印度 RhD 阴性孕妇抗 D 同种免疫与 HLA-DRB1 等位基因的关联。

Association of HLA-DRB1 alleles with anti-D alloimmunization in RhD negative pregnant women in India.

机构信息

Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.

出版信息

Transfus Apher Sci. 2023 Dec;62(6):103789. doi: 10.1016/j.transci.2023.103789. Epub 2023 Aug 22.

DOI:10.1016/j.transci.2023.103789

PMID:37673757

Abstract

BACKGROUND

Human leukocyte antigen (HLA) restriction plays an important role in the susceptibility to alloimmunization against red blood cell (RBC) antigens. The prevalence of anti-D alloimmunization in RhD negative pregnancy is still quite high in our population. Thus, we planned this study to determine the association of HLA-DRB1 alleles with anti-D alloimmunization in RhD negative pregnant women.

MATERIAL AND METHODS

RBC antibody screen (ABS) was performed for RhD negative pregnant women attending the antenatal clinic our institute. Those with a negative result were included in the 'non-alloimmunized' (NAL) group ('Control' group), while those with anti-D alloantibody on performing antibody identification were included in the alloimmunized (AL) group of the study (n = 50 each). ABS and identification were done using column agglutination technique. The HLA-DRB1 typing was done by Luminex based reverse sequence specific oligonucleotide probing (SSOP) using commercial kits. The HLA-DRB1 allele frequency was compared in both the groups.

RESULTS

There was a significant difference between the two groups in terms of gravida (p < 0.001) and history of anti-D immunoprophylaxis (p < 0.001). The frequency of HLA-DRB103 and HLA-DRB104 alleles was significantly higher in the AL group than the NAL group: 40 % versus 18 % [Odds Ratio (OR): 3.04, 95 % CI: 1.21-7.6; p = 0.015] for HLA-DRB103 alleles and 18 % versus 4 % (OR: 5.27, 95 % CI: 1.08-25.78, p = 0.025) for HLA-DRB104 alleles.

CONCLUSION

The frequency of HLADRB103 and HLADRB104 alleles was significantly higher in RhD negative pregnant women alloimmunized with anti-D alloantibody.

摘要

背景

人类白细胞抗原（HLA）限制在对红细胞（RBC）抗原的同种免疫易感性中起重要作用。在我们的人群中，RhD 阴性妊娠中抗-D 同种免疫的发生率仍然相当高。因此，我们计划进行这项研究，以确定 HLA-DRB1 等位基因与 RhD 阴性孕妇抗-D 同种免疫的相关性。

材料和方法

对我院产前门诊就诊的 RhD 阴性孕妇进行 RBC 抗体筛查（ABS）。阴性结果的孕妇纳入“非同种免疫（NAL）”组（“对照组”），而在进行抗体鉴定时发现抗-D 同种抗体的孕妇纳入研究的同种免疫（AL）组（每组 50 例）。ABS 和鉴定均采用柱凝集技术进行。HLA-DRB1 分型采用商业试剂盒基于 Luminex 的反向序列特异性寡核苷酸探针（SSOP）进行。比较两组之间的 HLA-DRB1 等位基因频率。

结果

两组在孕次（p<0.001）和抗-D 免疫预防史（p<0.001）方面存在显著差异。AL 组 HLA-DRB103 和 HLA-DRB104 等位基因的频率明显高于 NAL 组：40%对 18%（比值比（OR）：3.04，95%CI：1.21-7.6；p=0.015）对于 HLA-DRB103 等位基因，18%对 4%（OR：5.27，95%CI：1.08-25.78，p=0.025）对于 HLA-DRB104 等位基因。