肾移植受者单抗原磁珠法检测人类白细胞抗原DP抗体

Detection of antibodies to HLA-DP in renal transplant recipients using single antigen beads

目的本研究采用单抗原磁珠法检测肾移植病人的人类白细胞抗原DP（HLA-DP）抗体,并阐述HLA-DP抗体与移植肾功能的关系。方法采用流式细胞学单抗原磁珠法检测了323例患者的血清,这些患者来自4个不同的中心,并分为有功能组和排斥组。结果在138例有功能组的肾移植患者血清中有5.1﹪检测到HLA-DP抗体,而排斥组的185例患者血清中有19.5﹪检测到HLA-DP抗体（P〈0.001）。在有功能组和排斥组中分别有42.9﹪和63.9﹪的HLA-DP抗体阳性患者同时有DR/DQ抗体。在没有HLAI类及DR/DQ抗体的患者中,在排斥组中有13﹪的患者可检测出HLA-DP抗体,而有功能组中只有3.5﹪有HLA-DP抗体（P〈0.05）。在排斥组中,DP0301的检出频率最高。结论相对于有功能组来说,HLA-DP抗体在排斥组中有更高的检出率。特别是对于再次移植的患者来说,应该作HLA-DP的组织配型以避免HLA-DP等位基因引起的致敏。

Objective Here HLA-DP antibodies were detected with single antigen beads to see its effects on the renal graft function. Method We studied 323 sera of patients from four different centers with functioning or rejected kidney grafts. Results DP antibodies were found in 5.1﹪ of 138 patients with functioning grafts, and 19.5﹪ of 185 patients with rejected grafts （P 0.001）. 42.9﹪ and 63.9﹪ of the DP antibody positive patients had DR/DQ antibodies among the functioning and rejected group. Among patients who did not have Class I and DR/DQ antibodies, 13﹪ of those who rejected a graft had DP antibodies, compared to 3.5﹪ of patients with functioning grafts （P 0.05）. DP 0301 had the highest specificity frequency in the rejected group. Conclusion HLA-DP antibodies were detected at a higher frequency in patients who have rejected their grafts than those with functioning grafts. For regrafts, DP tissue typing is recommended to avoid presensitized DP alleles.