Collins R W, Harmer A W, Heads A J, Kondeatis E, Page G, Vaughan R W
South Thames Tissue Typing, NGH3, Guy's Hospital, St. Thomas Street, London, SE1 9RT, UK.
Transplantation. 2001 Dec 15;72(11):1851-3. doi: 10.1097/00007890-200112150-00027.
Antibody screening of a patient with a failed renal transplant showed positive reactions with most, but not all HLA-Bw4-associated B-locus antigens. However, the patient's serological HLA class I type suggested the presence of HLA-Bw4.
Standard molecular techniques were used to re-type the patient and donor. ELISA antibody screening helped determine the patient's antibody specificity.
The patient's type was HLA-B1402,4703;Bw6 and the donor HLA-B4703,51011;Bw4,6. Analysis of ELISA results identified three amino acids (positions 77,80,81) as the most likely epitope recognised by the patient's serum. These corresponded to HLA-B*51011 amino acid mismatches, explaining the lymphocytotoxic reactivity pattern. This epitope is located on a subgroup of the HLA-Bw4 antigen suggesting anti-Bw4 was not a sufficient description of this antibody.
This report identifies an antibody to a sub-group of the Bw4 public specificity and also confirms the need for sequence-level analysis in the tissue-typing laboratory to determine future unacceptable mismatches.
对一名肾移植失败患者进行的抗体筛查显示，该患者与大多数（但并非全部）HLA - Bw4相关的B位点抗原发生阳性反应。然而，患者的血清学HLA I类分型提示存在HLA - Bw4。
采用标准分子技术对患者和供体进行重新分型。酶联免疫吸附测定（ELISA）抗体筛查有助于确定患者抗体的特异性。
患者的分型为HLA - B1402,4703;Bw6，供体的分型为HLA - B4703,51011;Bw4,6。对ELISA结果的分析确定了三个氨基酸（第77、80、81位）为最有可能被患者血清识别的表位。这些氨基酸与HLA - B*51011的氨基酸错配相对应，解释了淋巴细胞毒性反应模式。该表位位于HLA - Bw4抗原的一个亚组上，这表明抗Bw4不足以描述这种抗体。
本报告鉴定出一种针对Bw4公共特异性亚组的抗体，同时也证实了组织分型实验室进行序列水平分析以确定未来不可接受错配的必要性。
