LAUSR

E lie Metchnikoff (1845-1916) was the first to demonstrate the immunogenicity of leukocytes. He reported that guinea pigs injected with rabbit blood produced antibodies against rabbit leukocytes, and he called the antibodies leukoagglutinins and leukolysins. In 1926, Charles Doan recognized that leukocyte incompatibility causes transfusion reactions and suggested that leukocytes have their own “groups.” Twentysix years later, Jean Dausset reported that leukoagglutinins were associated with chronic autoimmune neutropenia. Dausset’s report was followed by numerous publications on leukocyte immunology in Europe and the United States. In 1957, Tom Brittingham produced leukoagglutinins experimentally in humans. He volunteered to receive 100-mL blood infusions from a patient with chronic myelogenous leukemia for 9 consecutive weeks, the last 4 causing chills and fever. He could prevent the reaction by minimizing the number of the injected leukocytes. After 1 year, when the antibodies became undetectable, he repeated the experiment, receiving 50 mL of leukemic blood for 10 consecutive weeks. To study the effects of antibodies in donors’ blood, he received 50 mL of blood from a patient who had received numerous transfusions. The injection caused high fever, vomiting, dyspnea, cyanosis, and hypotension. Next day, the x-ray showed bilateral lung infiltrations, an early case of transfusion-related acute lung injury (TRALI)! It was in this period that Dausset and others demonstrated the inheritance of leukocyte antigens, and the identification of new antigens began (Fig. 1).