Zhao J, Fu Y X, Yang T, Shen Z Y, Wu C L
Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China; Department of Transplant Surgery, Tianjin First Central Hospital, Tianjin, China.
Department of Transplant Surgery, Tianjin First Central Hospital, Tianjin, China.
Transplant Proc. 2016 Jul-Aug;48(6):2235-40. doi: 10.1016/j.transproceed.2016.04.018.
Human leukocyte antigen (HLA) antibodies estimated by Luminex single-antigen beads, especially those that fix complement, are associated with antibody-mediated rejection and graft failure. However, the relationship between HLA antibody strength and complement-binding ability is controversial.
Serum samples of 31 sensitized renal patients waiting for renal transplantation were retrospectively analyzed by IgG-Luminex to identify HLA antibodies and in parallel by C1q-Luminex to determine the complement binding of HLA antibodies.
The percentage of HLA class I antibodies binding with C1q was lower than that of HLA class II antibodies (43.2% vs. 51.3%, P = .006). The mean fluorescence intensities (MFI) of IgG-Luminex correlated with the MFI of C1q-Luminex for the same antibodies (Spearman correlation; class I, r = 0.665, P < .01; class II, r = 0.761, P < .01). Receiver operating characteristic (ROC) curve analysis showed that the MFIs of HLA antibodies by IgG-Luminex predicted their C1q-binding abilities (area under the curve [AUC] class I = 0.917; AUC class II = 0.927). Using MFI cutoff values of 8238 and 6754 in IgG-Luminex for HLA class I and class II antibodies, respectively, the sensitivity and specificity for C1q binding were 82.4% and 87.4% for class I antibodies and 90.9% and 82% for class II antibodies.
The MFI of HLA antibodies by IgG-Luminex predicts the complement-binding capability to a certain extent before transplantation.
通过Luminex单抗原微珠估计的人类白细胞抗原（HLA）抗体，尤其是那些可固定补体的抗体，与抗体介导的排斥反应和移植物功能衰竭相关。然而，HLA抗体强度与补体结合能力之间的关系存在争议。
对31例等待肾移植的致敏肾病患者的血清样本进行回顾性分析，采用IgG-Luminex法鉴定HLA抗体，同时采用C1q-Luminex法测定HLA抗体的补体结合情况。
与C1q结合的HLAⅠ类抗体百分比低于HLAⅡ类抗体（43.2%对51.3%，P = 0.006）。对于相同抗体，IgG-Luminex的平均荧光强度（MFI）与C1q-Luminex的MFI相关（Spearman相关性；Ⅰ类，r = 0.665，P < 0.01；Ⅱ类，r = 0.761，P < 0.01）。受试者工作特征（ROC）曲线分析表明，IgG-Luminex检测的HLA抗体MFI可预测其C1q结合能力（曲线下面积[AUC]：Ⅰ类 = 0.917；Ⅱ类 = 0.927）。分别采用IgG-Luminex中HLAⅠ类和Ⅱ类抗体的MFI临界值8238和6754，Ⅰ类抗体C1q结合的敏感性和特异性分别为82.4%和87.4%，Ⅱ类抗体分别为90.9%和82%。
IgG-Luminex检测的HLA抗体MFI在移植前可在一定程度上预测补体结合能力。
