摘要
目的 探讨人类白细胞抗原（HLA）和人类血小板抗原（HPA）复合抗体诱发的血小板输注无效（PTR）患者的HPA/HLA基因型及抗体特异性.方法 选择2010年1月至2012年6月,于广州血液中心行血小板（PLT）配型的PTR患者中,6例同时具有HLA-Ⅰ类抗体和HPA抗体的患者作为研究对象（本研究遵循的程序符合广州血液中心人体试验委员会制定的伦理学标准,得到该委员会批准,并征得受试对象的知情同意）.采用酶联免疫吸附试验方法检测患者HLA抗体及PLT特异性糖蛋白（GP）抗体,应用序列特异性引物-聚合酶链反应（PCR-SSP）方法对患者HLA及HPA 1～17进行基因分型,根据HLA/HPA基因型和单克隆抗体特异性俘获血小板抗原实验（MAIPA）的抗体检测结果确认抗体特异性.结果 6例PTR患者的抗HLA-Ⅰ类抗体中,以抗HLA-A＊2、-A＊ 11及-B＊ 40最为常见;PLT特异性GP抗体以GPⅡb/Ⅲa抗体阳性为主,占83.3％（5/6）;经MAIPA PLT抗体特异性分析,3例（50.0％,3/6）患者存在抗HPA-3a抗体,2例（33.3％,2/6）患者HPA-3b抗体呈阳性,仅1例（16.7％,1/6）患者的HPA-5b抗体呈阳性.结论 临床上,对存在复合抗体的疑难PTR患者进行HLA/HPA基因型及其抗体特异性分析,能避免患者HLA/HPA抗体相应的PLT抗原输注,寻找与患者HLA/HPA基因型相匹配的献血者,可提高患者的PLT输注疗效,避免血液资源的浪费.
Objective To analyze the genotype of human leukocyte antigen （HLA）/human platelet antigen （HPA） and the antibody specificity in platelet transfusion refractoriness （PTR） patients caused by HLA antibodies combined with HPA antibodies.Methods From January 2010 to June 2012,a total of 6 patients who had HLA class Ⅰ antibodies and HPA antibodies were selected as research subjects from PTR patients who accepted platelet （PLT） crossmatch in Guangzhou Blood Center.HLA antibodies and antibody of membrane glycoprotein （GP） were measured by enzyme-linked immunosorbent assay （ELISA）,and the HLA and HPA1-17 genotype were analyzed by sequence specific primers-polymerase chain reaction （PCR-SSP） method.Then the antibodies specificity was confirmed according to HLA/HPA genotype and the antibodies detecting results using monoclonal antibody immobilization of platelet antigens assay （MAIPA）.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangzhou Blood Center.Informed consent was obtained from all participants.Results In these 6 PTR patients,anti-HLA-A ＊ 2,-A ＊ 11 and anti-HLA-B ＊ 40 of HLA-Ⅰ antibodies were common.The highest expression of PLT GP specific antibody was GP Ⅱ b/Ⅲ a,accounting for 83.3% （5/6）.3 patients （50.0%,3/6） had anti-HPA-3a antibody; 2 patients （33.3%,2/6） had anti-HPA-3b antibody; only 1 case （16.7%,1/6） had anti-HPA-5b antibody.Conclusions In clinically,the analysis of HLA/HPA genotype and antibody specificity in PTR patients could help us to avoid PLT transfusion which expresses HLA/HPA antibodies against corresponding antigen,to find the blood donors who have the same HLA/HPA genotypes with patients,to improve the efficacy of PLT transfusion and avoid blood waste.
出处
《国际输血及血液学杂志》
CAS
2014年第3期197-200,共4页
International Journal of Blood Transfusion and Hematology
基金
国家自然科学基金（81102294）
广州科技计划应用基础研究计划项目（2010Y1-C471）
广州市医药卫生科技重点项目（20121A021021,20121A021020）
广州市医药卫生科技一般项目（20131A011124）
关键词
血小板
血小板输注
HLA抗原
抗原
人血小板
Platelet antibodies
Platelet transfusion
HLA antigens
Antigens,human platelet
