Japanese Red Cross Osaka Blood Center, Morinomiya, Joto-ku, Osaka, Japan.
Transfusion. 2010 Jan;50(1):252-63. doi: 10.1111/j.1537-2995.2009.02388.x. Epub 2009 Sep 22.
Nonhemolytic transfusion reactions (NHTRs) are the most common transfusion reactions and include transfusion-related acute lung injury (TRALI) and allergic and febrile reactions. White blood cell (WBC) antibodies (Abs) against human leukocyte antigen (HLA) and human neutrophil antigen (HNA) in blood components are frequently implicated in NHTRs, especially in TRALI. Recently, we established a five-cell-lineage immunofluorescence test, a modified granulocyte immunofluorescence test, and a panel of cell lines stably expressing HNAs for efficient detection of Abs against well-known HNA-1 to HNA-5, and also Abs against neutrophil antigens other than HNA-1 to HNA-5. Using these techniques, we found that most of the non-HLA WBC Abs detected in NHTR cases were against antigens other than HNA-1 to HNA-5. In addition, using our newly established neutrophil activation test, which assesses neutrophil activation elicited by immunologic stimuli such as WBC Abs and immune complex, we found that heparin-binding protein is a potential final effector molecule that induces NHTRs, including TRALI. More recently, we reported that the basophil activation test, which was originally developed to identify allergens in the field of allergic diseases, might be useful in transfusion medicine. In this review, we summarize these new techniques and other related tests.
非溶血性输血反应（NHTRs）是最常见的输血反应，包括与输血相关的急性肺损伤（TRALI）以及过敏和发热反应。血液成分中的白细胞（WBC）抗体（Abs）针对人类白细胞抗原（HLA）和人类中性粒细胞抗原（HNA），经常与 NHTRs 有关，尤其是在 TRALI 中。最近，我们建立了一个五细胞谱系免疫荧光试验、改良的粒细胞免疫荧光试验和一组稳定表达 HNA 的细胞系，用于高效检测针对已知 HNA-1 至 HNA-5 的 Abs，以及针对除 HNA-1 至 HNA-5 以外的中性粒细胞抗原的 Abs。使用这些技术，我们发现 NHTR 病例中检测到的大多数非 HLA WBC Abs 针对的是 HNA-1 至 HNA-5 以外的抗原。此外，使用我们新建立的中性粒细胞激活试验，该试验评估免疫刺激物（如 WBC Abs 和免疫复合物）引起的中性粒细胞激活，我们发现肝素结合蛋白是一种潜在的最终效应分子，可引起包括 TRALI 在内的 NHTRs。最近，我们报告称，最初为识别过敏疾病领域中的过敏原而开发的嗜碱性粒细胞激活试验在输血医学中可能有用。在这篇综述中，我们总结了这些新技术和其他相关测试。
