人白细胞抗原-氨基酸残基配型标准与免疫反应性研究  

HLA-amino acid residue matching standard and immunogenic response

作　　者：谭建明[1] 唐孝达[1] 谢桐[1] 

机构地区：[1]上海市第一人民医院肾移植中心

出　　处：《中华医学杂志》1999年第11期810-813,共4页National Medical Journal of China

基　　金：博士后基金;卫生部科研基金!981314

摘　　要：目的提出汉族人人白细胞抗原（HLA）－氨基酸残基配型标准（ResM），评价其免疫反应性和致敏性。方法采用基因分型技术，分析大样本HLA抗原频率分布，提出适合于汉族人的Ⅰ类10个组、Ⅱ类7个组共17个组新的ResM标准。前瞻性应用于首次尸肾移植163例。通过混合淋巴细胞培养（MLC）、培养上清细胞因子、外周血免疫活性细胞和抗HLA－IgG抗体检测，并与六抗原配型标准（AgM）比较，研究接受ResM标准的免疫反应性和致敏性。结果采用ResM标准，供受者相配机率由AgM标准的1．2％提高到39．9％。残基相配的受者，术后MLC刺激指数、反映Th1细胞的γ干扰素、反映Th2细胞的白介素10、外周血CD4、CD8、CD28阳性细胞和CD4／CD8比值等，以及反映致敏性的HLA－IgG抗体水平，与抗原相配者十分接近；均明显优于残基错配或抗原错配者。结论新的ResM标准，可大幅度提高移植供受者的相配机率，显著降低术后的致敏性和免疫反应性，适合于汉族人器官移植临床应用。Objective TO Provide a standard for HLA-amino acid residue matching (Res M) for Chinese population and to evaluate its immunogemic response and sensitization to allograft. Methods Based on the setting up of DNA typing technique and the analysis of the distribution of HLA antigen frequencies, a new matching policy of Res M of 17 residues (10 amino acid residues for class Ⅰ and 7 DR supertypic groups for class Ⅱ) was presented and prospectively applied to 163 first-cadaver kidney transplants. Comparing with the 6-antigen maching program, the immunogenic response and sensitization of Res M to allograft were assayed using the mixed lymphocyte culture (MLC), cytokine in culture liquid, immune competent cells in the peripheral blood and specific anti-HLA IgG antibodies with PRA-STAT technique. Results The rate of Res-matched transplants increased significantly from 1. 2% by Ag M to 39. 9%. Immunogenic response and sensitization to allograft of recipients with Res-matched, containing index of stimulation (SI) of MLC, γ-IFN representing Th1 cell, IL-10 representing Th2 cell, CD4+, CD8+,CD28+ T cell and the ratio of CD4/CD8, as well as the level of sHLAIgG representing sensitization to allograft, were similar to those of Ag-matched transplants. Those parameters showed no difference between Res-matched and Ag-matched recipients, but showed significan difference in Resmismatched or Ag-mismatched transplants. Conclusion The New Res M can increase the rate of Res-matched transplants by a big margin, minimize the sensitization and immunogenic response to allograft, and be suitabe to the clinical application to organ transplatation in Chinese Han population.

关 键 词：组织相容性 移植免疫学 白细胞抗原 

分 类 号：R392.4[医药卫生—免疫学]