常见红细胞添加剂成分对双花扁豆凝集素与A1红细胞反应的影响  

Impact of Common Red Blood Cell Preservatives on the Dolichos Biflorus Agglutinin Binding to A1 Phenotype Red Blood Cells

作　　者：朱心怡 张成鑫 王秋实[2] 李佳佳 齐永 向东[1] 赵俸涌[1] ZHU Xinyi;ZHANG Chengxin;WANG Qiushi;LI Jiajia;QI Yong;XIANG Dong;ZHAO Fengyong(Shanghai Blood Center,Shanghai 200051;2Department of Blood Transfusion,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110004;3Department of Blood Transfusion,Changzheng Hospital,Naval Medical University,Shanghai 200003;4Department of Blood Transfusion,Central Theater General Hospital of Chinese People's Liberation Army,Wuhan,Hubei 430061)

机构地区：[1]上海市血液中心,上海200051 [2]中国医科大学附属盛京医院输血科,辽宁沈阳110004 [3]上海长征医院输血科,上海200003 [4]中国人民解放军中部战区总医院,湖北武汉430061

出　　处：《临床输血与检验》2024年第5期587-591,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：中国输血协会威高科研基金(No.CSBT-WG-2023-01)资助。

摘　　要：目的探索常见试剂红细胞添加剂中糖类物质和金属离子螯合剂成分对双花扁豆凝集素(Dolichos Biflorus Agglutinin,DBA,又称抗-A_(1))与A_(1)红细胞间血清学反应凝集强度的影响,为减少临床检测假阴性结果和凝集素功能特性研究提供数据支持,也为当前实验室A_(1)抗原鉴定质控实验提出改进方案。方法以生理盐水为基础红细胞稀释液,在反应体系中分别加入梯度稀释的糖溶液(葡萄糖、蔗糖、甘露醇)和棋盘滴定的强金属离子螯合剂(E_(DTA-Na_(2)))和二价金属阳离子(Ca^(2+)、Mg^(2+)),对不同反应条件下DBA-A_(1)红细胞凝集强度进行评估。结果在DBA-A_(1)红细胞反应体系中C_(E_(DTA-Na_(2)))>0.6 mM时出现了明显的凝集抑制现象,提高C_(Ca)^(2+)或C_(Mg)^(2+)可减弱高浓度E_(DTA-Na_(2))对DBA-A_(1)红细胞凝集强度的影响;另一方面,体系中糖类物质浓度的增高也使DBA-A_(1)红细胞凝集强度产生明显减弱,加入0.6%~5%葡萄糖溶液,1.3%~10%蔗糖溶液或5%甘露醇溶液时,DBA-A_(1)红细胞凝集明显减弱。结论红细胞添加剂中的E_(DTA-Na_(2))和糖类物质对-A_(1)红细胞反应存在凝集抑制,是血型血清学检测中植物凝集素制剂使用的重要干扰因素。Objective To explore the effects of carbohydrates and metal ion chelators present in common red blood cell(RBC)preservatives on the agglutination intensity of serological reactions between Dolichos Biflorus Agglutinin(DBA)and A_(1)RBCs,thus provide evidence for minimizing false negative results in clinical testing and enhancing the understanding of DBA's functional characteristics.Additionally,our study attempted to propose improvements to the current laboratory quality control procedures for A_(1)antigen identification.Methods The agglutination intensity of DBA-A_(1)erythrocytes under various conditions was quantitatively measured.This was achieved by introducing serial dilutions of sugar solutions(glucose,sucrose,mannitol)and performing checkerboard titrations of E_(DTA-Na_(2))and divalent metal cations(Ca^(2+),Mg^(2+))into the reaction system.Throughout the experiments,0.9%saline was used as the initial RBC diluent.Results C_(E_(DTA-Na_(2)))concentrations>0.6 mM significantly inhibited agglutination,while increasing concentrations of Ca^(2+)/Mg^(2+)reduced the negative effect of high concentration E_(DTA-Na_(2)).On the other hand,a notable decrease in DBA-A_(1)erythrocyte agglutination intensity was observed with increasing sugar concentrations.Specifically,the addition of 0.6%to 5%glucose solution,1.3%to 10%sucrose solution or 5%mannitol solution significantly weakened the aggregation of DBA-A_(1)red blood cells.Conclusion E_(DTA-Na_(2))and saccharides in RBC preservatives could exhibit inhibitory effects on the agglutination reaction between DBA and A_(1)RBCs,highlighting them as crucial risk factors in the application of plant lectins for blood group serological detection.

关 键 词：双花扁豆凝集素 试剂红细胞 红细胞保存液 A1亚型 

分 类 号：R457.1[医药卫生—治疗学]