Maternal Dq Response
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Maternal Dq Response
Maternal Dq Response
Missy is a three-year-old girl.
She adores being in the kitchen with her mother and grandmother.
She drags a chair up to the stove, hops into it, and peers into the boiling water pot.
The steam is scorching on her face, so she takes a step back, and the boiling water is dragged down on her as she falls from the chair.
Missy is transported to the hospital’s emergency room.
Grandma applied some butter to her fingers, but not on her face.
The nurse realizes that her hands, face, chest, and arms have been burned in the emergency room.
Although the doctor believes it is a partial thickness burn, her hands are blistering and edematous.
1. After a few days, the doctor starts talking about hand and face grafting.
Can you inform the parents about the type of care their child will require?
What is the status of this child’s home care?
Please also explore long-term issues, like as physical and emotional health, as well as how she will interact with her peers.
300-word limit
The method by which the fetal semi-allograft is able to evade maternal immune monitoring is currently unknown.
The absence of major histocompatibility complex (MHC) type I antigens in the placenta has been attributed to the lack of cytotoxic T-cell response towards the fetus (cytotoxic T-cell response requires presentation of the antigen by MHC-I antigens).
Some studies suggest that variations in some MHC-II antigens, particularly in the DQ-alpha region, cause immunological protective responses.
One explanation is that changes in DQ-alpha antigens cause stimulation of progesterone (P) receptors in gamma/delta T-cells, which then secrete a protein termed progesterone induced blocking factor when exposed to high concentrations of P (concentrations only formed at the maternal-fetal interface) (PIBF).
PIBF, in turn, suppresses natural killer (NK) cell cytolysis, causing a shift in cytokine dominance from TH1 to TH2.
One theory is that when DQ-alpha antigens are shared, PIBF is not sufficiently produced due to a failure to activate appropriate P receptors in gamma/delta T cells, increasing the chance of spontaneous abortion or causing implantation failure after IVF-ET.
Thirty-one couples who underwent in vitro fertilization and embryo transfer were tested for DQ-alpha antigen sharing.
There were 16 people who had a DQ-alpha antigen in common and 15 people who didn’t.
Clinical pregnancies were obtained in seven (43.7%) of individuals who shared antigens and six (40.0%) of those who did not.
There were no spontaneous abortions in the former and one in the latter.
Seven patients shared the 4.1 antigens, and three of them conceived, while eight patients shared a 1.1, 1.2, or 1.3 antigen, and four of them conceived.
These findings do not support the theory that sharing DQ-alpha antigens is linked to a poor IVF outcome.
Recent evidence suggests that variations in HLA-E, an MHC-I antigen, may be the key antigen.
HLA-E differences and conception outcomes will require similar research.
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