主要组织相容性复合体Ⅰ类样分子等位基因与活体小肠、肝、肾移植急性排斥反应相关性研究

Correlation between major histocompatibility complex class Ⅰ -related chain A gene alleles and graft rejective reaction in small intestine, liver and kidney transplantation

目的研究供、受者间主要组织相容性复合体（MHC）Ⅰ类样分子（MICA）等位基因匹配率与小肠、肝、肾移植急性排斥反应的相关性。方法对收集的4例活体小肠移植供、受者血液标本及组织病理切片，5例活体肝脏部分移植供、受者及6例活体肾脏移植供、受者血液标本，提取基因组DNA并进行HLA配型，针对MICA基因最常见的8个基因型13个等位基因进行聚合酶链反应-序列特异性引物法（PCR—SSP）检测，统计供、受者间等位基因匹配率，并分析其与临床急性排斥反应的相关性。结果所有移植病例供、受者HLA配型均为半相合状态。供、受者间MICA等位基因匹配率较高者（〉6／13），其受者显示出相对较轻的临床、病理排斥反应及相对较长的生存时间。而供、受体间MICA等位基因匹配率较低者（≤6／13），其受者则显示出相对较重的临床及病理排斥反应，生存时间亦较短。结论活体小肠、肝、肾移植中供、受者间MICA等位基因的匹配率高低与移植后受者急性排斥反应强度间存呈负相关，与生存时间呈正相关。

Objective To investigate the correlation between major histocompatibility complex （MHC） class Ⅰ chain-related gene A （MICA） gene alleles matching rates and graft rejective reaction in small intestine, liver and kidney transplantation. Methods Genome DNA were extracted from blood samples or pathological sections collected from donors and recipients of living-related transplantation, included 4 cases of small bowel transplantation, 5 cases of liver transplantation and 6 cases of kidney transplantation. The correlation between MICA alleles matching rates and acute graft rejective reaction was analyzed following 13 MICA alleles determination by polymerase chain reaction based on sequence-specific primers（PCR-SSP）. Results HLA zygosity of all donors and recipients was confirmed to be half-matching. The recipients displaying higher matching rates of MICA alleles with donors showed lighter clinical and pathological rejective reaction and longer survival time. On the contrary, recipients with lower matching rates of MICA alleles with donors showed severer clinical and pathological rejection and shorter survival time relatively. Conclusion Matching rates of MICA alleles has negative relevance to acute rejective reaction, and positive relevance to survival time of recipients in small bowel, liver, and kidney transplantation.