Brubaker D B, Romine M
Department of Pathology, Harbor-UCLA Medical Center, Torrance 90509.
Am J Hematol. 1987 Dec;26(4):341-52. doi: 10.1002/ajh.2830260407.
Platelet crossmatching assays have been used to predict the outcome of platelet transfusions in alloimmunized patients by detecting antibodies against platelets. The transfusion failure of HLA-matched platelets predicted by platelet crossmatching may be related to HLA antibodies undetected by lymphocytotoxicity but detected by platelet immunoglobulin-binding assays or platelet-specific antibodies (both antibodies defined here as platelet-reactive antibodies). To differentiate platelet-reactive antibodies from lymphocytotoxic HLA antibodies, we used HLA characterized lymphocytes in parallel with platelets from individuals to form separate frozen panels. Sera from 10 allosensitized patients were studied in the lymphocyte panel by lymphocytotoxicity and in the platelet panel by enzyme-linked immunoassay (ELISA). By comparing pattern and percent wells reacting in each panel, lymphocytotoxic HLA antibodies and antibodies reactive with platelets in ELISA were detected separately. In all 10 allosensitized patients, platelet-associated antibodies were present and 7 had additional lymphocytotoxic HLA antibodies. Using this double parallel panel technique, we found platelet-reactive antibodies important in platelet alloimmunization, unrecognized by lymphocytotoxicity. These data indicate platelet-crossmatching be solely used in the selection of platelets for allosensitized patients.
血小板交叉配型试验已被用于通过检测抗血小板抗体来预测同种免疫患者血小板输注的结果。血小板交叉配型预测的 HLA 匹配血小板输血失败可能与淋巴细胞毒性检测未发现但血小板免疫球蛋白结合试验或血小板特异性抗体（此处定义的两种抗体均为血小板反应性抗体）检测到的 HLA 抗体有关。为了区分血小板反应性抗体与淋巴细胞毒性 HLA 抗体，我们使用 HLA 特征化的淋巴细胞与个体血小板并行，形成单独的冷冻板。对 10 名同种致敏患者的血清在淋巴细胞板中进行淋巴细胞毒性研究，并在血小板板中通过酶联免疫吸附测定（ELISA）进行研究。通过比较每个板中反应的模式和孔百分比，分别检测淋巴细胞毒性 HLA 抗体和 ELISA 中与血小板反应的抗体。在所有 10 名同种致敏患者中，均存在血小板相关抗体，7 名患者还存在淋巴细胞毒性 HLA 抗体。使用这种双平行板技术，我们发现血小板反应性抗体在血小板同种免疫中很重要，而淋巴细胞毒性检测未识别出这些抗体。这些数据表明血小板交叉配型不能单独用于为同种致敏患者选择血小板。
