抗-MICA抗体在ESRD患者中的表达及其临床意义  

Expression of major histocompatibility complex class I-related chain A antibody in patients with end-stage renal disease and its clinical implications

作　　者：肖露露[1] 罗敏[1] 于立新[2] 朱伟[1] 

机构地区：[1]南方医科大学南方医院组织配型实验中心,广东广州510515 [2]南方医科大学南方医院器官移植科,广东广州510515

出　　处：《南方医科大学学报》2008年第11期1999-2001,共3页Journal of Southern Medical University

基　　金：广东省自然科学团队基金(23003)

摘　　要：目的探讨主要组织相容性复合物I类相关链A(MICA)抗体在终末期肾脏疾病(ESRD)患者中的表达。方法采用液相芯片分析技术和带有11种MICA抗原的荧光微球,对110例ESRD患者进行抗-MICA抗体的检测和抗-MICA抗体的特异性分析。结果在30例PRA阳性患者中抗-MICA抗体(+)的几率为40%(12/30),在80例PRA阴性患者中抗-MICA抗体(+)的几率为17.5%(14/80)。PRA阳性组患者与PRA阴性组患者抗-MICA抗体(+)几率之间呈显著性差异(χ2=6.120,P=0.013)。调查发现,26例MICA抗体(+)血清中表达出11种MICA抗原中的10种抗-MICA抗体特异性,其中,26.92%(7/26)为单特异性抗体,73.08%(19/26)为多特异性抗体。在随后的临床研究中还观察到,3例抗-MICA抗体(+)的患者接受尸体肾移植,术后随访2月,没有发生急性排斥并且移植肾功能良好。结论在PRA阳性患者中抗-MICA抗体(+)的几率亦高,说明抗-MICA抗体(+)的几率与PRA阳性的几率有明显的伴随关联。抗-MICA抗体表现为多特异性,抗-MICA抗体可能包含有IgM和IgG两种免疫球蛋白类型。研究提示,对于这部分ESRD患者未来接受移植替代治疗时,本研究数据将可以作为前瞻性数据提供临床进一步研究MICA与肾移植的关联和影响。Objective To study the frequency of major histocompatibility complex class I-related chain A （MICA） antibody in patients with end-stage renal disease （ESRD）. Methods Luminex flow cytometry and beads loaded with 11 MICA antigens were used to identify the MICA antibody and evaluate the antibody specificity in 110 patients with ESRD. Results The positivity rate of MICA antibody was 40% （12/30） in PRA-positive patients, significantly higher than the rate of 17.5% （14/80） in PRA-negative patients （x^2=-6.120, P=-0.013）. MICA-specific antibodies against 10 of the 11 MICA antigens were detected in 26 MICA antibody-positive patients, and 26.92% of the MICA antibody-positive patients had antibodies with single-specificity and 73.08% had polyspecific antibodies. Three MICA antibody-positive patients with cadaveric kidney transplantation showed good function of the graft without acute rejection 2 months after the operation. Conclusion The positivity rate of MICA antibody is significantly higher in PRA-positive patients, suggesting a strong correlation between MICA and PRA positivity. The MICA antibodies are polyspecific and probably consist of IgM and IgG. These data can be used as prospective data for these ESRD patients considering potential renal transplantation, and may facilitate further investigation of the association of MICA with renal transplantation.

关 键 词：MICA 抗体 终末期肾脏疾病 肾移植 

分 类 号：R692.5[医药卫生—泌尿科学]