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 采用单抗原磁珠法检测肾移植患者的人类白细胞抗原DP(HLA-DP)抗体,并探讨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。应用c2检验比较两组抗体例数的差异。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(c2=14.176,P=0.000)。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HLA-I类及DR/DQ抗体的患者中,在排斥组中有14.3﹪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(c2=7.165,P=0.007)。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 evaluate the effects of HLA-DP on renal graft function. Methods We studied 323 sera of patients from four different centers with functioning or rejected kidney grafts. Recipients were divided into functional group （n=138） and rejection group （n=185）. Pwl（DP0101）, DPw2（DP0201）, DPw3（DP0301）, DPw4（DP0401）, DPw5（DP0501） and DPwll（DPll01） were assayed. The results were compared with Chi-square test. Results DP antibodies were found in 5.1% of 138 patients with functioning grafts, and 19.5 % of 185 patients with rejected grafts （x2=14.176, P = 0.000） .In the functional group, 42.9% patients were positive for both DP antibody and DR/DQ antibodyies. In the rejection group, 63.9 %patients were positive for both DP antibody and DR/DQ antibody. Among patients who was in the rejection group and did not have Class I and DR/DQ antibodies, 14.3 %had DP antibody, compared to 3.5 % of patients with functioning grafts （x2=7.165, P = 0.007）. DP 0301 had the highest frequency in the rejection group. Conclusions HLA-DP antibodies were detected at a higher frequency in patients who have rejected their grafts than those with functioning grafts. DP tissue typing is recommended to avoid presensitized DP alleles if second transplantation is performed.