Roelen D L, Dover E L, Niimi M, Young N T, Morris P J, Wood K J
University of Oxford, Nuffield Department of Surgery, John Radcliffe Hospital, Headington, GB.
Eur J Immunol. 1996 Jul;26(7):1468-74. doi: 10.1002/eji.1830260710.
The beneficial effect on graft survival achieved by pretransplant blood transfusions is well established. However, the type of major histocompatibility complex (MHC) mismatch between transfusion donor and recipient seems to play a role in determining the outcome. The hypothesis that this sharing of MHC antigens is correlated with the level of sensitization or tolerization was studied in mice by pretreatment with semi-allogeneic (F1) or with fully allogeneic whole blood transfusions. Limiting dilution analysis (LDA) in vitro for donor-specific T helper (Thp) and cytotoxic T lymphocyte precursors (CTLp) performed on splenocytes isolated from transfused recipients 2 or 4 weeks after transfusion showed that the duration and magnitude of the response was reduced after a semi-allogeneic compared to a fully allogeneic transfusion. After a semi-allogeneic transfusion, both Thp and CTLp frequencies had returned to naive levels 4 weeks after transfusion, whereas after infusion of fully allogeneic blood, they remained elevated after 4 weeks. When a fully allogeneic heart was transplanted 2 or 4 weeks after transfusion, a small but significant improvement in graft prolongation (2 weeks, not significant, 4 weeks: p < 0.01) was observed following pretreatment with a semi-allogeneic transfusion (2 weeks: median survival time (MST) 30 days, 4 weeks: MST 29 days) compared to that obtained after fully allogeneic transfusion (2 weeks: MST 23 days, 4 weeks: MST 12 days). The semi-allogeneic transfusions were correlated with a statistically significant prolonged (7 days) persistence of donor-derived MHC class II+ cells in the recipient and with reduced levels of anti-donor MHC class I-specific antibody formation compared to these responses after transfusion with fully allogeneic cells. These results demonstrate that pretreatment with a semi-allogeneic blood transfusion is more tolerizing and less sensitizing than pretreatment with a fully allogeneic blood transfusion. These findings may be explained by the sharing of MHC antigens between recipient and transfusion donor.
移植前输血对移植物存活的有益作用已得到充分证实。然而，输血供体与受体之间主要组织相容性复合体（MHC）错配的类型似乎在决定结果方面发挥着作用。通过用半同种异体（F1）或完全同种异体全血输血进行预处理，在小鼠中研究了这种MHC抗原共享与致敏或耐受水平相关的假说。在输血后2周或4周从输血受体分离的脾细胞上进行的体外有限稀释分析（LDA），用于检测供体特异性T辅助细胞（Thp）和细胞毒性T淋巴细胞前体（CTLp），结果显示，与完全同种异体输血相比，半同种异体输血后反应的持续时间和强度降低。半同种异体输血后，输血4周后Thp和CTLp频率均恢复到初始水平，而输注完全同种异体血后，4周后它们仍保持升高。当在输血后2周或4周移植完全同种异体心脏时，与完全同种异体输血后相比（2周：中位生存时间（MST）23天，4周：MST 12天），半同种异体输血预处理后观察到移植物延长有微小但显著的改善（2周：不显著，4周：p<0.01）（2周：MST 30天，4周：MST 29天）。与完全同种异体细胞输血后的这些反应相比，半同种异体输血与受体中供体来源的MHC II类+细胞在统计学上显著延长（7天）的持续存在以及抗供体MHC I类特异性抗体形成水平降低相关。这些结果表明，与完全同种异体输血预处理相比，半同种异体输血预处理更具耐受性且致敏性更低。这些发现可能是由于受体与输血供体之间MHC抗原的共享。
