Two schools of thoughts: Lymphocyte immunization therapy

What if I had LIT solely on husband's lymphocyte? What if, we share many HLA antigen in common? I will not produce antibody against the common HLA. If I and my husband share many HLA antigen, chances are after 10 x of LIT with husband's lymphocyte the reaction code remains unchanged. Am I correct? What is more important- the reaction code between or the panel reactive antibody score? I guess I don't need to have a positive reaction in each of the serum from the panel reactive antibody. I need positive reaction to my husband's lymphocyte only. Immunologist wants 100% score because they feel high PRA is safe?


Oh, two school of thoughts. First, husband as the sole donor. Second, unrelated donors + husband.

I trust my watch 100%. I wear one watch only, or never at all.  Wearing two watches is quite confusing, if both are not synchronized, I don't know which is telling the correct time. It defeats the purpose of wearing a watch. Wearing three watch will be acceptable but quite odd. The logic here is majority wins. Wearing 4 watches is funny. 

And... what about my immunologist protocol on the number of donors? Why husband + 3 unrelated donor? My immunologist also wears three watches? He is not happy to wear one watch? Why not 7 donors at a time? I have 3 unrelated donors on first LIT, and another set of 3 unrelated donor on second LIT + husband= 7 donors total? Why not do it together?

"Dear Obgyne,
... She is responding slowly to the LIT. Most likely they share more than one HLA antigens in common...
Regards,
Immunologist"

It is betting time! what will be my reaction code 8-4 , 8-6 , 8-8 or 0-0 on my next LAT-M IgG test? Winners will receive surprise gift.

Back to my very old sentiment... my husband has erectile dysfunction. Limited exposure to sperm creates limited antibody. Therefore I failed in the LAT-M IgG test. I contested I don't have immunologic problem. I don't believe in the PRA thing.

My third LIT consultation

Doctor said my I have developed pustules against all donors, lymphocyte. This maybe viral infection. Yes, I have colds. Virus and bacteria makes our immune system to be active.

My base line for the reaction codes: 2-2. It has jumped to 6-4. The bad news is I slowly respond to LIT.  Ideally, the reaction code should be at the same. My induration from husband lymphocytes are smaller. He concluded that we share at least one common HLA.

Btw, what is LAT-M IgG? It measures the anti-HLA antibody. How can I be sure the my body will produce anti-iditotypic antibody after I have produced the anti-HLA antibody. Doctor said it definitely will. Anti-idiotypic antibody stops the production of rejecting antibody (anti-HLA antibody). Its function is to bind to anti-HLA antibody. Otherwise, my anti-HLA antibody will reproduce without limit.

What is PRA? What does it have to do with pregnancy? I don't believe much in PRA. There are cases wherein the father had raped his daughter. And they were able to bear a child. I feel blocking antibody is not a necessity to get pregnant. My fetus will be safer if I don't produce blocking antibody against my husband. Doctor said re: father raped daughter case. After the daughter has given birth, definitely she will have high level of blocking antibody against her father. Our body is programmed to distinguish our own cells from cancer cells, bacteria, etc... It is the function of ourmy immune system to restrict the unnecessary growth. Oh my god! My PRA theory is defeated.

I had a very long story of latent tuberculosis, what if my donor has latent tuberculosis? No medical and scientific studies show that latent tuberculosis can be spread through blood donation.

He requested for a uterine biophysical profile to see whether I have enough blood flow to the uterus at the time of ovulation. This affects the implantation success of ivf.

P.S. Doctor said don't get pregnant.

My blood safety questions

These questions popped up the yesterday while I was doing my lymphocyte immunization therapy:
1. People with latent tuberculosis may get positive in the skin tuberculin test. What is responsible for the skin sensitivity test? We are expecting for a delayed type hypersentivity reaction, correct? So, are we checking for its T-cell? Hmmm... T-cell is a white blood cell.

2. What if the donor has latent tuberculosis, can pulmonary tuberculosis spread through blood transfusion?  I believe Philippines belongs to the top 10 countries with the most incidence of tuberculosis cases. But my doctor assured me tuberculosis bacteria cannot be spread thru blood transfusion.

3. What if my donor had undetected autoimmune disorder? I have read some articles say having HLA-B27 gene does not necessarily mean that you will get spondyloarthropy. Why is it so? I guess because there is no HLA-B27 antibody to react with the surface antigen of the host cell. Therefore no inflammation. What if the donor has undetected rheumatoid arthritis? This entails I will produce HLA-DR4 antibody. Do I know my genome sequence? If I dont have HLA-DR4 gene, it will not affect me. What if i have that gene, then it will trigger my autoimmunoty. Correct?

4. Prions are not also included in the blood screen.

5. Are there other infections that can be spread thru blood transfusion? I am referring to mycoplasma and other curable bacteria infection that is not included in the standard blood screening test.

My third LIT- giant pustules

I feel febrile and little throbbing pain on the injection sites. I thought I have developed immune tolerance. After 8 hours, I saw 14 out of 16 injection sites developed pustules. They were bigger than the first LIT. I thought I will be graduating from lymphocyte immunization therapy in no time. Now, I feel not febrile anymore.

I said in my previous post, Anti-idiotypic antibody may compete with my donor's HLA in the binding site for anti-HLA-antibodies. Anti-idiotypic antibody halts antibody production. Ei, Did it just enhanced my immune activity? Anti-idiotypic antibody triggers the production of anti-HLA antibody. Hehe looping! Donor HLA triggers the production of anti-HLA antibody. Ergo, it has additive effect. Wahaha, my stilly theory.

Questions on idiotypic and anti-idiotypic antibody

I am stucked with my own reasoning glitch. I said in the past:  If I don't develop anti-blocking antibody against my husband , it does not necessarily mean  that I may not produce anti- blocking antibody against my husband in the future. Applying my logic, if I don't develop  anti-blocking antibody against my fetus in the first trimester, it is not guaranteed that i will not develop anti-blocking antibody against my fetus in my second trimester of pregnancy.

What is the anti-idiotypic antibody for? I guess this is a principle of double negation: -1x-1=+1. Double negation cancels the effect of negation. I guess anti-idiotypic antibody (anti-anti-HLA antibody) mimics those of my husband's HLA? Does anti-idiotypic antibody trigger the production of idiotypic antibody? Who knows, it is a cyclic and reversible process. How does anti-idiotypic antibody suppress immune response? I guess anti-idiotypic antibody mimics that of my husband's HLA. And I guess it will compete with my fetus HLA antigen in binding with anti-HLA antibody.

Can we do some immunologic engineering here? What if we intentionally select those with autoimmune disorder as donors? Then inject their lymphocyte NOT on me (on other patients please....). Their immune system will create anti HLA-B27 antibody and then it will trigger the production of secondary antibody which is the anti anti-HLA-B27 antibody. Then collect the anti anti-HLA-B27 antibody and sell it as vaccine.  Perhaps not for fertility treatment but this will be a breakthrough cure for spondyloarthropathy and uveitis. Anti Anti-HLA-DR4-antibody,  anti anti-cancer protein-antibody. Isn't it great? I will be the future Nobel Prize awardee in immunology. Ehem...

I am not against my immunologist. ^.^ I am just inquisitive. I don't believe much on the PRA thing. But I believe in him. Cyclic reasoning ya! Whatever.

I have 100% PRA

After two LITs, my PRA had shot up to 100%. My reaction code is now 6-4. My next LIT will be on Wednesday.  Then what? Should I start celebrating my 100% mark?

I told my obgyne's secretary that I feel like ovulating today.  I wish to have IUI tomorrow. I share to her my good news- my PRA is already 100%. Where is my immunologic clearance? She asked me where are the other parameters- KCT and etc...? She said it is a waste to do IUI.

Little sour-graping here, who wants to have IUI in ghost month? Better luck next cycle, after the ghost month is over.

Recounting my first LIT

I had a big genuine smile as I entered my immunologist's clinic for my first immunotherapy. My cowardice hid underneath my big smile. I was afraid of catching another autoimmune disease. I was afraid of triggering another round of inflammation: uveitis or spondylitis. My optimism and hope had overshadowed my fear. I was excited to have give immunotheraphy a try.

Is there room for trying? Whatever... I trust, believe and surrender. But, up to now, I have endless questions about immunology. Maybe it is not a 100% trust. But I choose to surrender. I choose to play the Simon Says Game.

Honestly, I am not so eager to know my crossmatch result. Of course, I wish to attain a 100% PRA and high reaction code of 8 - 8. Why am I not so eager to see my LAT-M result? Maybe up to now, I am not so enrolled with the PRA and LIT thing.

Grrrr.... Why did I choose to surrender to my immunologist? I will have donor screening again on Monday. I am praying my donors will not back out. There is still enthusiasm in playing the Simon Says Game. Hoping my third LIT will push through on Wednesday.

I hope next month is my last LIT. Let us see, if immunology is really a fiction? Or perhaps a placebo. How to explain placebo effect? LIT just give me the feeling that my 'immunologic side' is taken care of, but in fact it is useless. I just addicted to take "empty or sugar pills" and LIT believing it can alleviate my condition.

I hope immunology is not a fiction!