HLA⁃A2反应性抗体的产生原因及其eplets分析  

Causes of HLA⁃A2 reactive antibodies and analysis of their eplets

作　　者：黄晶晶 汤龙海[1] 左元玲[2] 曹燕[1] 李维洁[1] 蒋敏[2] 王明元[1] HUANG Jingjing;TANG Longhai;ZUO Yuan-ling;CAO Yan;LI Weijie;JIANG Min;WANG Mingyuan(Suzhou Blood center,Suzhou 215006,China;Depart-ment of Blood Transfusion,Suzhou University First Affiliated Hospital)

机构地区：[1]苏州市中心血站,江苏苏州215006 [2]苏州大学附属第一医院输血科

出　　处：《中国输血杂志》2023年第6期467-470,共4页Chinese Journal of Blood Transfusion

基　　金：苏州市公卫专项(GWZX202004);苏州市重点学科(SZXK202118);苏州市科技项目(SKYD2022041)。

摘　　要：目的分析输注相同血清学血小板后产生HLA等位基因特异性抗体的患者与血小板供者的eplets差异。方法利用PCR⁃SBT法检测患者和供者的HLA基因型;借助Luminex单抗原微珠包被法对患者血清中存在的HLA⁃Ⅰ类抗体进行筛选;再通过HLA Matchmaker对患者和供者等位基因上的差异氨基酸和功能性表位进行对比与分析。结果该患者携带HLA⁃A∗02∶03等位基因,输注A2亚型血小板(A∗02∶01、A∗02∶06、A∗02∶07)后体内产生了HLA⁃A2抗体。经序列对比发现,A∗02∶03与血清学同组血小板在第149位氨基酸上存在差异,导致其eplets不同,进而诱导相关抗体的产生。结论HLA抗体对HLA等位基因间因氨基酸差异而导致结构差异的抗原表位具有特异性,宜对患者和供者进行HLA⁃A、⁃B位点高分辨分型,基于表位而不是抗原来确定HLA的可接受错配,以减少同种异体免疫反应和提高血小板输注后计数。Objective To analyze differences of eplets between the patient who generated HLA allele⁃specific antibodies after platelet transfusion with donors.Methods The HLA genotypes of the patient and donors were detected by PCR⁃SBT,and the Luminex single antigen beads coating was used to screen HLA⁃Ⅰantibodies in the patient’s serum.HLA Matchmak⁃er was utilized to analyze different amino acids and eplets.Results The patient carried HLA⁃A∗02∶03 allele,and HLA⁃A2 antibodies were found in his serum after platelet transfusion(A∗02∶01,A∗02∶06,and A∗02∶07).Sequence alignment showed that the patient′s A∗02∶03 has a difference in position 149,which resulted in a different eplet between A∗02∶03 and A∗02∶01,A∗02∶06,A∗02∶07 and then induced the production of antibodies.Conclusion HLA antibodies are specific for HLA epitopes that have structural differences due to amino acid differences between HLA alleles,suggesting that high⁃resolu⁃tion typing of HLA⁃A,⁃B need to be conducted in patients and donors,and the acceptable mismatch of HLA should be deter⁃mined based on epitopes rather than antigens,so as to reduce alloimmune response and improve platelet count after transfu⁃sion.

关 键 词：HLA⁃Ⅰ类抗体 功能性表位 等位基因特异性抗体 

分 类 号：R331.142[医药卫生—人体生理学] R457.1[医药卫生—基础医学]