ELISA法和LABScreen法检测HLA抗体结果的差异

The difference of ELISA and LABScreen in detecting HLA antibodies

【摘要】目的比较ELISA法和LABScreen法检测HLA抗体结果的差异性，并分析两者对移植肾排斥的影响。方法选取2008年11月至2009年12月期间在本科做肾移植和随访发现肌酐异常并且有肾穿记录怀疑移植肾排斥或者临界改变的患者，用莱姆德抗原板（LAT）和混合抗原板（LAT-MIX）通过ELISA方法检测HLA抗体，并与LABScreen技术检测的HLA抗体结果比较，研究两种方法对肾移植排斥检测结果的差异。结果共277例患者被纳入研究，其中新移植230例，随访47例，术前HLA抗体阳性病例ELISA法为27例（9．7％），LABScreen法为145例（52．3％）。其中ELISA法阴性而LABScreen法阳性的病例为118例（42．6％），ELISA法阳性的病例LABScreen法均阳性。未出现LABScreen法阴性而ELISA法阳性的病例，LABScreen法阳性而ELISA阴性的118个病例中，术后出现移植。肾排斥的病例为41例（34．7％）。两者均阴性的132个病例中，出现术后移植肾排斥的病例为24例（18．2％）（P=0．003）。排斥组术后两周HIJA抗体荧光强度不低于术前的占31％，而在非排斥组，术后两周HLA抗体荧光强度不低于术前的比例仅占12．8％（P〈0．01）。结论LABScreen法在对HLA抗体检出率及敏感性上远高于ELISA法，并与移植肾排斥密切相关。

Objective To compare the difference of ELISA and LABScreen in detecting HLA antibodies and evaluate their effects on allograft rejection. Methods Consecutive patients undergoing kidney transplantion from November, 2008 to December, 2009 in the First Affiliated Hospital and the following up patients during the same period, with abnormal Scr who had completed kidney biopsies, were included in this study. Patients＇ HLA antibodies were detected by ELISA （Lambda antigen tray, LATTM） and LABSereen Mix Beads （LABScreen MIX, One Lambda, Canoga Park, CA, USA） or LABSereen Single antigen beads （LABSereenTM single antigen beads, One Lambda, Canoga Park, CA, USA）. Patients＇ Set were also detected at different time potints. Results There were 277 patietns included. Among them 145 （52.3%） cases were HLA antibody positive detected by LABScreen, which including 118 cases ELISA negative but LABScreen positive, and 27 cases both ELISA and LABScreen positive. No case was ELISA positive but LABScreen negative. Among 118 cases which were LABSereen positive but ELISA negative, 41 （34.7%） cases happened acute or chronic rejection. However, only 24 cases happened rejection in 132 double negative cases （18.2%, P = 0.003）.There were 31% patients in rejection group while only 12.8% patients （P = 0.01） in non- rejection group whose HLA antibody fluorescence intensity detected by LABSereen single antigen beads still increased two weeks after transplantation. Conclusion LABScreen is more sensitive than ELISA in detecting HLA antibodies, and its result highly correlates with the incidence of allograft rejection.