Article Sidebar

Submitted
January 12, 2025
Accepted
March 11, 2025
Published
March 26, 2025
Download
PDF
Statistic
Read Counter : 94

Main Article Content

Abstract





Autoimmune hemolytic anemia (AIHA) has become recognised as a complex and heterogeneous disease characterised by a wide range of immunopatholog- ical and biochemical mechanisms. Several treatment options exist in the field of AIHA however; there is as yet little or no evidence of therapeutic strategies targeted on molecular aspects of the disease. An up-to-date comprehensive sys- tematic review covering immunopathology for emerging areas of experimental therapy of AIHA will help direct future research and optimize clinical deci- sions, by focusing on issues needing improvement. This structured systematic review will focus on the immunopathological molecular mechanisms and the most recent emerging therapeutic strategies for AIHA or emerging therapeu- tic strategies targeted at the molecular mechanisms of the disease. The aim of the review is to collect, critically evaluate, and systematically summarise all available evidence on the immunopathology and experimental therapy of AIHA. For the immunopathology of AIHA, the main issues of interest are: the initiation and development of the disease, the immunological and biological mechanisms of red blood cell destruction, diagnostic markers predicting the response to therapy, the relationship with other autoimmune disorders and aspects of the genetics of AIHA. Experimental therapy will include newly ap- plied or planned treatment protocols and compounds, or medications present- ing disease-modifying and non-conventional mechanisms of action. This review will be oriented toward researchers and clinicians engaged in the management and research of AIHA, and results will be analysed and presented in light of their potential to translate findings into practice. Eligibility for inclusion criteria, salience assessment, and data extraction analysis aims to critically synthesize available data, identify research gaps and assess the quality of ev- idence. Substantial advances in the comprehension of the immunopathology of the disorder or the emergence of new advanced science verified drugs and other compounds in therapy will be explored. Summarised results will point toward research fields most urgently needing further investigation and provide a comprehensive synthesis of evidence helpful for the optimization of clinical decisions and the initiation of innovative therapies.





Keywords

Immunopathology Autoimmune Hemolytic Anemia Therapeutic Strategies

Article Details

License

Copyright (c) 2025 Ahmad Maher Ibrahim Al Sayeh, Mohammad Rawashdeh (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite
1.
Al Sayeh AMI, Rawashdeh M. Immunopathology of Autoimmune Hemolytic Anemia: A Systematic Review of Molecular Mechanisms and Emerging Therapeutic Strategies. JBB [Internet]. 2025 Mar. 26 [cited 2025 Apr. 24];4(1):40-51. Available from: http://biomedbiochem.nabea.pub/biomedbiochem/article/view/88
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

How to Cite

1.
Al Sayeh AMI, Rawashdeh M. Immunopathology of Autoimmune Hemolytic Anemia: A Systematic Review of Molecular Mechanisms and Emerging Therapeutic Strategies. JBB [Internet]. 2025 Mar. 26 [cited 2025 Apr. 24];4(1):40-51. Available from: http://biomedbiochem.nabea.pub/biomedbiochem/article/view/88
Crossref
Scopus
Google Scholar
Europe PMC

References

  1. Gehrs BC, Friedberg RC. Autoimmune hemolytic anemia. American Journal of Hematology. 2002;69(4):258-71. doi:10.1002/ajh.10062.
  2. Barcellini W. Immune hemolysis: Di- agnosis and treatment recommendations. Seminars in Hematology. 2015;52(4):304-12. doi:10.1053/j.seminhematol.2015.07.001.
  3. Barcellini W, Fattizzo B. The changing landscape of autoimmune hemolytic anemia. Frontiers in Immunology. 2020;11:946. doi:10.3389/fimmu.2020.00946.
  4. Jäger U, Barcellini W, Broome CM, et al. Diagno- sis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting. Blood Reviews. 2020;41:100648. doi:10.1016/j.blre.2019.100648.
  5. Barcellini W, Fattizzo B. Clinical applications of hemolytic markers in the differential diagnosis and management of hemolytic anemia. Disease Markers. 2015;2015:635670. doi:10.1155/2015/635670.
  6. Duffy TP. Autoimmune hemolytic anemia and paroxysmal nocturnal hemoglobinuria. Rossi’s Principles of Transfusion Medicine. 2009;3.
  7. Gertz MA. Updates on the diagnosis and management of cold autoimmune hemolytic anemia. Hematology/Oncology Clinics of North America. 2022;36(2):341. doi:10.1016/j.hoc.2021.11.001.
  8. Mitchell KD. The acute phase response in ca- nine autoimmune hemolytic anemia. University of Guelph; 2008. Doctoral dissertation. Available from: https: /hdl.handle.net/10214/22224.
  9. Miya W. Initial Sputum Smear Grading as a Factor in Predicting Treatment Outcome in Newly Diagnosed Sputum Smear Positive Pulmonary Tuberculosis Patients. Rajiv Gandhi University of Health Sciences (India); 2018. Doctoral disser- tation.
  10. Hill QA, Stokes M, Massey E, Grainger JD, Provan D, Hill A. The diagnosis and management of primary autoimmune haemolytic anaemia. British Journal of Haematology. 2017;176(3):395-411. doi:10.1111/bjh.14478.
  11. Jalink M, De Boer EC, Evers D, Havinga MQ, Vos JM, Zeerleder S, et al. Halting targeted and collateral damage to red blood cells by the complement system. In: Seminars in Immunopathol- ogy. Springer Berlin Heidelberg; 2021. p. 1-18. doi:10.1007/s00281-021-008598.
  12. Barcellini W, Fattizzo B. The changing landscape of autoimmune hemolytic anemia. Frontiers in Immunology. 2020;11:946. doi:10.3389/fimmu.2020.00946.
  13. Cooper GS, Bynum ML, Somers EC. Recent insights in the epidemiology of autoim- mune diseases: improved prevalence estimates and understanding of clustering of diseases. Journal of Autoimmunity. 2009;33(3-4):197-207. doi:10.1016/j.jaut.2009.09.008.
  14. Sharma SK. B Cells. In: Basics of Hematopoi- etic Stem Cell Transplant. Springer Nature Singapore; 2023. p. 87-120. doi:10.1007/978-981-19-5802-1_10.
  15. Street NE, Mosmann TR. Functional diversity of T lymphocytes due to secretion of different cytokine patterns. The FASEB Journal. 1991;5(2):171-7. doi:10.1096/fasebj.5.2.1825981.
  16. Mossong J, Hens N, Jit M, Beutels P, Auranen K, Mikolajczyk R, et al. Social contacts and mixing patterns relevant to the spread of infectious diseases. PLoS Medicine. 2008;5(3):e74. doi:10.1371/journal.pmed.0050074.
  17. Group DD. Prevalence of small vessel and large vessel disease in diabetic patients from14 centres: the World Health Organisation multinational study of vascular disease in dia- betics. Diabetologia. 1985;28(Suppl 1):615-40.doi:10.1007/BF00290267.
  18. Loriamini M, Cserti-Gazdewich C, Branch DR. Autoimmune hemolytic anemias: classifications, pathophysiology, diagnoses and management. International Journal of Molecular Sciences. 2024;25(8):4296. doi:10.3390/ijms25084296.
  19. Salama A. Complement-mediated autoimmune hemolysis and its treatment. Clinical and Developmental Immunology. 2012;2012:181258. doi:10.1155/2012/181258.
  20. Andrew M Kaunitz M, Deanna C McCullough M, Erin H Burnett M. Medical management of abnormal uterine bleeding in reproductive-age women. OBG Management. 2021;31(9):31 34.
  21. Dhaliwal G, Cornett PA, Tierney Jr LM. Hemolytic anemia. American Family Physician. 2004;69(11):2599-607. Available from: https: /www.aafp.org/pubs/afp/issues/2004/ 0601/p2599.html.
  22. van Loo G, Schotte P, Van Gurp M, Demol H, Hoorelbeke B, Gevaert K, et al. Endonu- clease G: a mitochondrial protein released in apoptosis and involved in caspase-independent DNA degradation. Cell Death & Differentiation. 2001;8(12):1136-42.doi:10.1038/sj.cdd.4400944.
  23. Michel M. Warm autoimmune hemolytic anemia: Current and emerging treatment options. Hematology American Society of Hema- tology Education Program. 2017;2017(1):201-6. doi:10.1182/asheducation-2017.1.201.
  24. Michalak SS, Olewicz-Gawlik A, Rupa-Matysek J, Wolny-Rokicka E, Nowakowska E, Gil L. Autoimmune hemolytic anemia: current knowledge and perspectives. Immunity & Ageing. 2020;17:1-6. doi:10.1186/s12979-020-00208-7.
  25. Dierickx D, Kentos A, Delannoy A. The role of rituximab in adult patients with warm antibody autoimmune hemolytic anemia. Blood. 2015;125(21):3223-9. doi:10.1182/blood-2014-11-577346.
  26. Paul WE. Fundamental Immunology. Philadel- phia, PA: Wolters Kluwer Health; 2013.
  27. Englinger B, Pirker C, Heffeter P, Terenzi A, Kowol CR, Keppler BK, et al. Metal drugs and the anticancer immune response. Chemical Reviews. 2018;119(2):1519-624. doi:10.1021/acs.chemrev.8b00396.
  28. Vasilev VV, Radanova M, Lazarov VJ, Dragon-Durey MA, Fremeaux-Bacchi V, Roumenina LT. Autoantibodies against C3b—functional consequences and disease relevance. Frontiers in Immunology. 2019;10:64. doi:10.3389/fimmu.2019.00064.
  29. Berentsen S, Sundic T. Red blood cell destruction in autoimmune hemolytic anemia: Role of complement and potential therapeutic tar- gets. Frontiers in Immunology. 2019;10:1604. doi:10.3389/fimmu.2019.01604.
  30. Denomme GA. The structure and function of the molecules that carry human red blood cell and platelet antigens. Trans- fusion Medicine Reviews. 2004;18(3):203-31. doi:10.1016/j.tmrv.2004.03.006.
  31. Richards AL, Kapp LM, Wang X, Howie HL, Hudson KE. Regulatory T cells are dispensable for tolerance to RBC antigens. Frontiers in Immunology. 2016;7:348. doi:10.3389/fimmu.2016.00348.
  32. Barcellini W, Fattizzo B, Zaninoni A. Cur- rent and novel treatment options for autoimmune hemolytic anemia. Drugs. 2018;78(11):1093-117. doi:10.1007/s40265-018-0931-1.
  33. Turpin C, Catan A, Meilhac O, Bourdon E, Canonne-Hergaux F, Rondeau P. Erythrocytes: central actors in multiple scenes of atherosclerosis. International Journal of Molecular Sciences. 2021;22(11):5843. doi:10.3390/ijms22115843.
  34. Michalak SS, Olewicz-Gawlik A, Rupa-Matysek J, Wolny-Rokicka E, Nowakowska E, Gil L. Autoimmune hemolytic anemia: current knowledge and perspectives. Immunity & Ageing. 2020;17:1-6. doi:10.1186/s12979-020-00208-7.
  35. Gertz MA. Cold agglutinin disease: Current understanding and treatment approaches. Hematology Am Soc Hematol Educ Program. 2016;2016(1):226-31. doi:10.1182/asheducation-2016.1.226.
  36. Michalak SS, Olewicz-Gawlik A, Rupa-Matysek J, Wolny-Rokicka E, Nowakowska E, Gil L. Autoimmune hemolytic anemia: current knowledge and perspectives. Immunity & Ageing. 2020;17:1-6. doi:10.1186/s12979-020-00208-7.
  37. Hill QA, Hill A. Autoimmune hemolytic anemia. Hemolysis and Hematology. 2018;24(2):103-17.doi:10.1016/j.haem.2018.01.002.
  38. Vale AM, Schroeder HW. Clinical consequences of defects in B-cell development. Journal of Allergy and Clinical Immunology. 2010;125(4):778-87. doi:10.1016/j.jaci.2010.02.018.
  39. Ma L, Zeng X, Liu X, et al. Advances in the pathogenesis and treatment of autoimmune hemolytic anemia. J Transl Med. 2021;19(1):25. doi:10.1186/s12967-021-02718-9.
  40. Jäger U, Knöbl P, Lechner K. Mechanisms of immune-mediated hemolysis and novel therapeutic approaches. Transfus Med Hemother. 2019;46(6):349-58. doi:10.1159/000503801.
  41. Berentsen S, Randen U, Tjønnfjord GE. Cold agglutinin disease. Hematol Oncol Clin North Am. 2015;29(3):455-71.doi:10.1016/j.hoc.2015.01.005.
  42. Michalak SS, Olewicz-Gawlik A, Rupa-Matysek J, Wolny-Rokicka E, Nowakowska E, Gil L. Autoimmune hemolytic anemia: current knowledge and perspectives. Immunity & Ageing. 2020;17:1-6. doi:10.1186/s12979-020-00208-7.
  43. Barcellini W, Fattizzo B. The changing landscape of autoimmune hemolytic anemia. Frontiers in Immunology. 2020;11:946. doi:10.3389/fimmu.2020.00946.
  44. Rubin RH. Infectious disease complications of renal transplantation. Kidney International. 1993;44(1):221-36. doi:10.1038/ki.1993.234.

Similar Articles

You may also start an advanced similarity search for this article.