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开发和验证通用献血者基因分型平台:一项多国家前瞻性研究。

Development and validation of a universal blood donor genotyping platform: a multinational prospective study.

机构信息

Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom.

NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, United Kingdom.

出版信息

Blood Adv. 2020 Aug 11;4(15):3495-3506. doi: 10.1182/bloodadvances.2020001894.

Abstract

Each year, blood transfusions save millions of lives. However, under current blood-matching practices, sensitization to non-self-antigens is an unavoidable adverse side effect of transfusion. We describe a universal donor typing platform that could be adopted by blood services worldwide to facilitate a universal extended blood-matching policy and reduce sensitization rates. This DNA-based test is capable of simultaneously typing most clinically relevant red blood cell (RBC), human platelet (HPA), and human leukocyte (HLA) antigens. Validation was performed, using samples from 7927 European, 27 South Asian, 21 East Asian, and 9 African blood donors enrolled in 2 national biobanks. We illustrated the usefulness of the platform by analyzing antibody data from patients sensitized with multiple RBC alloantibodies. Genotyping results demonstrated concordance of 99.91%, 99.97%, and 99.03% with RBC, HPA, and HLA clinically validated typing results in 89 371, 3016, and 9289 comparisons, respectively. Genotyping increased the total number of antigen typing results available from 110 980 to >1 200 000. Dense donor typing allowed identification of 2 to 6 times more compatible donors to serve 3146 patients with multiple RBC alloantibodies, providing at least 1 match for 176 individuals for whom previously no blood could be found among the same donors. This genotyping technology is already being used to type thousands of donors taking part in national genotyping studies. Extraction of dense antigen-typing data from these cohorts provides blood supply organizations with the opportunity to implement a policy of genomics-based precision matching of blood.

摘要

每年,输血都挽救了数以百万计的生命。然而,在当前的血液匹配实践中,对非自身抗原的致敏是输血不可避免的不良反应。我们描述了一种通用供体分型平台,全世界的血液服务机构都可以采用该平台来促进通用的扩展血液匹配政策,并降低致敏率。这种基于 DNA 的测试能够同时对大多数临床相关的红细胞(RBC)、人类血小板(HPA)和人类白细胞(HLA)抗原进行分型。我们使用来自两个国家生物库的 7927 名欧洲、27 名南亚、21 名东亚和 9 名非洲献血者的样本进行了验证。我们通过分析因多种 RBC 同种异体抗体致敏的患者的抗体数据,说明了该平台的有用性。基因分型结果显示,在 89371、3016 和 9289 次 RBC、HPA 和 HLA 临床验证的分型结果比较中,与 RBC、HPA 和 HLA 的一致性分别为 99.91%、99.97%和 99.03%。基因分型将可用的抗原分型结果总数从 110980 增加到>1200000。密集的供体分型可以识别出 2 到 6 倍更多的相容供体,为 3146 名患有多种 RBC 同种异体抗体的患者提供服务,为 176 名以前在相同供体中找不到血液的个体提供至少 1 个匹配。这种基因分型技术已经用于对参与国家基因分型研究的数千名献血者进行分型。从这些队列中提取密集的抗原分型数据为血液供应组织提供了机会,可以实施基于基因组学的精确配血政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce3a/7422129/f998710c28f0/advancesADV2020001894absf1.jpg

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