Passive IgE‐sensitization by blood transfusion

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Abstract
Background:  To study the mechanisms of passive sensitization of patients receiving plasma containing IgE antibodies to a defined allergen.Methods:  When required for medical reasons, regular donor plasma with IgE antibodies to timothy grass allergen (8–205 kUA/l), was given. Kinetics of IgE antibodies in the recipients’ serum and his/her basophil allergen threshold sensitivity, CD‐sens, was monitored up to 2–3 weeks after transfusion. The IgE antibodies were quantitated by ImmunoCAP. The CD‐sens in plasma recipients, determined by CD63 up‐regulation, was measured by flow cytometry and compared to CD‐sens of patients with allergic asthma and/or rhinitis.Results:  There was a significant correlation (r = 0.98; P < 0.001) between amount of IgE antibody given and recipient serum peak concentration. The T1/2 for IgE antibody in circulation was 1.13 days (95% confidence limit 0.35–1.91 days). The recipients became CD‐sens positive already 3 h after transfusion. The CD‐sens peak was observed after 3.4 days and the value were correlated (r = 0.68; P < 0.02) to the amount of IgE antibody transfused and were of the same magnitude as found in allergic patients. The T1/2 of CD‐sens indicated two populations of basophils; one with a CD‐sens decrease T1/2 of 4 days and one of 10 days.Conclusion:  Transfused IgE antibodies will sensitize mast cells and basophils to CD‐sens levels similar to those of allergic patients. The recipients expressed ‘slow’ or ‘rapid’ CD‐sens decline, indicating two different basophil populations. After transfusion of plasma with >10 kUA/l IgE antibody the recipient could have allergen reactive basophils for up to 7 weeks.

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