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中国南方献血者中白细胞同种抗体的流行情况。

The prevalence of leucocyte alloantibodies in blood donors from South China.

作者信息

Xia W, Ye X, Xu X, Chen D, Deng J, Chen Y, Ding H, Shao Y, Wang J, Liu J, Li H, Huang Y F, Fu Y, Santoso S

机构信息

Institute of Blood Transfusion, Guangzhou Blood Center, Guangzhou, China.

Department of Biotechnology, Guangdong Food and Drug Vocational College, Guangzhou, China.

出版信息

Transfus Med. 2015 Dec;25(6):385-92. doi: 10.1111/tme.12276. Epub 2016 Feb 15.

DOI:10.1111/tme.12276

PMID:26876912

Abstract

BACKGROUND

Several studies had demonstrated that leucocyte antibodies including anti-human leucocyte antigen (anti-HLA) antibodies (class I and class II) and anti-human neutrophil antigen (anti-HNA) antibodies (HNA-1, -2 and -3) present in the blood products are responsible for transfusion-related acute lung injury (TRALI). Therefore, selection of blood products exclusive of anti-HLA and anti-HNA antibodies may lower the risk of TRALI reaction. However, the prevalence of leucocyte antibodies among blood donors in China is currently not known.

STUDY DESIGN AND METHODS

Blood samples were collected from 454 male and 560 female donors (143 nulliparous and 417 multiparous female). HLA class I and II antibodies were analyzed by bead assays. Anti-HNA-1 and -2 antibodies were screened by the LABScreen assay (One Lambda Inc.), and HNA-3 were detected by antigen capture assay, and confirmed by the granulocyte agglutination test (GAT).

RESULTS

Screening of the total cohort showed higher prevalence of HLA antibodies in female compared with male donors (19.64 vs. 4.63%). We found antibodies against HLA class I (13.21%) and HLA class II (11.43%) in 560 female donors. The most frequent antibodies against HLA class I and II in parous females (n = 69) reacted with were A11 (28.81%), B07 (42.37%), Cw07 (20.34%) and DRB104 (40.43%) molecules. Among 778 donors (randomly selected from 1014 donors), we found three donors with neutrophil reactive antibodies, two against HNA-2 and one without known specificity. Anti-HNA-3 antibodies were not found so far.

CONCLUSION

In this study, we found alloimmunization against HLA class I, II and HNA in 4.63, 24.70 and 0.39%, respectively, in our female blood donors, indicating that the use of plasma containing blood products from parous female blood donors without HLA antibodies pre-testing may increase the risk of TRALI reaction. Although immunization against HNA seems to be a rare event in China, further observation is necessary to decide the necessity of HNA antibodies screening in our blood donors.

摘要

背景

多项研究表明，血液制品中存在的白细胞抗体，包括抗人类白细胞抗原（抗HLA）抗体（I类和II类）以及抗人类中性粒细胞抗原（抗HNA）抗体（HNA-1、-2和-3），是输血相关急性肺损伤（TRALI）的病因。因此，选择不含抗HLA和抗HNA抗体的血液制品可能会降低TRALI反应的风险。然而，目前尚不清楚中国献血者中白细胞抗体的流行情况。

研究设计与方法

采集了454名男性和560名女性献血者（143名未生育女性和417名已生育女性）的血样。通过微珠分析法分析HLA I类和II类抗体。采用LABScreen检测法（One Lambda公司）筛选抗HNA-1和-2抗体，通过抗原捕获试验检测HNA-3，并通过粒细胞凝集试验（GAT）进行确认。

结果

对整个队列的筛查显示，女性献血者中HLA抗体的流行率高于男性（19.64%对4.63%）。我们在560名女性献血者中发现了抗HLA I类（13.21%）和抗HLA II类（11.43%）抗体。已生育女性（n = 69）中最常见的抗HLA I类和II类抗体与A11（28.81%）、B07（42.37%）、Cw07（20.34%）和DRB104（40.43%）分子发生反应。在778名献血者（从1014名献血者中随机选取）中，我们发现3名献血者有中性粒细胞反应性抗体，2名针对HNA-2，1名特异性不明。目前尚未发现抗HNA-3抗体。

结论

在本研究中，我们发现女性献血者中抗HLA I类、II类和抗HNA的同种免疫率分别为4.63%、24.70%和0.39%，这表明使用来自未进行HLA抗体预检测的已生育女性献血者的含血浆血液制品可能会增加TRALI反应的风险。尽管在中国抗HNA免疫似乎是罕见事件，但仍需进一步观察以确定对我国献血者进行HNA抗体筛查的必要性。