Ouwehand A J, Baan C C, Vaessen L M, Jutte N H, Balk A H, Bos E, Claas F H, Weimar W
Department of Internal Medicine, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Hum Immunol. 1994 Apr;39(4):233-42. doi: 10.1016/0198-8859(94)90266-6.
The influence of HLA mismatches between donor and recipient on the phenotypes, function, and specificity of T-lymphocyte cultures derived from endomyocardial biopsies was studied in 118 heart transplant recipients. In case of HLA-DR mismatches, the majority of the EMB-derived cultures were dominated by CD4+ T cells while, in patients with HLA-A and -B mismatches but without DR mismatches, CD8+ T cells comprised the predominant T-cell subset. Cytotoxicity against donor antigens was observed in 75% of the cultures. A significantly (p < 0.005) lower proportion of the cultures showed cytotoxicity against HLA-A antigens (36%) when compared with HLA-B (53%) or HLA-DR (49%). An HLA-A2 mismatch elicited a cytotoxic response that was comparable to that found against HLA-B and -DR antigens: 62% of the cultures from HLA-A2 mismatched donor-recipient combinations was reactive against A2. A higher number of A, B, or DR mismatches resulted in a higher number of cytotoxic cultures directed against these antigens. A higher number of HLA-B and -DR mismatches was associated with a lower freedom from rejection. Our data indicate that, despite the use of adequate immunosuppressive therapy, the degree of HLA matching plays a crucial role in the immune response against a transplanted heart, resulting in a significant effect on freedom from rejection.
在118名心脏移植受者中，研究了供体与受体之间HLA错配对内心肌活检来源的T淋巴细胞培养物的表型、功能和特异性的影响。在HLA-DR错配的情况下，大多数心内膜活检来源的培养物以CD4 + T细胞为主，而在HLA-A和 -B错配但无DR错配的患者中，CD8 + T细胞是主要的T细胞亚群。75%的培养物观察到对供体抗原的细胞毒性。与HLA-B（53%）或HLA-DR（49%）相比，对HLA-A抗原表现出细胞毒性的培养物比例显著较低（p < 0.005）（36%）。HLA-A2错配引发的细胞毒性反应与针对HLA-B和 -DR抗原的反应相当：来自HLA-A2错配供体-受体组合的培养物中有62%对A2有反应。更多数量的A、B或DR错配导致针对这些抗原的细胞毒性培养物数量增加。更多数量的HLA-B和 -DR错配与较低的无排斥率相关。我们的数据表明，尽管使用了适当的免疫抑制治疗，但HLA匹配程度在针对移植心脏的免疫反应中起着关键作用，对无排斥率有显著影响。
