Mantovani V, Martinelli G, Bragliani M, Buzzi M, Selva P, Collina E, Farabegoli P, Rosti G A, Bandini G, Tura S
Tissue Typing Laboratory, Malpighi Hospital, Bologna, Italy.
Bone Marrow Transplant. 1995 Sep;16(3):329-35.
The selection of fully matched unrelated volunteer donors (UVD) in BMT requires a molecular characterization of MHC polymorphism, since most phenotypically HLA-identical donors can be non-identical when analyzed at a genomic level. The present report describes a molecular typing protocol for HLA genes developed for the selection of UVD, and its application to some donor-recipient pairs. The protocol involves three successive steps. Firstly, PCR with sequence-specific primers for HLA-DRB1 and -DQB1 genes is performed to identify the major alleles of the recipient. PCR-fingerprint matching is then introduced for HLA-A, B, C and DRB, DQB and DPB genes to screen prospective donors. Those showing matched fingerprinting patterns are finally submitted to direct sequencing of the DRB1 gene. DPB compatibility is assessed by oligotyping when there are several potential class I and DRB matched donors. This strategy was applied retrospectively to three BMT recipients and their previously selected donors. Three other patients and their 12 prospective donors were submitted to our protocol before BMT. Clinical evaluation of transplant outcomes indicates the primary importance of complete DRB and class I matching, while DQB and DPB compatibility seems to be less critical.
在骨髓移植中选择完全匹配的无关志愿供者（UVD）需要对MHC多态性进行分子特征分析，因为大多数表型上HLA相同的供者在基因组水平分析时可能并不相同。本报告描述了一种为选择UVD而开发的HLA基因分子分型方案及其在一些供者 - 受者配对中的应用。该方案包括三个连续步骤。首先，使用针对HLA - DRB1和 - DQB1基因的序列特异性引物进行PCR，以鉴定受者的主要等位基因。然后对HLA - A、B、C和DRB、DQB及DPB基因引入PCR指纹匹配以筛选潜在供者。那些显示指纹匹配模式的供者最终进行DRB1基因的直接测序。当有几个潜在的I类和DRB匹配供者时，通过寡核苷酸分型评估DPB相容性。该策略被回顾性地应用于三名骨髓移植受者及其先前选择的供者。另外三名患者及其12名潜在供者在骨髓移植前接受了我们的方案。移植结果的临床评估表明完全的DRB和I类匹配至关重要，而DQB和DPB相容性似乎不太关键。
