血小板输注无效患者的HLA-Ⅰ类抗体特性分析

Analysis of HLA-I antibody specificity in patients with platelet transfusion refractoriness

目的 分析血小板输注无效患者的HLA-Ⅰ类抗体特性。方法 本研究以65例血小板输注无效患者为对象。采用Luminex平台进行血小板相关抗体筛查和HLA-Ⅰ类抗体特异性鉴定。计算不同等位基因对应抗原的相对免疫原性。结果 65例标本有50例检出HLA-Ⅰ类抗体,且均包括HLA-A抗体和HLA-B抗体。河南汉族人群中HLA-A、B位点频率最高的等位基因A~*11:01和B~*13:02对应的抗体阳性率分别为0.33、0.65,相对免疫原性为0.1130和0.1838。而A~*34:01在河南人群的等位基因频率仅为0.0004,其对应抗原的相对免疫原性高达48.7953;同样,B~*44:02的等位基因频率仅为0.0001,其对应抗原的相对免疫原性高达127.4204。结论 HLA-Ⅰ类抗体对应抗原的免疫原性存在差异。通过分析抗体特性及抗原相对免疫原性可为患者选择合适供者,提高输注效果,预防新的抗体产生时提供数据支撑。

Objective To analyze the specificity of HLA-I antibody in patients with platelet transfusion refractoriness.Methods Samples from 65 patients with platelet transfusion refractoriness were collected.Luminex platform was used to screen platelet-related antibodies and identify the specificity of HLA-I antibodies.The relative immunogenicity of different alleles was calculated according to the frequency of HLA-I alleles in Henan Han population reported in the laboratory and the number of positive antibodies detected in this experiment.Results HLA-I antibodies were detected in 51 of 65 samples including HLA-A antibodies and HLA-B antibodies.The antibody positive rates of A*11:01 and B*13:02 with the highest alleles frequencies of HLA-A and B loci were 0.33 and 0.65,respectively,and the relative immunogenicity was 0.1130and0.1838.The allele frequency of A*34:01 in Henan population was only 0.0004,but the relative immunogenicity of corresponding antigen was as high as 48.7953.Similarly,the allele frequency of B*44:02 is only 0.0001,but the relative immunogenicity of its corresponding antigen is up to 127.4204.Conclusion The characteristics of HLA-I antibodies are different in the patients with platelet transfusion refractoriness,and the immunogenicity of their corresponding antigens is different.The analysis of antibody characteristics and antigen relative immunogenicity can provide data support for the selection of appropriate donors for the patients,improve the infusion effect,and prevent the production of new antibodies.