Imoto S, Araki N, Shimada E, Saigo K, Nishimura K, Nose Y, Bouike Y, Hashimoto M, Mito H, Okazaki H
Hyogo Red Cross Blood Center, Kobe, Japan.
Transfus Med. 2007 Dec;17(6):455-65. doi: 10.1111/j.1365-3148.2007.00802.x.
To study the relationship between antibodies detected in patients' and/or donors' sera and the clinical features of acute non-haemolytic transfusion reactions (ANHTRs), and to determine any gender-related difference. ANHTRs range from urticaria to transfusion-related acute lung injury (TRALI). Antibodies to human leukocyte antigen (HLA), granulocytes, platelets, and/or plasma proteins are implicated in some of the ANHTRs. A higher antibody positivity is expected for females than for males. A comparative study of ANHTRs for antibody positivity and their clinical features between females and males for both patients and donors is helpful for characterizing ANHTRs including TRALI more clearly, but such studies are few and outdated. Two hundred and twenty-three ANHTR cases reported by 45 hospitals between October 2000 and July 2005 were analysed. The patients and 196 donors of suspect blood products were screened for antibodies to HLA Class I, HLA Class II, granulocytes, and platelets. The patients were also screened for anti-plasma protein antibodies. The types and severity of ANHTR did not differ significantly between female and male patients. The frequency of the anti-HLA antibodies, but not that of the non-HLA antibodies, was significantly higher in females. Non-HLA antibodies were significantly associated with severe reactions in females. All the TRALI cases had predisposing risk factors for acute lung injury, and 60% of the cases showed anti-leucocyte antibodies. Although the anti-HLA antibodies were detected more frequently in females than males, no significant association of ANHTRs including TRALI with gender, not only for patients, but also for donors, could be shown in this study.
研究患者和/或供者血清中检测到的抗体与急性非溶血性输血反应（ANHTRs）临床特征之间的关系，并确定是否存在性别差异。ANHTRs范围从荨麻疹到输血相关急性肺损伤（TRALI）。人类白细胞抗原（HLA）、粒细胞、血小板和/或血浆蛋白的抗体与部分ANHTRs有关。预计女性的抗体阳性率高于男性。对患者和供者中女性与男性的ANHTRs抗体阳性情况及其临床特征进行比较研究，有助于更清晰地界定包括TRALI在内的ANHTRs，但此类研究较少且已过时。分析了2000年10月至2005年7月期间45家医院报告的223例ANHTR病例。对患者及196名可疑血液制品供者进行了HLAⅠ类、HLAⅡ类、粒细胞和血小板抗体筛查。还对患者进行了抗血浆蛋白抗体筛查。女性和男性患者的ANHTRs类型和严重程度无显著差异。女性抗HLA抗体的频率显著高于非HLA抗体。非HLA抗体与女性的严重反应显著相关。所有TRALI病例均有急性肺损伤的易感危险因素，60%的病例显示抗白细胞抗体。尽管女性比男性更频繁地检测到抗HLA抗体，但本研究未显示包括TRALI在内的ANHTRs与性别之间存在显著关联，无论是患者还是供者。
