Impact of Underlying Health on Alloimmunization

Healthy people are not transfused, and the diseases and treatments that result in patients requiring transfusion all impact the function of the immune system in distinct ways. We have demonstrated that many of these interventions impact the alloimmune response to platelet transfusion in unexpected ways. Different inflammatory signals can either enhance (poly(I:C)) or suppress (LPS) the alloimmune response, leading to differences in the amount and type of antibody produced, and the allo-specific B cell responses to transfusion. Induction chemotherapy, which we generally think of as immunosuppressive, leads to enhanced alloantibody responses to platelet transfusion, and this is associated with enhanced T cell responses, activation of transitional B cells, and upregulation of soluble BAFF.