血清学及质谱鉴定抗-Jr^(a)  

Identification of anti-Jr^(a) antibodies by serology and mass spectrometry

作　　者：凌止发 曾小莉 袁学文[1] 沈伟[2] LING Zhifa;ZENG Xiaoli;YUAN Xuewen;SHEN Wei(Department of Blood Transfusion,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Shanghai Blood Center)

机构地区：[1]川北医学院附属医院输血科,四川南充637000 [2]上海市血液中心

出　　处：《中国输血杂志》2024年第7期827-830,共4页Chinese Journal of Blood Transfusion

基　　金：四川省南充市社科项目(NC24B56)。

摘　　要：目的 报告1例无输血史但产生高频抗体抗-Jr^(a)的孕妇抗体特异性鉴定过程。方法 采用盐水介质法和间接抗人球蛋白法(微柱凝胶卡、PEG)进行抗体筛选及抗体鉴定;检测患者除ABO血型外其他血型来排除相应的高频抗体;采用各种酶处理过的细胞与患者血浆反应,进一步判定抗体类型;采用人源抗-Jr^(a)检测患者Jr^(a)抗原,MALDI-TOF质谱检测体系对患者进行JR血型基因分型;测定抗体效价。结果 患者血型为O型RhD(+)、CcDEe,患者血浆与抗筛细胞以及抗体鉴定细胞盐水介质反应均阴性,抗人球蛋白介质反应均阳性,自身对照为阴性;患者Jr^(a)抗原血清学检测和质谱血型基因分型阴性;患者血浆抗-Jr^(a)效价为1∶2。质谱发现其4号外显子存在纯合无义突变(c.376C>T)。结论 该患者因妊娠免疫产生同种高频抗原抗体抗-Jr^(a)。Objective To report the antibody specific identification process of a pregnant woman who had no history of blood transfusion but presented high-frequency anti-Jr^(a) antibodies.Methods Antibody screening and identification were performed by saline and indirect Coomb's technique(microcolumn gel card,PEG).ABO,Rh and other blood group antigens were identified by saline.Further antibody identification tests were performed by the reaction between cells treated with various enzymes and patient plasma.Jr^(a) antigen was identified by human anti-Jr^(a )antibody.JR blood type genotyping was performed by MALDI-TOF mass spectrometry detection system.Antibody titer in serum was tested.Results The patient′s blood type was O with RhD(+) and CcDEe.The plasma reacted negatively with antibody screening and identification cells by saline,but positively by indirect globulin test.The self-control was negative.The patient′s Jr^(a )antigen was negative in serological tests and mass spectrometry blood type genotyping.Mass spectrometry revealed a homozygous nonsense mutation(c.376C>T) in exon 4.The anti-Jr^(a) antibody titer was 1∶2.Conclusion The patient developed high-frequency anti-Jr^(a )antibodies during pregnancy.

关 键 词：血浆 Jr^(a)抗原 抗-Jr^(a) 

分 类 号：R446.11[医药卫生—诊断学] R457.1[医药卫生—临床医学]