Minucci Pellegrino B, Grimaldi Vincenzo, Casamassimi Amelia, Cacciatore Francesco, Sommese Linda, Picascia Antonietta, Resse Marianna, Sabia Chiara, Russo Adolfo, Napoli Claudio
U.O.C. of Immunohematology and Immunology of Transplantation, CRT-AORN Cardarelli, Salvatore Maugeri Foundation, IRCCS, Institute of Telese, 82037, Benevento, IT.
Exp Clin Transplant. 2011 Dec;9(6):381-6.
The relevance of anti-HLA antibodies in patients awaiting kidney transplants is well recognized. During the past 40 years, kidney transplant candidates have been tested for these antibodies, and the choice of the detection assay has become essential. Recently, the pioneer method, the complement-dependent cytotoxicity, has been integrated but has not been replaced by more-sensitive solid-phase assays, such as the enzyme-linked immunosorbent assay and the bead-based technology (ie, flow cytometry: FlowPRA, and FlowAnalyzer: Luminex).
We compared the sensitivity and antibody specificity of these 4 techniques for detecting panel-reactive antibodies in a population of 101 consecutive patients awaiting a renal transplant (which had already resulted positive in a prescreening analysis).
Sera positive for class I and class II antibodies were 62 and 90 as assessed by the complement-dependent cytotoxicity method, 76 and 58 by using enzyme-linked immunosorbent assay, 83 and 65 with Flow-panel-reactive antibodies, and 90 and 79 by Luminex. Luminex gave more positive scores than the others for class I HLA antibodies, whereas complement-dependent cytotoxicity revealed more positives for those of class II.
Although Luminex appears more efficient among these assays, our results indicate that use of multiple methods is still the best approach for characterizing the immunologic status of these patients.
抗人白细胞抗原（HLA）抗体在等待肾移植患者中的相关性已得到充分认识。在过去40年中，肾移植候选者已接受这些抗体检测，检测方法的选择变得至关重要。最近，先驱方法即补体依赖细胞毒性法已被整合，但尚未被更灵敏的固相检测法所取代，如酶联免疫吸附测定法和基于微珠的技术（即流式细胞术：FlowPRA和FlowAnalyzer：Luminex）。
我们比较了这4种技术在101例连续等待肾移植患者（在预筛查分析中已呈阳性）群体中检测群体反应性抗体的敏感性和抗体特异性。
通过补体依赖细胞毒性法评估，I类和II类抗体血清阳性分别为62例和90例；酶联免疫吸附测定法分别为76例和58例；Flow-panel反应性抗体分别为83例和65例；Luminex分别为90例和79例。Luminex对I类HLA抗体给出的阳性分数比其他方法更多，而补体依赖细胞毒性法对II类抗体显示出更多阳性。
尽管Luminex在这些检测中似乎更有效，但我们的结果表明，使用多种方法仍然是表征这些患者免疫状态的最佳方法。
