Wiebe Chris, Nickerson Peter
aDepartment of Medicine and Immunology, University of Manitoba bDiagnostic Services of Manitoba, Winnipeg, Manitoba, Canada.
Curr Opin Organ Transplant. 2014 Aug;19(4):442-6. doi: 10.1097/MOT.0000000000000104.
To summarize the evidence concerning human leukocyte antigen (HLA) epitope mismatch analysis as a means to predict donor-specific antibody (DSA) development and allograft survival.
HLA epitope mismatch analysis outperforms traditional whole molecule antigen mismatch for predicting the risk of de-novo DSA development. By analyzing the number of epitope mismatches for a given donor-recipient pair, thresholds have been identified to stratify patients into those at high or low risk of de-novo DSA development. Epitope specificity assignment in patients who develop de-novo DSA compared with controls who do not provides an opportunity to study the relative immunogenicity of mismatched HLA epitopes.
Recognizing that de-novo DSA is a major cause of graft loss, HLA epitope mismatch analysis is a strategy to minimize de-novo DSA development and improve long-term graft survival.
总结关于人类白细胞抗原（HLA）表位错配分析作为预测供者特异性抗体（DSA）产生及同种异体移植物存活的一种手段的证据。
在预测新发DSA产生的风险方面，HLA表位错配分析优于传统的全分子抗原错配分析。通过分析给定供者 - 受者对的表位错配数量，已确定阈值以将患者分层为新发DSA产生风险高或低的人群。与未产生新发DSA的对照相比，产生新发DSA的患者中的表位特异性分配为研究错配的HLA表位的相对免疫原性提供了机会。
认识到新发DSA是移植物丢失的主要原因，HLA表位错配分析是一种将新发DSA产生降至最低并改善长期移植物存活的策略。
