin (40µM in KG-1 and U937 cell lines), sorafenib (5 µM and 7 µM in U937 and KG-1, respectively) and their combination. Moreover, the mRNA level of AKT gene was downregulated in KG-1 and U937 cells. 

Conclusions:  

Our results suggest that combination of curcumin and sorafenib could lead to promote apoptosis. Furthurermore, downregulation of AKT gene shows that these agents can be considered as effective agents on AML cells.

Over-ordering of blood before operation can cause unnecessary cross matches, blood bank staff overload, blood unit wastages due to outdating, and increase hospital costs. So, we aimed to survey the efficacy of MSBOS on blood utilization in Faghihi Hospital, Shiraz, Iran. 

This cross sectional study was conducted over a three month period in 2019 and 2020 (before and after MSBOS establishment) in Faghihi Hospital, Shiraz, Iran. The education class was held for surgeons to order blood according to MSBOS. The frequency of cross matches, transfused blood units, and the cross match to transfusion ratio were compared before and after MSBOS establishment by comparison of proportions by MedCalc software in the elective surgical ward. 

The cross match to transfusion ratio significantly decreased after MSBOS establishment (3.97 to 1.46). The transfusion index and transfusion probability increased significantly after MSBOS establishment (25.2% to 63.6%, 24.7% to 59.4%)) p < 0.001). The cross match rates also decreased (51.13%). The cross match costs also decreased from 293898528 Rials (Iranian currency) to 143626560.

Conclusions: 

In this study, the cross match to transfusion ratio decreased significantly after MSBOS establishment which shows the effectiveness of MSBOS on rational blood use. So, the education of surgeons and emphasis on blood ordering according to MSOBS can improve blood usage.

The Crimean-Congo Hemorrhagic Fever (CCHF) is a hemorrhagic viral infection with a high mortality rate. Due to the lack of specific treatment, the disease is managed by medical supports and antiviral drugs. In the present study, we assessed the consumption of blood products during the last outbreak of CCHF in 2017 in Sistan and Baluchestan Province. 

In this cross-sectional study, during the CCHF outbreak in 2016, all hospitalized patients with CCHF in the province, their disease status and used blood products were recorded. In addition, the probable causes of CCHF infection and response to treatment were recorded. The disease was diagnosed and confirmed in the patients by serological studies and reverse transcriptase polymerase chain reaction (RT-PCR). The statistical analysis was done by SPSS 16 and descriptive levels. 

During the study period, 18 patients with a definitive diagnosis of  Crimean-Congo Fever and mean age of 27.5 6 + 6.9 were hospitalized. All patients were male and most were slaughterhouse workers (44.5%). The main cause of CCHF contamination was contact with contaminated meat and infected livestock. Of the 18 patients, 11 (61%) required blood transfusions, and platelet concentrate was the most commonly used (83.2%) blood product among the patients. A total of 191 blood products units were consumed and none of the patients died from CCHF.

Conclusions: 

CCHF is a hemorrhagic disease that required high rate of blood products transfusion, mostly platelet.

Thalassemia is a group of inherited hemoglobin disorders with defect in the synthesis of hemoglobin chains. 

Case:

The young couple resident in Bandar Abbas,  a 23 year old woman with MCV:63fl; MCH:19; HbA2:3.9  and  a 25 year old man with MCV:94fl; MCH:32; HbA2:2.1; HbF:36, were referred to the Bandar Abbas Medical Genetic & PND Center for genetic counselling before marriage. 

Conclusions:  

A rare CD139 mutation (AAT → GAT) was detected which led to substitution of Asparagine by Aspartic Acid in 139th amino acid in hemoglobin chain and created a hemoglobin variant named Hb Geelong. This is the first report for Hb-Geelong in Iran. It seems that this mutation affects the hemoglobin stability though a non-pathologic process and has a phenotype similar to minor β+ thalassemia.

Recently, mesenchymal stem cells have attracted much attention in regenerative medicine and cell-based therapies. Mesenchymal stem cells are used in regenerative medicine mainly based on their capacity to differentiate into several cell lineages, low immunogenicity, and in particular their anti-inflammatory and immunosuppressive-immunomodulatory properties. 

The present manuscript, by reviewing more than 150 recent published articles, introduces the latest information regarding the anti-inflammatory and immunosuppressive-immunomodulatory properties of the mesenchymal stem cells. 

The fibroblast-like mesenchymal stem cells can be isolated from various sources such as bone marrow, adipose tissue, skeletal muscle, Wharton jelly, umbilical cord, placenta, and amniotic fluid. The immunomodulatory properties of mesenchymal stem cells result from their interactions with innate and adaptive immune systems to inhibit immune cells. Such an inhibitory function is due to the interaction of these cells with immune cells through direct cell-cell contact or via paracrine secretory factors. The composition of these secretions or secretom of these cells includes various components such as growth factors, cytokines, chemokines, anti-inflammatory mediators and exosomes. Many in vivo studies in animal models have demonstrated that the ability of mesenchymal stem cells to regenerate and repair tissues is more attributed to their immunosuppressive-immunomodulatory function rather than their proliferative properties. 

Conclusions:  

Therefore, understanding the mechanisms establishing the interactions of these cells with immune system would be important for their use as a promising therapeutic approach in the future for treatment of immunological diseases as well as in the field of regenerative medicine.