HLA-Cw基因常规检测区外第1、5、6、7外显子核苷酸序列测定的研究及临床应用

Sequencing analysis of exons 1,5, 6, 7 of HLA-Cw gene located outside of the routine testing region and its application in clinical matching

目的 研究中国人群HLA-Cw基因第1、5、6、7外显子的分子遗传多态性,探讨增加第1、5 6 7外显子核苷酸序列测定在临床组织配型工作中的重要性及意义.方法 应用PCR-SBT法,对324份样本的HLA-Cw基因第2、3、4外显子作常规测序分型.对检出的模棱两可结果,设计HLACw第1、5 6 7外显子序列测序引物并优化测序反应条件,增加第1、5、6、7外显子核苷酸序列分析.结果 对HLA-Cw基冈第2、3、4外显子常规检测,一次性获得等位基因前4位数分型结果 的样本占23.8%（77/324）;出现模棱两可结果的样本数占76.2%（247/324）,检出的模棱两可等位基因组合有73种;增加HLA-Cw基因的第1、5、6、7外显子多态性检测,可解决Cw＊ 030201/030202、030301/0320N、Cw＊ 040101/0409N/0430、Cw＊ 070201/0750、Cw＊ 0403/0409N/0430和Cw＊ 080101/0822等10种常见的模棱两可等位基因组合.结论 在临床HLA-Cw基因配型中增加第1、5、6、7外显子多态性检测,有助于解决测序分型中的模棱两可的结果 和提高HLA-Cw基因分型精确度,对临床组织配型工作具有重要意义.

Objective To study the molecular genetic polymorphism of exons 1,5, 6, 7 of HLA-C gene in Chinese population and evaluate the significance of additional sequencing based typing at exons 1,5, 6, 7 of HLA-Cw gene in clinical HLA matching, Methods A total of 324 individuals were typed at exons 2,3, 4 of HLA-C gene by sequence-based typing. If ambiguities appeared outside of exons 2 -4, we designed a total of 5 in-house sequencing primers and optimized the sequencing reaction, additional sequencing based typing at exons 1,5, 6, 7 was performed to solove the emerging ambiguities. Results In the three hundred and twenty-four samples typed by PCR-SBT at exons 2, 3 and 4 of HLA-Cw gene, 23.8 % （77/324） of the typed samples were assigned the conclusive genotype in four digital level 76. 2% （247/324） of the typed samples were given with the ambiguous allele combination results, in which 73 kinds of ambiguous allele combinations were detected. Increasing the additional sequencing analysis at exons 1, 5, 6, 7 of HIA-C gene, ten frequent ambiguities including Cw＊ 030201/030202, Cw＊ 070201/0750, Cw＊ 040101/0409N/0430, Cw＊ 0403/0409N/0430, Cw＊ 080101/0822 could be distinguished. ConclusionsIncreasing the sequencing anlysis at exons 1, 5, 6 and 7 of HLA-Cw gene will help to make clear the ambiguous SBT results and also improve the accuracy of HLA-Cw typing. It shows important significance in clinical histoeompatibility matching.