Autologous carrier

In one clinical situation, the nature of the autologous carrier may be rather clearly defined this is in drug-induced hemolytic anemia based on immunologic mechanisms. It has been shown that destruction of erythrocytes is due to interaction of IgG antibodies with the red cell membrane after its appreciable penicilloy-lation during therapy with high doeses of penicillin (Levine and Redmond 1967). The antibodies involved were penicilloyl specific but it appeared possible that modified structures of the red cell surface are also contributing to the specificity. If this can be substantiated, the erythrocyte will be definitively implicated as the actual immunogenic carrier. 

A different classification problem is raised by immunogens produced by metal salts. In these cases, autologous carriers are thought to become modified by metal ion interaction, and NAD which contain the metal and others which may not contain it can be envisaged. The question here is rather whether the coordinate bonds which are inferred for the transition metals should not be simply considered as covalent. 

Various immunogenic substances requiring association with carriers are listed in Table 2. Picric acid, discussed as an exceptional low molecular weight sensitizer in Sect. C.II.l, may be cited with some confidence as a compound which associates with autologous carriers, giving rise to an immunogenic complex. This may be inferred from the cross-reactivity data already mentioned, namely that reactions in contact-sensitized animals may only be evoked by contact application of picryl chloride, not by intradermal application or by means of picrylated protein. 

A number of metal salts have been found to induce delayed hypersensitivity, mainly of the contact type, in humans or in laboratory animals. Sensitivity to ions of chromium, mercury, platinum, nickel, beryllium, and others seem well established and Table 2 shows some recent findings. The best studied metal sensitizers are the chromium salts, since chromium eczema due to cement is the most important occupational dermatosis (Polak et al. 1973). Hexavalent chromium, in the form of potassium dichromate, is a better sensitizer than trivalent chromium. This seems related to the much better skin penetrating capacity of the dichromate, since numerous studies have shown that trivalent chromium compounds as opposed to hexavalent salt are the actual sensitizers (Polak et al. 1973). The same authors conclude that chromium is probably a component of the determinants formed with autologous carriers and does not produce autoantigens without further participation of the metal ion. In particular, oxidation reactions as generators of determinants seem inoperative in chromium hypersensitivity, since other strong oxidizers like... 

Standi, T. (2005) [Autologous transfusion—from euphoria to reason Clinical practice based on scientific knowledge. (Part IV). Artificial oxygen carriers Cell-free hemoglobin solutions—current status 2004]. Anaesthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie, 40, 38-45. 

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