Geo Jeethu Anu, Ameen Reem, Al Shemmari Salem, Thomas Jibu
Medical Laboratory Sciences Department, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
Department of Biotechnology, Karunya Institute of Technology and Sciences, Coimbatore, India.
Med Princ Pract. 2024;33(3):215-231. doi: 10.1159/000538176. Epub 2024 Mar 5.
HLA typing serves as a standard practice in hematopoietic stem cell transplantation to ensure compatibility between donors and recipients, preventing the occurrence of allograft rejection and graft-versus-host disease. Conventional laboratory methods that have been widely employed in the past few years, including sequence-specific primer PCR and sequencing-based typing (SBT), currently face the risk of becoming obsolete. This risk stems not only from the extensive diversity within HLA genes but also from the rapid advancement of next-generation sequencing and third-generation sequencing technologies. Third-generation sequencing systems like single-molecule real-time (SMRT) sequencing and Oxford Nanopore (ONT) sequencing have the capability to analyze long-read sequences that span entire intronic-exonic regions of HLA genes, effectively addressing challenges related to HLA ambiguity and the phasing of multiple short-read fragments. The growing dominance of these advanced sequencers in HLA typing is expected to solidify further through ongoing refinements, cost reduction, and error rate minimization. This review focuses on hematopoietic stem cell transplantation (HSCT) and explores prospective advancements and application of HLA DNA typing techniques. It explores how the adoption of third-generation sequencing technologies can revolutionize the field by offering improved accuracy, reduced ambiguity, and enhanced assessment of compatibility in HSCT. Embracing these cutting-edge technologies is essential to advancing the success rates and outcomes of hematopoietic stem cell transplantation. This review underscores the importance of staying at the forefront of HLA typing techniques to ensure the best possible outcomes for patients undergoing HSCT.
HLA分型是造血干细胞移植中的一项标准操作,以确保供体和受体之间的相容性,防止发生同种异体移植排斥反应和移植物抗宿主病。过去几年广泛使用的传统实验室方法,包括序列特异性引物PCR和基于测序的分型(SBT),目前面临过时的风险。这种风险不仅源于HLA基因内部的广泛多样性,还源于下一代测序和第三代测序技术的快速发展。像单分子实时(SMRT)测序和牛津纳米孔(ONT)测序这样的第三代测序系统有能力分析跨越HLA基因整个内含子-外显子区域的长读长序列,有效解决与HLA模糊性和多个短读长片段的定相相关的挑战。预计这些先进测序仪在HLA分型中的主导地位将通过持续改进、降低成本和最小化错误率而进一步巩固。本综述聚焦于造血干细胞移植(HSCT),探讨HLA DNA分型技术的前瞻性进展和应用。它探讨了采用第三代测序技术如何通过提高准确性、减少模糊性和增强HSCT中的相容性评估来彻底改变该领域。采用这些前沿技术对于提高造血干细胞移植的成功率和结果至关重要。本综述强调了站在HLA分型技术前沿以确保接受HSCT的患者获得最佳可能结果的重要性。