从IgG1、IgG3亚型分析红细胞意外抗体的临床意义  

Clinical significance of unexpected antibody from IgG1 and IgG3 subtypes

作　　者：李竹[1] 李丹红[1] 刘子豪[1] 赵珺 杨程茹 王守梅[1] 丁香[1] LI Zhu;LI Danhong;LIU Zihao;ZHAO Jun;YANG Chengru;WANG Shoumei;DING Xiang(Department of Blood Transfusion,The First Hospital of Jiamusi University,Jiamusi 154002,China)

机构地区：[1]佳木斯大学附属第一医院输血科,黑龙江佳木斯145002

出　　处：《中国输血杂志》2024年第11期1241-1246,共6页Chinese Journal of Blood Transfusion

基　　金：黑龙江省教育厅基础科研业务费科研项目(2021-KYYWF-0607)。

摘　　要：目的探究红细胞意外抗体IgG1、IgG3亚型的临床意义。方法对本院检测出的Rh、Duffy和Kidd 3个血型系统IgG型同种抗体进行IgG1、IgG3分型,同时对其中12例抗-E进行IgG1、IgG3效价测定及单核细胞单层试验,分析抗-E不同IgG亚型的特性。结果115例IgG意外抗体中,81例单特异性抗体以IgG1(58.02%,47/81)为主;17例混合抗体以IgG1+IgG3(47.06%,16/34)为主。在单核细胞单层试验中,IgG1和IgG3单独存在的抗体中吞噬率和抗体效价均呈正性相关,而在IgG1+IgG3复合型的抗体中,主要与IgG3相关,其抗体效价越高,吞噬率越高。在抗-E效价均为32时,IgG1+IgG3复合型的吞噬率最高,IgG3单独的吞噬率次之,IgG1单独的最低。结论意外抗体中的单特异性抗体以IgG1为主,混合抗体以IgG1+IgG3为主。MMA结果表明IgG1+IgG3复合型引起的免疫反应更严重。因此当抗-E等抗体合并其他抗体存在时,即使效价低,引起的免疫反应也可能会严重,在临床工作中需要引起足够重视。Objective To explore the clinical significance of the IgG1 and IgG3 subtypes of red blood cell unexpected antibodies.Methods The IgG1 and IgG3 typing tests were performed on the IgG type alloantibodies of Rh,Duffy and Kidd blood group systems detected in our hospital.Additionally,IgG1 and IgG3 titers were measured and monocyte monolayer assay was performed on 12 cases of anti-E to analyze the characteristics of different IgG subtypes of anti-E.Results Among the 115 cases of unexpected IgG antibodies,81 cases of monospecific antibodies were predominantly IgG1(58.02%,47/81);17 cases of mixed antibodies were predominantly IgG1+IgG3(47.06%,16/34).In monocyte monolayer assays,the phagocytic rate and antibody titer of IgG1 and IgG3 antibodies were positively correlated,while in IgG1+IgG3 complex antibodies,it was mainly associated with IgG3,with higher antibody titers correlating with higher phagocytic rates.When the anti-E titers were 32 for all,the IgG1+IgG3 complex had the highest phagocytosis rate,followed by IgG3 alone,and IgG1 alone had the lowest phagocytic rate.Conclusion Monospecific antibodies among unexpected antibodies are primarily IgG1,while mixed antibodies are mainly IgG1+IgG3.The results of MMA indicate that the immune response caused by the IgG1+IgG3 complex is more severe.Therefore,when antibodies like anti-E coexist with other antibodies,even if the titer is low,the immune response may still be severe,which should be taken seriously in clinical practice.

关 键 词：意外抗体 IGG亚型 IGG1 IGG3 抗体效价 单核细胞单层试验 

分 类 号：R457.11[医药卫生—治疗学]