女性新冠肺炎康复者捐献的恢复期血浆中HLA抗体检测及分析

Detection and analysis on HLA antibodies in convalescent plasma from female donors recovered from COVID-19 inGuangzhou, China

目的检测分析广州地区女性新冠肺炎(COVID-9)康复者所捐献的恢复期血浆中抗-HLA,以避免输血不良反应的发生。方法参照《新冠肺炎康复者恢复期血浆临床治疗方案(试行第二版)》,借助Luminex技术平台,运用抗-HLA特异性检测试剂盒对检测8位COVID-9女性康复者恢复期血浆中的抗-HLA,再通过GEN-PROBE MATCH IT软件获取捐献者抗-HLA-Ⅰ/Ⅱ的特异性。结果本组女性COVID-19康复者所捐献的血浆中,一次妊娠史共3人,未检出抗-HLA;多次妊娠史共5人, 3人(3/5)检出抗-HLA:其中2人(2/5)为抗-HLA-Ⅰ+Ⅱ阳性,1人(1/5)为抗-HLA-Ⅰ阳性。3人血浆中HLA等位基因主要为A*25∶01(Epitopes为76ESI)、A*29∶02、B*35∶08、DRB1*07∶01(Epitopes为78V2)、DRB1*09∶01(Epitopes为78V2)、DRB1*15∶01(Epitopes为71A)、DPB1*04∶01(Epitopes为35FA)等。结论根据COVID-19康复者恢复期血浆特殊检测要求开展抗-HLA检测,尤其针对有多次妊娠史或输血史的女性康复者,对避免输血相关急性肺损伤(TRALI)的发生十分必要。

Objective To detect and analyze the HLA antibodies in convalescent plasma from female donors recovered from COVID-19 in Guangzhou, aimed to avoid the occurrence of adverse reactions to blood transfusion. Methods HLA antibodies in convalescent plasma from 8 women recovered from COVID-19 were detected by HLA antibody specific detection kits(LIFECODES LSATM Class I & Class II) based on Luminex technology platform, with references to Clinical Treatment Plan of Convalescent Plasma Therapy for Patients with COVID-19(Trial Version 2), and the HLA I/II antibody specificity of donors were obtained using GEN-PROBE MATCH IT software. Results 3 female donors with one pregnancy had no HLA antibody detected out. Out of the 5 donors with more than one pregnancy, 3(3/5) presented HLA antibodies, while positive HLAⅠ+Ⅱ antibody and positive HLAⅠantibody constituted 2(2/5) and 1(1/5) cases respectively. HLA antibody alleles in these 3 female donors were mainly A* 25∶01(Epitopes 76 ESI), A*29∶02, B* 35∶08, DRB1* 07∶01(Epitopes 78 V2), DRB1* 09∶01(Epitopes 78 V2),DRB1* 15∶01(Epitopes 71 A), and DPB1* 04∶01(Epitopes 35 FA). Conclusion In accordance with the special requirements for convalescent plasma therapy, HLA antibodies testing in female donors, especially those with more than one pregnancy or blood transfusion history, was necessary for minimizing the occurrence of transfusion-related acute lung injury(TRALI).