Nishimura M, Hashimoto S, Takanashi M, Okazaki H, Satake M, Nakajima K
Research Section, Tokyo Metropolitan Red Cross Blood Center, Tokyo, Japan.
Transfus Med. 2007 Apr;17(2):129-34. doi: 10.1111/j.1365-3148.2006.00721.x.
Recently, evidence implicating the roles of the anti-human leucocyte antigen (HLA) class II antibody in the development of transfusion-related acute lung injury (TRALI), which is one of the most serious possible side effects of transfusion, has been accumulating. The aim of this study is to clarify the roles of the anti-HLA DR alloantibody in TRALI development. Cultured human lung microvascular endothelial (LME) cells were incubated with either HLA-DR15-positive or HLA-DR15-negative monocytes together with serum from a single multiparous donor previously implicated in a clinical case of TRALI and known to contain anti-HLA DR15 antibody. Production of soluble leukotriene B(4) (LTB(4)) was measured in the supernatant and found to be markedly increased in the presence of HLA-DR15-positive monocytes but not with the HLA-DR15-negative monocytes or in the absence of LME cells. The vascular cell adhesion molecule-1 expression in LME cells and leucocyte-function-associated molecule-1 (LFA-1) expression in HLA-DR15-positive monocytes were notably enhanced after combined culture of LME cells, HLA-DR15-positive monocytes and TRALI-inducing anti-HLA DR15 antibody-positive serum. In conclusion, anti-HLA DR alloantibodies may be implicated in LME dysfunction that leads to TRALI, in a monocyte-dependent manner.
最近，有关抗人类白细胞抗原（HLA）II类抗体在输血相关急性肺损伤（TRALI）发生过程中作用的证据不断积累，TRALI是输血可能产生的最严重副作用之一。本研究的目的是阐明抗HLA DR同种异体抗体在TRALI发生中的作用。将培养的人肺微血管内皮（LME）细胞与HLA-DR15阳性或HLA-DR15阴性单核细胞一起孵育，并加入来自一位多胎产妇的血清，该产妇曾参与过一例TRALI临床病例，且已知其血清中含有抗HLA DR15抗体。检测上清液中可溶性白三烯B4（LTB4）的产生情况，发现与HLA-DR15阳性单核细胞共同孵育时，LTB4产生显著增加，而与HLA-DR15阴性单核细胞共同孵育或无LME细胞时则无此现象。LME细胞、HLA-DR15阳性单核细胞和诱导TRALI的抗HLA DR15抗体阳性血清共同培养后，LME细胞中血管细胞黏附分子-1的表达以及HLA-DR15阳性单核细胞中白细胞功能相关分子-1（LFA-1）的表达均显著增强。总之，抗HLA DR同种异体抗体可能以单核细胞依赖的方式参与导致TRALI的LME功能障碍。
