Garner S F, Gorick B D, Lai W Y, Brown D, Taverner J, Hughes-Jones N C, Contreras M, Lubenko A
North London Blood Transfusion Centre, Colindale, UK.
Vox Sang. 1995;68(3):169-76. doi: 10.1111/j.1423-0410.1995.tb03921.x.
Sera containing anti-D, taken from 44 RhD-negative women with RhD-positive infants, were tested in antibody-dependent cellular cytotoxicity (ADCC) and monocyte monolayer assays (MMA) which used similar target and effector cell populations. In addition, the anti-D concentration was measured in the Auto Analyzer and the number of IgG1 and IgG3 anti-D molecules bound to the target red cells was measured by flow cytometry. The results of the functional assays and Auto Analyzer quantitation were examined for correlation with IgG subclass quantitation and all results were compared for their ability to predict the severity of haemolytic disease of the newborn (HDN). ADCC correctly predicted HDN in 39/44 (88.6%) cases, Auto Analyzer quantitation in 35/44 (79.5%) and the MMA in 32/44 (72.7%). For all three assays, the number of correct predictions was highest when the maternal serum contained both IgG1 and IgG3 anti-D. ADCC activity and HDN were correlated with the number of cell-bound IgG1 molecules (r > or = 0.58), but MMA activity was most closely correlated with the number of cell-bound IgG3 molecules (r = 0.68). Hence the superior predictive value of ADCC is due to its ability to reflect the IgG1 component of maternal anti-D, which has a better correlation than IgG3 anti-D with the severity of HDN.
从44名RhD阴性且婴儿为RhD阳性的女性体内采集了含抗-D的血清，在抗体依赖细胞毒性（ADCC）和单核细胞单层试验（MMA）中进行检测，这两种试验使用了相似的靶细胞和效应细胞群体。此外，在自动分析仪中测定抗-D浓度，并通过流式细胞术测定与靶红细胞结合的IgG1和IgG3抗-D分子数量。检查功能试验结果和自动分析仪定量结果与IgG亚类定量的相关性，并比较所有结果预测新生儿溶血病（HDN）严重程度的能力。ADCC在39/44（88.6%）例中正确预测了HDN，自动分析仪定量在35/44（79.5%）例中正确预测，MMA在32/44（72.7%）例中正确预测。对于所有这三种试验，当母血清同时含有IgG1和IgG3抗-D时，正确预测的数量最高。ADCC活性和HDN与细胞结合的IgG1分子数量相关（r≥0.58），但MMA活性与细胞结合的IgG3分子数量相关性最密切（r = 0.68）。因此，ADCC的优越预测价值归因于其反映母源性抗-D的IgG1成分的能力，该成分与HDN严重程度的相关性比IgG3抗-D更好。
