HLA表位在肾脏移植组织配型中的应用  

Application of HLA Epitope in tissue matching of renal transplantation

作　　者：郑瑾[1] 薛武军[1] ZHENG Jin;XUE Wujun(Department of Renal Transplantation,Hospital of Nephrology,the First Affiliated Hospital of Medical College ,Xi'an Jiaotong University ,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院肾移植科,710061

出　　处：《临床外科杂志》2018年第12期980-983,共4页Journal of Clinical Surgery

摘　　要：组织配型技术的快速发展,包括广泛使用的HLA高特异性分子分型方法和等位基因特异性抗HLA抗体的固相分析技术,推动了器官移植供受者选择达到更为精准的层面,促进了器官移植匹配的科学发展。目前,人们通过对T细胞介导排斥反应(TCMR)的预防和治疗,移植物存活率得到了很大的改善,但导致移植物丢失的主要原因—体液免疫反应,仍然没有得到有效的控制。将HLA抗原描述为一系列抗体靶点或表位,相对于血清学反应模式或精确的氨基酸序列,可能会提供一个更能结合临床实际的HLA匹配系统,来帮助避免移植术后抗体介导排斥反应(AMR)的发生,减少移植后致敏,以及在受者预存HLA抗体阳性的情况下选择避开预存抗体的器官。以下内容,在组织配型的研究背景下,对HLA抗原表位(Epitopes)及其在移植中的潜在作用进行阐述,并探讨HLA抗原表位匹配在肾移植组织配型临床实践中的潜在意义。The rapid changes of tissue-typing technology,including the widely used of highly specific molecular typing methods and solid phase analysis technology for detection of alleles specific antiHLA antibodies,promoted the selection of organ transplant recipients to a more accurate level and promoted the scientific development of organ transplant matching. At present,the graft survival rate has been greatly improved through the prevention and treatment of T-cell-mediated rejection( TCMR),but the humoral immune response,the main cause of late graft loss,is still not effectively controlled. Describing HLA antigens as a series of antibody targets,or epitopes,relative to serological response patterns or precise amino acid sequences,may provide a better HLA matching system,combined with clinical practice to help avoid antibody-mediated rejection( AMR),reduce sensitization after transplantation,and select the most appropriate organs to avoid pre-existing antibodies in the case of persisting HLA antibody positive recipients choosing. The following contents,in the background of the study of tissue matching,describe the HLA epitopes system and its potential role in transplantation,and explore the potential significance of HLA epitope matching in the clinical practice of renal transplantation.

关 键 词：人类白细胞抗原 肾脏移植 组织配型 

分 类 号：R699.2[医药卫生—泌尿科学]