A global effort was made to respond to COVID-19 using convalescent plasma therapy. The United States Food and Drug Administration Emergency Use Authorization facilitated rapid deployment, enabling the treatment of 94,287 patients by August 2020. The guidelines continuously evolved to emphasize the importance of a high titer plasma and specific immunocompromised patient groups. Korea has developed guidelines for treatment with convalescent plasma based on the successful treatment of two patients. By December 2023, convalescent plasma was collected from 67 donors at nine blood centers and transfused to 67 patients at 10 hospitals in Korea. The Association for the Advancement of Blood and Biotherapies recommendations, based on recent research, are believed to encompass the therapeutic effects of convalescent plasma therapy in COVID-19 patients. Korea initially considered convalescent plasma but experienced difficulties in development because of the switch to hyperimmune globulin and monoclonal antibodies. The insights gained from COVID-19 convalescent plasma treatment will be helpful in future pandemics caused by new infectious agents, underscoring the importance of domestic readiness for timely policy implementation.

Background: Due to the importance of the cold chain related to vaccine transportation, it is necessary to establish a blood cold chain operation strategy by checking the status of blood transportation from blood donation to transfusion. Methods: The blood transportation system and blood storage facilities were checked by inspecting the Korean Red Cross (KRC) Blood Centers and its affiliated supplier and Hanmaeum Blood Center. The status of the cold chain was evaluated through an interview with the quality control manager or blood supply team leader. For the hospital, the status was investigated from the perspective of the 30-min rule. A questionnaire survey was conducted for medical technicians and nurses working at the hospital. Results: Data on temperature during transport of blood components were computerized, and all standards were met. A nationwide network that could supply blood from the blood supply center to the hospitals within 2 hours was established. The frequency of temperature monitoring in the blood transport box and constant temperature check in the transport box during long-distance transport were evaluated. Conclusion This study confirmed that blood storage and transportation in Korea complied with the cold chain standards of high-income countries or higher. The evaluation of the cold chain is a constantly evolving process requiring continuous attention. When standards for storage and transportation of blood products are established, strict regulations and examinations will be required.

Asthma is a heterogeneous disease whose development is shaped by a variety of environmental and genetic factors. While several recent studies suggest that microbial dysbiosis in the gut may promote asthma, little is known about the relationship between the recently discovered lung microbiome and asthma. Innate lymphoid cells (ILCs) have also been shown recently to participate in asthma. To investigate the relationship between the lung microbiome, ILCs, and asthma, we recruited 23 healthy controls (HC), 42 patients with non-severe asthma, and 32 patients with severe asthma. Flow cytometry analysis showed severe asthma associated with fewer natural cytotoxicity receptor (NCR) + ILC3s in the lung.Similar changes in other ILC subsets, macrophages, and monocytes were not observed. The asthma patients did not differ from the HC in terms of the alpha and beta-diversity of the lung and gut microbiomes. However, lung function correlated positively with both NCR + ILC3 frequencies and microbial diversity in the lung. Sputum NCR + ILC3 frequencies correlated positively with lung microbiome diversity in the HC, but this relationship was inversed in severe asthma. Together, these data suggest that airway NCR + ILC3s may contribute to a healthy commensal diversity and normal lung function.

BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) is a rare disease that is often associated with genetic defects. Mutations of complement factor H (CFH) are the most common genetic defects that cause aHUS and often result in end-stage renal disease. Since CFH is mainly produced in the liver, liver transplantation (LT) has been performed in patients with defective CFH. METHODS: The clinical courses of four kidney allograft recipients who lost their native kidney functions due to aHUS associated with a CFH mutation were reviewed. RESULTS: Subject A underwent kidney transplantation (KT) twice, aHUS recurred and the allograft kidney failed within a few years. Subject B received a KT and soon experienced a recurrence of aHUS coinciding with infection. Her allograft kidney function has worsened, and she remains on plasma infusion therapy. Subject C underwent LT followed by KT. She is doing well without plasma infusion therapy after combined LT-KT for 3 years. Subject D received KT following LT and is now recurrence-free from aHUS. CONCLUSION: In patients with aHUS associated with a CFH mutation, KT without LT was complicated with a recurrence of aHUS, which might lead to allograft loss. Conversely, LT was successful in preventing the recurrence of aHUS and thus might be another option for a recurrence-free life for aHUS patients associated with CFH mutation.
Allografts ; Atypical Hemolytic Uremic Syndrome ; Complement Factor H ; Complement System Proteins ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney ; Liver Transplantation ; Liver ; Plasma ; Rare Diseases ; Recurrence

Previous studies have demonstrated the role of hydroquinone (HQ), a hydroxylated benzene metabolite, in modulating various immune responses; however, its role in macrophage-mediated inflammatory responses is not fully understood. In this study, the role of HQ in inflammatory responses and the underlying molecular mechanism were explored in macrophages. HQ down-regulated the expression of interferon (IFN)-β mRNA in LPS-stimulated RAW264.7 cells without any cytotoxicity and suppressed interferon regulatory factor (IRF)-3-mediated luciferase activity induced by TIR-domain-containing adapter-inducing interferon-β (TRIF) and TANK-binding kinase 1 (TBK1). A mechanism study revealed that HQ inhibited IRF-3 phosphorylation induced by lipopolysaccharide (LPS), TRIF, and AKT by suppressing phosphorylation of AKT, an upstream kinase of the IRF-3 signaling pathway. IRF-3 phosphorylation is highly induced by wild-type AKT and poorly induced by an AKT mutant, AKT C310A, which is mutated at an inhibitory target site of HQ. We also showed that HQ inhibited IRF-3 phosphorylation by targeting all three AKT isoforms (AKT1, AKT2, and AKT3) in RAW264.7 cells and suppressed IRF-3-mediated luciferase activities induced by AKT in HEK293 cells. Taken together, these results strongly suggest that HQ inhibits the production of a type I IFN, IFN-β, by targeting AKTs in the IRF-3 signaling pathway during macrophage-mediated inflammation.
Benzene ; HEK293 Cells ; Inflammation ; Interferons ; Luciferases ; Macrophages ; Phosphorylation ; Phosphotransferases ; Protein Isoforms ; RNA, Messenger

Over the last two decades, newer immunosuppressive agents have been introduced in the field of solid organ transplantation, and provided better graft and patient outcome. A wider range of immunosuppressants available to transplant physicians have resulted in improved therapeutic strategies to offer the combinations of medications with non-overlapping toxicities and more suitable immunosuppression. However, only a few clinical trials of new immunosuppressants have been conducted in pediatric patients. This review will discuss the cutting-edge strategy of immunosuppression in children and the current status of new immunosuppressive agents in pre- and post-transplant management to prevent kidney allograft rejection.
Allografts ; Child ; Humans ; Immunosuppression* ; Immunosuppressive Agents ; Kidney Transplantation ; Kidney* ; Organ Transplantation ; Transplants

Information on the blood safety management system in Japan was collected by visiting the Ministry of Health, Labour and Welfare (MHLW), Japanese Red Cross Blood Service Headquarter, Kanto-Koshinetsu Block Blood Center, and Yurakucho Blood Room of Tokyo Metropolitan Blood Center, in July 2014, to improve the quality of the blood management system in Korea. In Japan, all blood products are supplied by the Japanese Red Cross Blood Service. In April 2012, the function of screening tests and blood product production of the provincial blood centers was transferred to the block blood centers. Donor suitability is assessed by medical doctors and EKG was tested for donors over 40 years old annually. To prevent bacterial contamination, the shelf life of platelets was shortened to 4 days after production, but routine bacterial screening test was not performed. Adverse reactions and infection following transfusions are reported to MHLW through the Red Cross Blood Service, and the case was reviewed by Pharmaceuticals and Medical Devices Agency (PMDA). Before transfusion, HBsAg, anti-HBs, anti-HBc, anti-HCV, and HCVcAg of the recipient is tested, and testing for HIV antigen is performed if the recipient has risk factors for HIV infection. Even when hepatitis B NAT is positive, look back is not performed if anti-HBc is negative and there is no history of blood donation within 125 days before the current donation. Good Manufacturing Practice (GMP) for blood centers was introduced in the 1990s and PMDA performs the test every 5 years. In introduction of GMP in Korea, it is necessary to decide how to absorb the expense.
Asian Continental Ancestry Group ; Blood Donors ; Blood Safety ; Electrocardiography ; Hepatitis B ; Hepatitis B Surface Antigens ; HIV ; HIV Infections ; Humans ; Japan* ; Korea ; Mass Screening ; Red Cross ; Risk Factors ; Tissue Donors

Anti neutrophil cytoplasmic antibody (ANCA)-positive vasculitis and crescentic glomerulonephritis has been rarely reported in patients suffering from Graves' disease and treated with Propylthiouracil. We experienced a case of ANCA-positive crescentic glomerulonephritis presenting good prognosis after discontinuing Propylthiouracil. A 40-year-old female visited due to the proteinuria and hematuria in urinalysis. She had been medicated Propylthiouracil for 3 years. Blood pressure was 100/60 mmHg. BUN and serum creatinine were 24.7 mg/dL, and 1.9 mg/dL, respectively. Urinalysis revealed protein 1481 mg/day, many RBC's/HPF (dysmorphic 80%), Serological ANCA was positive, anti-myeloperoxidase (MPO) antibody 1,922 AAU/ mL (normal <150 AAU/mL). The histologic finding showed crescentic glomerulonephritis on light microscopy, but no immuno deposit on immunofluorescence and light microscopy. So we diagnosed ANCA positive pauci-immune glomerulonephritis. Propylthiouracil was discontinued and steroid, cyclophosphamide was medicated within about 1 month, but stopped due to cytopenia. Patient's creatinine level was maintained 1.3 mg/dL and showed stable progress for about over 18 months. We report this case that showed good prognosis after discontinuation of Propylthiouracil.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Blood Pressure ; Creatinine ; Cyclophosphamide ; Female ; Fluorescent Antibody Technique ; Glomerulonephritis ; Graves Disease ; Hematuria ; Humans ; Light ; Microscopy ; Prognosis ; Propylthiouracil ; Proteinuria ; Stress, Psychological ; Urinalysis ; Vasculitis

Though the development of immunosuppressive agents has increased the survival rate of transplanted kidneys, the opportunistic infection has increased in transplant recipients. Aspergillus may cause invasive aspergillosis via sino-pulmonary route in immunocompromized patients. We report a rare case of invasive aspergillosis of a transplanted kidney without having disseminated disease. A 41 year-old female, who underwent cadaveric renal transplantation 10 months ago, presented with diarrhea and anemia. Ultrasound examination and CT scan revealed an abscess lesion in the transplanted kidney. Surgical curettage and percutaneous drainage were performed. Because, microscopic examination demonstrated fungal hyphae consistent with Aspergillus species, antifungal agents were prescribed. Later, partial transplant nephrectomy and embolization of the remnant kidney were performed.
Abscess ; Anemia ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Cadaver ; Curettage ; Diarrhea ; Drainage ; Female ; Humans ; Hyphae ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Nephrectomy ; Opportunistic Infections ; Survival Rate ; Transplantation, Homologous ; Transplants

Cardiac amyloidosis describes a clinical disorder caused by infiltration of abnormal insoluble fibrils in the heart, characterized by progressive heart failure and a grave prognosis. Pleural effusion in cardiac amyloidosis may represent a sign of heart failure, but it can also result from pleural infiltration of amyloid, manifested by recurrent large fluid accumulations. Recently, the role of vascular endothelial growth factor (VEGF) has been implicated in the pathogenesis of refractory pleural effusion. We report a case of a 53 year-old female patient with cardiac amyloidosis who presented with recurrent accumulation of large pleural effusions. She was initially treated with high dose loop diuretics, but the pleural effusion persisted, with the daily amount of drainage averaging 1 L/day. Accumulation of pleural fluid did not subside after 3 cycles of melphalan/prednisolone therapy. After the introduction of bevacizumab, an anti-VEGF antibody, the amount of pleural effusion decreased significantly. Efficacy of anti-VEGF therapy for refractory pleural effusions needs to be defined through further studies.
Amyloid ; Amyloidosis ; Antibodies, Monoclonal, Humanized ; Drainage ; Female ; Heart ; Heart Diseases ; Heart Failure ; Humans ; Pleural Effusion ; Prognosis ; Sodium Potassium Chloride Symporter Inhibitors ; Vascular Endothelial Growth Factor A ; Bevacizumab