抗Ku及其他高频抗原抗体的鉴定思路  

The Identification Idea of Antibodies Against Ku and Other High-Frequency Antigens

作　　者：张飞飞 李婧薇 沈伟[2] 何屹[1] 袁红[1] 田力 叶志君[4] ZHANG Fei-Fei;LI Jing-Wei;SHEN Wei;HE Yi;YUAN Hong;TIAN Li;YE Zhi-Jun(Department of Blood Transfusion,Sichuan Academy of Medical Science&Sichuan Provincial People’s Hospital,Chengdu 610072,Sichuan Province,China;Shanghai Blood Center,Shanghai 200051,China;Institute of Blood Transfusion,Chinese Academy of Medical Science,Chengdu 610052,Sichuan Province,China;Department of Nutritional,Sichuan Academy of Medical Science&Sichuan Provincial People’s Hospital,Chengdu 610072,Sichuan Province,China)

机构地区：[1]四川省医学科学院·四川省人民医院输血科,四川成都610072 [2]上海市血液中心,上海200051 [3]中国医学科学院输血研究所,四川成都610052 [4]四川省医学科学院·四川省人民医院营养科,四川成都610072

出　　处：《中国实验血液学杂志》2024年第3期875-882,共8页Journal of Experimental Hematology

基　　金：中国医学科学院创新工程(2016-I2M-3-024)。

摘　　要：目的:通过对一例女性高频抗原抗体(抗-Ku)病例进行血清学鉴定及血型基因测序分析,为高频抗原抗体的鉴定提供一定思路。方法:运用血型鉴定、患者红细胞抗原鉴定、抗体筛选、抗体鉴定等方式检测该患者的血型及抗体。以巯基试剂处理后的血清与筛选细胞反应、患者血清与酶或巯基试剂处理的筛选细胞反应的方式来判断该抗体的类型及特点,采用基因测序的方法确定患者血型的基因型。结果:该患者血型为O型RhD^(+),其血清与抗体筛选细胞及抗体鉴定细胞在间接抗人球及盐水介质中的反应呈强反应性,且强度一致,自身阴性,直接抗人球蛋白弱阳性;其他血型为CcEe、Jk(a+b-)、P1-、Le(a-b-)、Lu(a-b+)、K-、k-、Kp(a-b-)。血清经2-ME处理后,在间接抗人球介质中仍与3组筛选细胞反应;血清与经木瓜酶、菠萝酶修饰后的筛选细胞反应强度不变,与巯基试剂DTT、2-ME处理后的筛选细胞反应为阴性。基因测序显示该患者KEL基因型为KEL*02N.24,为罕见的K0表型。结论:血清学试验和分子生物学实验鉴定出该患者为罕见的Kell-null血型(又称K0),该患者体内产生了IgG及IgM性质的高频抗原抗体抗-Ku。血清学方法及分子生物学方法在此类稀有血型及高频抗原抗体的鉴定中具有重要意义。Objective:This study was aimed to provide ideas for identifying the antibodies to high-frequency antigens by analyzing a female case of high-frequency antigen antibody(anti-Ku)using serological and sequencing method.Methods:The methods for identification of blood group,erythrocyte antigen,screening and identification of antibody were used to detect the blood type and antibody in the proband.The proband’s serum and reagent screening cells treated with Sulfhydryl reagent were applied to judge the type and characteristics of this antibodies when reacted with the regaent screening cells or proband’s serum respectively.Gene sequencing was used to determine the genotype of the proband’s blood group.Results:The proband’s red blood cells were determined as O type RhD positive,whose serum showed strong positive reaction to antibody-screening cells and antibody identification cells with the same intensity in saline and IAT medium,however,the self-cells showed negative effect.The Direct Antihuman Globulin of proband’s red blood cells also showed weak positive reaction,and the other blood types were CcEe,Jk(a+b-),P1-,Le(a-b-),Lu(a-b+),K-,k-,Kp(a-b-).Serum of the proband treated with 2-ME still react with three groups of screening cells in IAT medium.The reaction intensity of proband’s serum was also unchanged with the cells modified with papain and bromelain,but showed negative effect when the cells were treated with sulfhydryl agents including DTT and 2-ME.Gene sequencing revealed that the KEL genotype of the patient was KEL02N.24.This patient had a rare K0 phenotype.Conclusion:The rare Kell-null blood group(also known as K0)were identified by serolog molecular tests in the proband who produced both IgG and IgM type of antibody to high-frequency antigen(anti-Ku).These two methods are of great significance in the identification of this rare blood group as well as the antibody to high frequency antigen.

关 键 词：高频抗原抗体 K0 抗-Ku 血清学实验 基因测序 

分 类 号：R457.1[医药卫生—治疗学]