Nemours Children's Health, Nemours Center for Cancer and Blood Disorders, Wilmington, DE, United States.
Nemours Children's Health, Nemours Center for Cancer and Blood Disorders, Wilmington, DE, United States.
Hum Immunol. 2022 Oct;83(10):687-694. doi: 10.1016/j.humimm.2022.03.002. Epub 2022 Mar 25.
Human leukocyte antigen (HLA) matching is an essential component of allogeneic hematopoietic stem cell transplant (HSCT). However, for some clinicians the biology underpinning HLA structure and function may be but a distant memory from lectures many years past, and, understanding the complexities of HLA matching can be challenging for clinicians new to the field, particularly as there have been several important advances in the field this past decade. In this review, we provide an up to date resource to educate and remind clinicians of: 1) Why HLA matching matters, including reviewing the role HLA molecules play in the adaptive immune system and the consequences of HLA mismatch. 2) What is involved in HLA matching, including a review of the different HLA genes, HLA protein structure, HLA sequencing approaches through time, and HLA allele nomenclature. And 3) how to apply this knowledge to identify an HLA matched donor for allogeneic HSCT, including discussion regarding HLA-DPB1 permissive mismatching and Donor Specific Antibodies.
人类白细胞抗原 (HLA) 配型是异基因造血干细胞移植 (HSCT) 的重要组成部分。然而，对于一些临床医生来说，HLA 结构和功能的生物学基础可能只是多年前讲座中遥远的记忆，而且，对于该领域的新手临床医生来说，理解 HLA 配型的复杂性可能具有挑战性，特别是在过去十年中，该领域取得了几项重要进展。在这篇综述中，我们提供了最新的资源，以教育和提醒临床医生：1）为什么 HLA 配型很重要，包括回顾 HLA 分子在适应性免疫系统中的作用以及 HLA 不匹配的后果。2）HLA 配型涉及哪些内容，包括对不同 HLA 基因、HLA 蛋白结构、随时间变化的 HLA 测序方法以及 HLA 等位基因命名法的回顾。3）如何将这些知识应用于识别异基因 HSCT 的 HLA 匹配供体，包括讨论 HLA-DPB1 允许性不匹配和供体特异性抗体。
