目的:分析不规则抗体所致新生儿溶血病(hemolytic disease of newborn, HDN)的抗体检测意义及其分布特点,为临床HDN的明确诊断和治疗措施提供依据。方法:选取102例在医院检测并证实为非ABO-HDN病例,收集患儿致病抗原体、日龄、是否输血...目的:分析不规则抗体所致新生儿溶血病(hemolytic disease of newborn, HDN)的抗体检测意义及其分布特点,为临床HDN的明确诊断和治疗措施提供依据。方法:选取102例在医院检测并证实为非ABO-HDN病例,收集患儿致病抗原体、日龄、是否输血、是否合并ABO-HDN以及母亲妊娠史、输血史等资料,分析其分布特点。结果:102例患儿中,Rh系统85例(83.33%),MNS系统14例(13.73%),Kidd系统3例(2.94%)。母亲有妊娠史78例(76.47%);有输血史15例(14.71%);男58例(56.86%),女44例(43.14%);合并ABO-HDN 14例(13.73%),未合并88例(86.27%)。非ABO-HDN患儿不规则抗体常见于Rh系统的抗-D抗体,占比47.06%,其次为抗-E抗体,占比17.65%,以Kidd系统最少,占比2.94%;37℃反应性:1+~4+;免疫球蛋白(Ig)类型:IgG类93例,IgG+IgM类3例,IgM类6例。分析患儿各类指征与输血的相关性显示,患儿合并ABO-HDN与输血有关(P<0.05),与母亲妊娠史、患儿性别、抗体特异无关(P>0.05)。结论:不规则抗体所致HDN患儿多见于Rh系统的抗-D和抗-E抗体,37℃反应性:1+~4+,Ig类型主要为IgG类,合并ABO-HDN患儿与输血有关,应及时进行HDN抗体检测,根据检测结果及时临床干预,以降低HDN的病死率。展开更多
Despite the significant resources dedicated to the development of monoclonal antibody(m Ab)therapies for solid tumors,the clinical success,thus far,has been modest.Limited efficacy of m Ab in solid tumors likely relat...Despite the significant resources dedicated to the development of monoclonal antibody(m Ab)therapies for solid tumors,the clinical success,thus far,has been modest.Limited efficacy of m Ab in solid tumors likely relates to unique aspects of tumor physiology.Solid tumors have an aberrant vasculature and a dense extracellular matrix that slow both the convective and diffusive transport of m Abs into and within tumors.For m Abs that are directed against cellular antigens,high antigen expression and rapid antigen turnover can result in perivascular cells binding to and eliminating a significant amount of extravasated m Ab,limiting m Ab distribution to portions of the tumor that are distant from functional vessels.Many preclinical investigations have reported strategies to improve m Ab uptake and distribution;however,to our knowledge,none have translated into the clinic.Here,we provide an overview of several barriers in solid tumors that limit m Ab uptake and distribution and discuss approaches that have been utilized to overcome these barriers in preclinical studies.展开更多
基金funded by the National Institutes of Health/National Cancer Institute(Grant Nos.CA204192 and CA246785)。
文摘Despite the significant resources dedicated to the development of monoclonal antibody(m Ab)therapies for solid tumors,the clinical success,thus far,has been modest.Limited efficacy of m Ab in solid tumors likely relates to unique aspects of tumor physiology.Solid tumors have an aberrant vasculature and a dense extracellular matrix that slow both the convective and diffusive transport of m Abs into and within tumors.For m Abs that are directed against cellular antigens,high antigen expression and rapid antigen turnover can result in perivascular cells binding to and eliminating a significant amount of extravasated m Ab,limiting m Ab distribution to portions of the tumor that are distant from functional vessels.Many preclinical investigations have reported strategies to improve m Ab uptake and distribution;however,to our knowledge,none have translated into the clinic.Here,we provide an overview of several barriers in solid tumors that limit m Ab uptake and distribution and discuss approaches that have been utilized to overcome these barriers in preclinical studies.
