Shankarkumar U, Pawar A, Ghosh K
Institute of Immunohaematology, 13th Floor, K.E.M Hospital, Parel, Mumbai, Maharashtra, India.
J Postgrad Med. 2008 Jan-Mar;54(1):41-4. doi: 10.4103/0022-3859.39192.
Serology-based conventional microlymphocytotoxicity HLA typing method, which has been regarded as the gold standard in organ and hematopoietic stem cell transplantation, has been replaced now by DNA-based typing. Many laboratories all over the world have already switched over to molecular methods. Microlymphocytotoxicity-based tissue typing was done using commercial sera, while the molecular typing by genomic DNA based. DNA quality and its quantity obtained using various DNA extraction protocols was found to be an important factor in the molecular method of tissue typing in transplant outcome. Many polymerase chain reaction-based molecular techniques have been adopted with far reaching clinical outcome. The sequence-based typing (SBT) has been the ultimate technique, which has been of the highest reliability in defining the HLA alleles. The nonavailability of specific HLA antisera from native populations, large number of blank alleles yet to be defined and comparable low resolution of HLA alleles in SSP or SSOP technique, suggests that highly refined DNA-based methods like SBT should be used as an adjunct to HLA serology and/or low/intermediate/high resolution HLA typing in order to achieve a better transplant outcome.
基于血清学的传统微量淋巴细胞毒 HLA 分型方法，曾被视为器官和造血干细胞移植的金标准，如今已被基于 DNA 的分型方法所取代。全球许多实验室都已转而采用分子方法。基于微量淋巴细胞毒的组织分型使用商业血清进行，而分子分型则基于基因组 DNA。发现使用各种 DNA 提取方案获得的 DNA 质量及其数量是移植结果中组织分型分子方法的一个重要因素。许多基于聚合酶链反应的分子技术已被采用，并产生了深远的临床结果。基于序列的分型（SBT）一直是终极技术，在确定 HLA 等位基因方面具有最高的可靠性。来自本地人群的特异性 HLA 抗血清不可用、大量空白等位基因有待确定以及 SSP 或 SSOP 技术中 HLA 等位基因的分辨率相对较低，这表明应使用像 SBT 这样高度精细的基于 DNA 的方法作为 HLA 血清学和/或低/中/高分辨率 HLA 分型的辅助手段，以实现更好的移植结果。
