Blood transfusions, often life-saving interventions, have long been recognized for their potential to elicit allergic transfusion reactions (ATRs), particularly among pediatric patients. While the precise triggers of these reactions have remained elusive, a recent study conducted by Japanese scientists suggests a novel association between food allergies in blood donors and ATRs in recipients.
Published online in the journal Allergy, the study delves into the intricate relationship between donors’ pre-donation diets and the onset of ATRs in children. Led by Dr. Ryu Yanagisawa of Shinshu University Hospital, in collaboration with Dr. Minoru Tozuka and Dr. Yasunori Ito from Nagano Children’s Hospital, the research sheds new light on the potential role of food allergens in blood transfusion complications.
ATRs, characterized by immediate hypersensitivity reactions mediated by immunoglobulin E (IgE), pose a significant risk to transfusion recipients, especially children. Despite the recognized association with IgE-mediated type 1 allergy, the specific allergens responsible for ATRs have remained unidentified.
Seeking to address this gap in knowledge, the research team embarked on a comprehensive investigation spanning over a year. Between May 2022 and December 2023, blood samples were collected from more than 100 children and adolescents diagnosed with food allergies, focusing on common allergens such as eggs, wheat, and milk.
Concurrently, serum samples were obtained from healthy donors before and after consuming significant quantities of these allergenic foods. These samples were then subjected to basophil activation tests (BATs), a standard method for assessing allergic reactions by measuring the activation of basophils in response to allergen exposure.
The results yielded intriguing findings, particularly concerning patients with egg allergies. Basophil activation levels were markedly elevated when exposed to serum from donors who had recently ingested eggs, with peak activation observed four hours post-consumption. While variations were observed in milk and wheat allergy cases, a consistent pattern emerged linking allergen-specific IgE levels to basophil activation.
Dr. Yanagisawa underscored the significance of these observations, suggesting a potential link between donors’ dietary habits and the occurrence of ATRs in susceptible recipients. Although further validation and mechanistic studies are warranted, the study lays a crucial foundation for understanding and mitigating the risks associated with blood transfusions.
Looking ahead, the researchers envision a future where predictive models could anticipate ATRs, enabling the implementation of targeted preventive measures. By elucidating the interplay between dietary factors and transfusion outcomes, the study offers a promising pathway towards safer blood transfusions for all.
