96例血小板基因配型患者的HLA-Ⅰ类抗体特性分析及抗原免疫原性估算  

Analysis of HLA-Ⅰ antibody specificity and estimation of antigen immunogenicity:96 patients recieved genotype-matched platelet transfusions

作　　者：刘瑛[1] 黄新宇 张兵 徐罡[1] 许先国[1] 何吉[1] 朱发明[1] LIU Ying;HUANG Xinyu;ZHANG Bing;XU Gang;XU Xianguo;HE Ji;ZHU Faming(Blood Center of Zhejiang Province,Key Laboratory of Blood Safety Research of Zhejiang Province,Hangzhou 310052,China)

机构地区：[1]浙江省血液中心浙江省血液安全研究重点实验室,浙江杭州310052

出　　处：《中国输血杂志》2022年第11期1105-1109,共5页Chinese Journal of Blood Transfusion

基　　金：浙江省基础公益研究计划项目(TGY23H080011,LGF20H080002);浙江医药卫生科技项目(WKJ-ZJ-2021,2023KY088)。

摘　　要：目的 分析血小板基因配型患者的HLA-Ⅰ抗体特异性,并估算HLA抗原免疫原性。方法 标本来自医院送检本中心申请血小板基因配型的血小板输注无效(PTR)患者,共计96份。采用Luminex技术对患者标本进行HLA-Ⅰ抗体特异性检测,并根据MFI分析抗体表达水平。人群HLA抗原错配率、相对免疫原性根据HLA-A、-B位点等位基因频率分布和抗体检出频次分别进行估算。结果 96份患者标本均检出HLA-Ⅰ类抗体,但抗体种类分布较广。HLA-A、-B、-C磁珠包被抗原(共计97个)对应抗体的平均阳性检出率分别为0.38、0.47、0.28。在浙江人群中HLA-A和-B系统中,抗原频率较高的分别为HLA-A2、A11、A24和HLA-B60、B46、B58,其相对免疫原性分别为0.403、0.283、0.342和0.100、0.067、0.178。结论 PTR患者存在不同种类特性的HLA-Ⅰ抗体,证实不同HLA-A、-B抗原的相对免疫原性存在差异。Objective To analyze the specificity of HLA class-Ⅰ antibody in the patients received HLA-matched platelet transfusions and estimate the relative immunogenicity of HLA-Ⅰ antigens. Methods The samples from 96 patients who suffered from platelet transfusion refractorines(PTR) and applied for transfusion with genotype-matched platelet were collected. The specificity of HLA I antibody was detected by Luminex technique, and the antibody expression level was analyzed according to MFI. The mismatch rate of HLA antigen and relative immunogenicity of the population were estimated according to the allele frequency distribution of HLA-A and B loci as well as the yielding frequency of antibody. Results HLA-Ⅰ antibodies were detected in all 96 patients, with varied species of antibodies. The average positive yielding rates of antibodies corresponding to HLA-A,-B and-C magnetic bead coated antigens(97 in total) were 0.38, 0.47 and 0.28, respectively. Among the HLA-A and-B loci in the Zhejiang population, HLA-A2, A11, A24 and HLA-B60, B46, B58 were the antigens with higher frequency, and their relative immunogenicity was 0.403, 0.283, 0.342, and 0.100, 0.067, 0.178, respectively. Conclusion The specificity of HLA-Ⅰ antibodies in PTR patients is different, which confirms that the relative immunogenicity differs by HLA-A and-B antigens.

关 键 词：血小板输注无效 HLA-Ⅰ类抗体 抗原错配率 相对免疫原性 

分 类 号：R457.11[医药卫生—治疗学] R331.143[医药卫生—临床医学] R446.6