细胞吸附法去除输血前相容性检测中CD47单克隆抗体药物干扰的可行性及有效性分析  

Study on removal of CD47 monoclonal antibody drug interference in pre-transfusion compatibility testing using cell adsorption method

作　　者：陈洁[1] 魏华 赵静雅 季延红 Chen Jie;Wei Hua;Zhao Jingya;Ji Yanhong(Department of Pathogenic Biology and Immunology,School of Basic Medical Sciences,Xi′an Jiaotong University,Xi′an 710061,Shaanxi Province,China;Department of Blood Transfusion,Tangdu Hospital,Air Force Medical University,Xi′an 710038,Shaanxi Province,China)

机构地区：[1]西安交通大学基础医学院病原生物学与免疫学系,西安710061 [2]空军军医大学唐都医院输血科,西安710038

出　　处：《国际输血及血液学杂志》2024年第6期520-526,共7页International Journal of Blood Transfusion and Hematology

基　　金：唐都医院社会人才基金资助计划(2021SHRC049)。

摘　　要：目的探讨采用人卵巢癌细胞系OVCAR-3细胞吸附血浆中CD47抗体的可行性和有效性。方法选择2023年1月至5月空军军医大学唐都医院收治并接受CD47单克隆抗体药物联合阿扎胞苷治疗的2例骨髓增生异常肿瘤(MDS)患者为研究对象。患者1为男性,50岁,O型血型;患者2为女性,69岁,A型血型。选择并培养高表达CD47的OVCAR-3细胞。将OVCAR-3细胞与构建成功的CD47抗体阳性血浆模型及患者CD47抗体阳性血浆标本分别混合,于37℃孵育15 min后离心取上清液。采用微柱凝胶法对上清液标本进行不规则抗体筛查和交叉配血试验,检测OVCAR-3细胞对血浆标本中CD47抗体的清除效果,以及对不规则抗体检出的影响。并且进一步研究OVCAR-3细胞于4℃保存10和20 d,对其清除CD47抗体效果的影响。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》要求。结果①不规则抗体筛查和交叉配血试验结果显示,OVCAR-3细胞能够有效消除CD47抗体干扰。②OVCAR-3细胞处理血浆的过程,未对血浆中的E、K、Fy b、Jk a和S抗体等不规则抗体的检出产生影响。③于4℃保存10 d的OVCAR-3细胞仍对血浆标本中的CD47抗体具有良好的清除效果,而4℃保存20 d的OVCAR-3细胞的清除效果不佳。结论采用OVCAR-3细胞排除输血前相容性检测中的CD47抗体干扰可行,并且效果良好。Objective To investigate the feasibility and effectiveness of using human ovarian cancer cell line OVCAR-3 cells to adsorb CD47 antibodies in plasma.Methods From January to May 2023,a total of 2 patients with myelodysplastic neoplasm(MDS)who were admitted to Tangdu Hospital of Air Force Medical University and received treatment with CD47 monoclonal antibody combined with azacitidine were selected as research subjects.Patient 1 was a 50-year-old male with type O blood.Patient 2 was a 69-year-old female with type A blood.OVCAR-3 cells with high expression of CD47 antibody were selected and cultivated.These OVCAR-3 cells were mixed separately with CD47 antibody positive plasma models and CD47 antibody positive patients′plasmas,and incubated at 37℃for 15 min,and then centrifuged to obtain the supernatants.The microcolumn gel method was used to perform irregular antibody screening and cross-matching tests on supernatant samples to verify the clearance effect of OVCAR-3 cells on CD47 antibodies in plasma samples,as well as the impact on detection of irregular antibodies.Additionally,OVCAR-3 cells stored at 4℃for 10 and 20 d on their effects of clearing CD47 antibody were investigated.This study was in line with World Medical Association Declaration of Helsinki revised in 2013.Results①The results of the irregular antibody screening and cross-matching tests showed that plasma with CD47 antibody interference could be effectively cleared with OVCAR-3 cells.②This process of OVCAR-3 cells treating plasma did not affect the detection of E,K,Fy b,Jk a,and S antibodies among irregular antibodies.③OVCAR-3 cells stored at 4℃for 10 d still had a good clearance effect on CD47 antibodies in plasma samples,while OVCAR-3 cells stored at 4℃for 20 d had a poor clearance effect.Conclusions It is feasible to use OVCAR-3 cells to eliminate the interference of CD47 antibodies in pre-transfusion compatibility testing,and the effect is good.

关 键 词：CD47抗原 单克隆抗体 OVCAR-3细胞 抗体吸附 输血前相容性检测 

分 类 号：R446.6[医药卫生—诊断学]