Bratisl Lek Listy. 2021;122(3):179-183. doi: 10.4149/BLL_2021_028.
It remains unclear, why only some patients form alloantibodies against foreign RBC antigens. Transfusion of red blood cell (RBC) products and pregnancy are the most relevant causes of immunization against RBC alloantigens. Here we investigated the relationship between RBC alloantibodies, Rh phenotype, and HLA phenotype among patients with multiple RBC alloantibodiesMETHODS: In a group of 124 multi-responders ‒ including both pregnant women and transplant recipients ‒ we analysed the distribution of HLA-Class II variants in subgroups of multi-responders to RBC alloantigens according to their Rh status.
As expected, the RhD-negative phenotype was overrepresented in our alloimmunized group (49.2 %) compared to in the general population. Importantly, HLA-DRB115 carriers were significantly overrepresented among D-negative multi-responders compared to D-positive multi-responders (Pc = 0.045). Furthermore, the linked HLA-DRB113, HLA-DQB106, and HLA-DQA101 variants were more frequent in individuals with the DCCee phenotype than in other RhD-positive phenotypes.
Our present findings showed that RBC multispecific alloimmunization was associated with particular HLA-Class II variants based on Rh status (Tab. 3, Ref. 22).
目前尚不清楚为什么只有部分患者会对异体 RBC 抗原产生同种抗体。输注 RBC 制品和妊娠是导致 RBC 同种异体抗原免疫的最相关原因。在此,我们研究了 RBC 同种抗体、Rh 表型和 HLA 表型之间的关系,这些关系存在于具有多种 RBC 同种抗体的患者中。
在一组 124 名多反应者中——包括孕妇和移植受者——我们根据 Rh 状态分析了 RBC 同种异体抗原多反应者亚组中 HLA-Class II 变体的分布。
正如预期的那样,与一般人群相比,我们的同种免疫组中 RhD 阴性表型的比例过高(49.2%)。重要的是,与 RhD 阳性多反应者相比,D 阴性多反应者中 HLA-DRB115 携带者明显过多(Pc=0.045)。此外,DCCee 表型个体中 HLA-DRB113、HLA-DQB106 和 HLA-DQA101 相关变体的频率高于其他 RhD 阳性表型。
我们目前的研究结果表明,根据 Rh 状态,RBC 多特异性同种免疫与特定的 HLA-Class II 变体相关(表 3,参考文献 22)。