Bushell A, Wood K J, Morris P J
Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK.
Hum Immunol. 1988 Nov;23(3):191-206. doi: 10.1016/0198-8859(88)90057-2.
Many studies, including those from our own center, have shown that matching the donor and recipient for HLA-DR antigens has a beneficial effect on the outcome of cadaveric renal transplantation. However, cases of irreversible graft rejection are sometimes seen in patients who have received an HLA-DR-compatible kidney, suggesting that serologic compatibility for HLA-DR may not always ensure reduced alloreactivity toward the graft. We have examined a number of recipients and their serologically DR-compatible cadaveric donors by Southern blotting and hybridization with locus specific HLA class II probes in order to determine whether in these patients there were class II mismatches that had been undetected by serology. The results show that the analysis of DR beta restriction fragment patterns does little more than complement and confirm the serologic identification of HLA-DR. Hybridization with DQ alpha and DQ beta probes, however, significantly extends the number of DQ specificities that can be detected and suggests that DQ mismatches in DR-compatible donor-recipient pairs may be more common than previously supposed, although it is not possible to draw any conclusions on the influence of DQ incompatibilities in the presence of DR compatibility on graft outcome.
许多研究，包括我们自己中心的研究，都表明供体和受体的HLA - DR抗原匹配对尸体肾移植的结果有有益影响。然而，在接受了HLA - DR相容肾脏的患者中，有时会出现不可逆的移植排斥情况，这表明HLA - DR的血清学相容性可能并不总能确保降低对移植物的同种异体反应性。我们通过Southern印迹法并用位点特异性HLA II类探针进行杂交，检查了一些受体及其血清学DR相容的尸体供体，以确定在这些患者中是否存在血清学未检测到的II类错配。结果表明，对DRβ限制性片段模式的分析只不过是对HLA - DR血清学鉴定的补充和确认。然而，用DQα和DQβ探针进行杂交，显著增加了可检测到的DQ特异性数量，并表明在DR相容的供体 - 受体对中，DQ错配可能比以前认为的更常见，尽管在存在DR相容性的情况下，关于DQ不相容性对移植结果的影响无法得出任何结论。
