非HLA抗体相关肾移植排斥反应的研究进展  

Research progress on kidney transplantation rejection associated with non-HLA antibody

作　　者：张淑宇 李月红[1] Zhang Shuyu;Li Yuehong(Department of Nephrology,Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院肾内科,北京102218

出　　处：《器官移植》2023年第5期730-735,共6页Organ Transplantation

基　　金：首都卫生发展科研专项基金(首发2022-3-2243);清华大学精准医学基金(2022TS007)。

摘　　要：人类白细胞抗原(HLA)是由HLA基因复合体所编码的产物,定位于6号染色体短臂上,是异体免疫的主要靶点,但HLA抗体阳性并不能解释所有的肾移植排斥反应。非HLA抗体是同种异体肾移植中供者基因表达的产物,术中缺血-再灌注损伤、异体和自身免疫相互作用、细胞外囊泡的介导作用等都可以触发免疫系统反应,促使非HLA抗体产生。多项研究表明非HLA抗体是诱发排斥反应、影响肾移植结局的重要因素。因此,本文就肾移植非HLA抗体类型及形成机制进行综述,总结非HLA抗体相关肾移植排斥反应的研究进展,以期为肾移植术后非HLA抗体相关排斥反应的研究提供参考。Human leukocyte antigen(HLA)is a product encoded by HLA gene complex,which is located on the short arm of chromosome 6 and is the main target of alloimmunity.However,positive HLA antibody is not responsible for all kinds of rejections in kidney transplantation.Non-HLA antibody is the product of donor gene expression in allogeneic kidney transplantation.Intraoperative ischemia-reperfusion injury,the interaction between alloimmunity and autoimmunity and the mediation of extracellular vesicles may trigger immune system response and promote the production of non-HLA antibody.Multiple studies have demonstrated that non-HLA antibody is an important factor of inducing rejection and affecting the outcomes of kidney transplantation.Consequently,the types and formation mechanism of non-HLA antibody in kidney transplantation were reviewed,and research progress on kidney transplantation rejection associated with non-HLA antibody was summarized,aiming to provide reference for in-depth study of kidney transplantation rejection associated with non-HLA antibody.

关 键 词：肾移植 排斥反应 人类白细胞抗原 次要组织相容性抗原 主要组织相容性复合体 供者特异性抗体 缺血-再灌注损伤 细胞外囊泡 

分 类 号：R617[医药卫生—外科学] R392.4[医药卫生—临床医学]