Lambermont M, Wybran J
Clin Exp Immunol. 1980 Mar;39(3):635-44.
A new test termed the human allogeneic rosette test (HART) is reported for the detection of small amounts of erythrocyte autoantibodies. It compares the percentage of rosettes formed around lymphocytes from normal subjects when either red cells from patients are added or autologous or allogeneic normal red cells. The HART is positive when the percentage of rosettes made with the control's red blood cells is significantly more than the percentage of those made with the patient's red blood cells. Twenty-two out of twenty-six patients with a positive antiglobulin test had a positive HART. Thirty patients with a negative antiglobulin test but with clinical or biological data suggesting an erythrocyte autoimmune disorder were also studied with the HART. Out of sixteen patients with chronic lymphatic leukaemia, ten had a positive test; all three patients with idiopathic thrombocytopenic purpura showed a positive HART; two out of three patients with cirrhosis and one out of four patients with Hodgkin's disease also had a positive test. No correlation was found between the positivity of the HART in these patients and their haematological values. Two patients with suspected autoimmune haemolytic anaemia and with a negative anti-globulin test but a positive HART were treated with steroids. Both responded very rapidly to the treatment suggesting an immune origin for the anaemia. The HART has been reproduced experimentally. Normal human red blood cells, sensitized with different amounts of either an auto-antibody or anti-D were rosetted with autologous normal lymphocytes. The results showed that the percentage of rosettes with red cells coated with small amounts of antibody was significantly less than the percentage of rosettes with uncoated red cells. A plot of these results seemed to indicate that the HART was about twenty times more sensitive than the antiglobulin test. The nature of the cells involved in the positive HART-negative direct antiglobulin test red cell binding was also analysed. They appear to be related to the T cell population. The role of the receptors for IgG in the HART was demonstrated by showing that aggregated and non-aggregated human IgG could inhibit the HART phenomenon. In conclusion, the HART appears to be a new and sensitive immunological test capable of analysing erythrocyte autoimmune disorders.
据报道，一种名为人类同种异体玫瑰花结试验（HART）的新检测方法可用于检测少量红细胞自身抗体。该试验比较了在加入患者红细胞或自体或同种异体正常红细胞时，正常受试者淋巴细胞周围形成玫瑰花结的百分比。当用对照红细胞形成的玫瑰花结百分比显著高于用患者红细胞形成的玫瑰花结百分比时，HART试验呈阳性。26例抗球蛋白试验阳性的患者中，有22例HART试验阳性。对30例抗球蛋白试验阴性但临床或生物学数据提示存在红细胞自身免疫性疾病的患者也进行了HART试验研究。16例慢性淋巴细胞白血病患者中，有10例试验阳性；3例特发性血小板减少性紫癜患者的HART试验均呈阳性；3例肝硬化患者中有2例、4例霍奇金病患者中有1例试验也呈阳性。在这些患者中，未发现HART试验阳性与其血液学值之间存在相关性。2例疑似自身免疫性溶血性贫血且抗球蛋白试验阴性但HART试验阳性的患者接受了类固醇治疗。两人对治疗反应都非常迅速，提示贫血具有免疫起源。HART试验已在实验中得到重现。用不同量的自身抗体或抗-D致敏的正常人红细胞与自体正常淋巴细胞形成玫瑰花结。结果显示，被少量抗体包被的红细胞形成玫瑰花结的百分比显著低于未包被红细胞形成玫瑰花结的百分比。这些结果的图表似乎表明，HART试验的敏感性比抗球蛋白试验高约20倍。还分析了HART试验阳性而直接抗球蛋白试验阴性的红细胞结合中所涉及细胞的性质。它们似乎与T细胞群体有关。通过显示聚集和未聚集的人IgG均可抑制HART现象，证实了IgG受体在HART试验中的作用。总之，HART试验似乎是一种能够分析红细胞自身免疫性疾病的新的敏感免疫学检测方法。
