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白细胞去除和紫外线处理均可降低 HLA 抗体反应的幅度和持续时间。

Leukoreduction and ultraviolet treatment reduce both the magnitude and the duration of the HLA antibody response.

机构信息

Blood Systems Research Institute, San Francisco, California; Puget Sound Blood Center, Seattle, Washington; University of California, Davis, California; National Institutes of Health, Bethesda, Maryland; University of Southern California, Los Angeles, California; Children's National Medical Center, Washington, DC; Department of Laboratory Medicine, University of California, San Francisco, California; Department of Medicine, University of California, San Francisco, California; University of Washington School of Medicine, Seattle, Washington.

出版信息

Transfusion. 2014 Mar;54(3):672-80. doi: 10.1111/trf.12317. Epub 2013 Jun 30.

Abstract

BACKGROUND

Both leukoreduction and ultraviolet (UV) light treatment of blood products have been shown to reduce the incidence of HLA antibody development in recipients, but the impact of these treatments on the magnitude and persistence of the antibody response is less clear.

STUDY DESIGN AND METHODS

Longitudinal samples from 319 subjects taken from four different study cohorts were evaluated for HLA antibodies to determine the effects of leukoreduction and UV treatment on HLA antibody generation and persistence.

RESULTS

Subjects receiving leukoreduced or UV-treated blood products were less likely to generate Class I HLA antibodies, and those receiving leukoreduced blood were also less likely to generate Class II HLA antibodies. Among those receiving nonleukoreduced blood, 55% developed Class I HLA antibodies and 51% developed Class II HLA antibodies compared with 28% (Class I) and 15% (Class II) for those receiving leukoreduced blood and 36% (Class I) and 54% (Class II) for those receiving UV-treated blood. Among alloimmunized subjects, leukoreduction resulted in a significant twofold reduction in the magnitude of Class I HLA antibodies, and UV treatment resulted in a significant threefold reduction in the magnitude of Class II HLA antibodies. Both treatments resulted in shorter persistence of Class I HLA antibodies.

CONCLUSIONS

These data demonstrate that leukoreduction and UV treatment of blood products results not only in a reduction in the incidence of HLA antibody production, but also in lower and more transient HLA antibody levels among sensitized transfusion recipients.

摘要

背景

白细胞去除和血液制品的紫外线(UV)处理已被证明可降低受者 HLA 抗体产生的发生率,但这些处理对抗体反应的幅度和持续时间的影响尚不清楚。

研究设计和方法

从四个不同的研究队列中抽取了 319 名受试者的纵向样本,用于检测 HLA 抗体,以确定白细胞去除和 UV 处理对 HLA 抗体产生和持续的影响。

结果

接受白细胞去除或 UV 处理的血液制品的受试者产生 HLA 类 I 抗体的可能性较小,而接受白细胞去除的血液制品的受试者产生 HLA 类 II 抗体的可能性也较小。在接受非白细胞去除血液的受试者中,55%产生 HLA 类 I 抗体,51%产生 HLA 类 II 抗体,而接受白细胞去除血液的受试者中,28%(类 I)和 15%(类 II)产生抗体,接受 UV 处理血液的受试者中,36%(类 I)和 54%(类 II)产生抗体。在同种免疫的受试者中,白细胞去除导致 HLA 类 I 抗体的幅度显著降低两倍,而 UV 处理导致 HLA 类 II 抗体的幅度显著降低三倍。两种处理均导致 HLA 类 I 抗体的持续时间缩短。

结论

这些数据表明,白细胞去除和血液制品的 UV 处理不仅降低了 HLA 抗体产生的发生率,而且还降低了致敏输血受者 HLA 抗体水平的幅度和持续时间。

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