Autologous platelet scintigraphy and clinical outcome of splenectomy in immune thrombocytopenia:A systematic review and meta-analysis

Autologous platelet sequestration pattern is associated with post-splenectomy platelet response in patients with immune thrombocytopenia (ITP). However, published results are contradictory, and have not been systematically reviewed. Our aim is to systematically review and meta-analyse the association between sequestration pattern and post-splenectomy platelet response. Articles were selected from MEDLINE when they a) included ITP patients, b) performed scintigraphy, and c) included post-splenectomy platelet response. The 23 included studies (published between 1969-2018) represented 2966 ITP-patients. Response to splenectomy occurred most frequently in patients with a splenic pattern (87.1 % in splenic versus 47.1 % in mixed and 25.5 % in hepatic patterns). A pooled analysis of 8 studies showed an odds ratio of 14.21 (95 % CI: 3.65-55.37) for platelet response in the splenic versus the hepatic group. Our findings indicate that a splenic sequestration pattern is associated with better response after splenectomy. Platelet sequestration patterns may be useful in the clinical decision-making regarding splenectomy.Immunobiology of allogeneic stem cell transplantation and immunotherapy of hematological disease

Haemovigilance:current practices and future developments

Haemovigilance is the systematic surveillance of adverse events in the transfusion chain, and encompasses activities that contribute to the safety and quality in the process of blood donation and transfusion. From the start in the early 1990s, haemovigilance has put emphasis on different adverse reactions and incidents in recipients and subsequently in donors, pointing to vulnerabilities in the transfusion chain and areas for prevention. More recently, the monitoring of efficacy and efficiency of transfusion practice has been introduced in the concept of haemovigilance. The purpose of this review is to present an overview of the current status and future developments of haemovigilance. Haemovigilance is part of the quality systems of the blood collection establishments, transfusion laboratories and the transfusion institutions. The monitoring, investigation and analysis of adverse events generates relevant data for the quality cycle of these systems, driving continuous improvement in transfusion practice. Recommendations based on haemovigilance findings have led to changes in clinical guidelines and policies. Despite the progress haemovigilance has made, further developments are needed. Current challenges lie in the field of the establishment of haemovigilance systems in low resource settings, the international harmonisation of definitions and the prevention of underreporting. In addition, the causal relationship between the transfusion and the reaction is often unclear. Biomarkers may aid in the imputability assessment and their role in the diagnosis of transfusion reactions needs to be further investigated. Future developments are expected in automated reporting, the use of big data and increased shareability of international data, contributing to a better understanding of the causal mechanisms and risk factors, and to prevention of adverse events. Haemovigilance is an evolving discipline and will continue to contribute to improving the safety of blood donation and transfusion

Energierijk: Deelproject algenteelt

In de loop van 2012 heeft ACCRES-Wageningen UR in samenwerking met het bedrijf Algae Food & Fuel algenproductiefaciliteiten gerealiseerd op het terrein van ACRRES in Lelystad. Deze faciliteiten bestaan uit algenvijvers en fotobioreactoren met LED-verlichting. Het unieke van deze testfaciliteiten is dat verschillende productieprocessen aan elkaar gekoppeld worden door reststromen uit het ene proces toe te passen in het andere proces. Dit gebeurt binnen het zogenaamde EnergieRijk project. Centraal staat een co-vergister met warmtekrachtkoppeling. Het digestaat dat na het vergistingsproces overblijft, kan worden gebruikt als meststof voor de algenteelt. De gasmotor waarin het biogas verbrand wordt om stroom te produceren levert warmte en CO2 die in de algenvijvers verbruikt worden

Anti-glycoprotein antibodies and sequestration pattern of indium-labeled platelets in immune thrombocytopenia

Antiglycoprotein (anti-GP) antibodies play an important role in the pathophysiology of immune thrombocytopenia (ITP). The sequestration pattern of platelets in the spleen and liver can be studied with (111)In-labeled autologous platelet scans. No studies have investigated the role of anti-GP antibodies in sequestration patterns in ITP patients. In this study, we examined the association between antibodies and (1) platelet sequestration site and (2) clearance rate of platelets. All ITP patients receiving an (111)In-labeled autologous platelet study between 2014 and 2018 were included. Antibodies were measured using the direct MAIPA method to determine the presence and titer of anti-GPIIb/IIIa, anti-GPIb/IX, and anti-GPV antibodies. Multivariate regression models were used to study the association between anti-GP antibodies, sequestration site, and clearance rate. Seventy-four patients were included, with a mean age of 36 years. Forty-seven percent of the patients showed a predominantly splenic sequestration pattern, 29% mixed, and 25% a hepatic pattern. In 53% of the patients, anti-GP antibodies were detected. Regression models showed a significant association between splenic sequestration and GPV autoantibodies. Furthermore, in patients where antibodies were present, the clearance rate was higher in patients with a splenic sequestration. Anti-GPV antibodies are associated with a splenic sequestration pattern in ITP patients. These associations provide insight into the possible pathophysiological mechanisms of ITP, which may lead to better detection and treatment of this partly idiopathic and prevalent disease

AlgaeEconomics: bio-economic production models of micro-algae and downstream processing to produce bio energy carriers

This report describes results of work carried out within the EnAlgae project to describe production costs and identify the variables that have most effect in determining future cost prices so that R&D can be focussed on these issues. This has been done by making use of pilots within the EnAlgae consortium and by describing the process in Excel models that have been spread among and discussed with stakeholders active in the field of commercial algae production. The expectation is that this transparency and interaction will lead to an increase of the learning curve to make algae production cheaper and thus supplying more markets

The interplay between GPIb/IX antibodies, platelet hepatic sequestration, and TPO levels in patients with chronic ITP

Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder with an incompletely understood pathophysiology but includes platelet-clearance in the spleen and liver via T cells and/or platelet autoantibodies. Strikingly, thrombopoietin (TPO) levels remain low in ITP. Platelet-glycoprotein (GP)Ibα has been described to be required for hepatic TPO generation; however, the role of GPIb antibodies in relation to platelet hepatic sequestration and TPO levels, with consideration of platelet counts, remains to be elucidated. Therefore, we examined 53 patients with chronic and nonsplenectomized ITP for whom we conducted indium-labeled autologous platelet scintigraphy and measured platelet antibodies and TPO levels. Upon stratification toward the severity of thrombocytopenia, no negative association was observed between GPIb/IX antibodies and TPO levels, suggesting that GPIb/IX antibodies do not inhibit or block TPO levels. Surprisingly, we observed a positive association between GPIb/IX antibody levels and TPO levels and GPIb/IX antibodies and platelet hepatic sequestration in patients with severe, but not mild or moderate, thrombocytopenia. In addition, platelet hepatic sequestration and TPO levels were positively associated. This collectively indicates that GPIb/IX antibodies may be associated with increased platelet hepatic sequestration and elevated TPO levels in patients with severe thrombocytopenic ITP; however, further research is warranted to elucidate the pathophysiologic mechanisms.</p

Zuivering brouwerijprocesafvalwater met behulp van microalgen: Resultaten onderzoek 2012

In een samenwerkingsverband van Heineken Nederland BV, Algae Food & Fuel en WUR (Acrres) is in 2012 een onderzoeksproject gestart om de mogelijkheden van zuivering van procesafvalwater van de brouwerijen met behulp van algen te onderzoeken. In het kader van dit project is in 2012 een literatuurstudie gedaan naar ervaringen met afvalwaterzuivering door algen en zijn een aantal laboratoriumproeven uitgevoerd naar de stikstof en fosforverwijdering door algen uit procesafvalwater uit de brouwerij. Dit rapport beschrijft de resultaten van de genoemde activiteiten

Potential Diagnostic Approaches for Prediction of Therapeutic Responses in Immune Thrombocytopenia

Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder in which, via unresolved mechanisms, platelets and megakaryocytes (MKs) are targeted by autoantibodies and/or T cells resulting in increased platelet destruction and impairment of MK function. Over the years, several therapeutic modalities have become available for ITP, however, therapeutic management has proven to be very challenging in several cases. Patients refractory to treatment can develop a clinically worsening disease course, treatment-induced toxicities and are predisposed to development of potentially life-endangering bleedings. It is therefore of critical importance to timely identify potential refractory patients, for which novel diagnostic approaches are urgently needed in order to monitor and predict specific therapeutic responses. In this paper, we propose promising diagnostic investigations into immune functions and characteristics in ITP, which may potentially be exploited to help predict platelet count responses and thereby distinguish therapeutic responders from non-responders. This importantly includes analysis of T cell homeostasis, which generally appears to be disturbed in ITP due to decreased and/or dysfunctional T regulatory cells (Tregs) leading to loss of immune tolerance and initiation/perpetuation of ITP, and this may be normalized by several therapeutic modalities. Additional avenues to explore in possible prediction of therapeutic responses include examination of platelet surface sialic acids, platelet apoptosis, monocyte surface markers, B regulatory cells and platelet microparticles. Initial studies have started evaluating these markers in relation to response to various treatments including glucocorticosteroids (GCs), intravenous immunoglobulins (IVIg) and/or thrombopoietin receptor agonists (TPO-RA), however, further studies are highly warranted. The systematic molecular analysis of a broad panel of immune functions may ultimately help guide and improve personalized therapeutic management in ITP

The interplay between GPIb/IX-antibodies, platelet hepatic sequestration, and TPO levels in patients with chronic ITP.

Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder with an incompletely understood pathophysiology, but includes platelet-clearance in the spleen and liver via T-cells and/or platelet-autoantibodies. Strikingly, thrombopoietin (TPO) levels remain low in ITP. Platelet-glycoprotein (GP)Ibα has been described to be required for hepatic TPO generation, however, the role of GPIb-antibodies in relation to platelet hepatic sequestration and TPO-levels, with consideration of platelet counts, remains to be elucidated. Therefore, we performed a study in which we included 53 chronic and non-splenectomized ITP patients for which we conducted indium labeled autologous platelet scintigraphy, measured platelet-antibody profiles and TPO-levels. Upon stratification towards the severity of thrombocytopenia, no negative association was observed between GPIb/IX-antibodies and TPO levels, suggesting that GPIb/IX-antibodies do not inhibit or block TPO levels. Surprisingly, we observed a positive association between GPIb/IX-antibody levels and TPO levels, and GPIb/IX-antibodies and platelet hepatic sequestration, in patients with severe thrombocytopenia, but not in patients with mild or moderate thrombocytopenia. In addition, platelet hepatic sequestration and TPO levels were positively associated. This collectively indicates that GPIb/IX-antibodies may be associated with an increased platelet hepatic sequestration and elevated TPO levels in severe thrombocytopenic ITP patients, however, further research is warranted to elucidate the pathophysiological mechanisms.Immunobiology of allogeneic stem cell transplantation and immunotherapy of hematological disease

Nieuwe verwaarding algenbiomassa : literatuurstudie en praktische screening van enkele ontsluitingsmethoden

Om de eiwitten, oliën, koolhydraten, carotenoïden en andere nuttige stoffen aanwezig in algencellen los van elkaar te kunnen benutten, is het nodig om de celwanden van de algen open te breken, ofwel om de algen te ontsluiten. Uiteraard is het van belang om dit te doen op een manier die de te winnen componenten zo min mogelijk beschadigt. Dit rapport bestaat uit twee delen. Het eerste is een literatuurstudie waarin een aantal algensoorten wordt omschreven, met waar mogelijk nadruk op de celwandstructuur. Verder wordt een aantal methoden beschreven om de celwanden te openen of te verzwakken. In het tweede deel van het rapport worden een aantal uitgevoerde proeven beschreven waarbij algen zijn behandeld met enzymen, schoonmaakazijn, of ethanol