Munkhbat B, Hagihara M, Sato T, Tsuchida F, Sato K, Shimazaki J, Tsubota K, Tsuji K
Department of Transplantation Immunology, Tokai University, School of Medicine, Isehara, Kanagawa, Japan.
Transplantation. 1997 Apr 15;63(7):1011-6. doi: 10.1097/00007890-199704150-00018.
We analyzed the effect of matching for HLA class II alleles on corneal graft outcome in a single-center, retrospective study from January 1991 through April 1996. The study involved 81 transplant recipients at high and low risk of corneal graft rejection, who were typed by the polymerase chain reaction-restriction fragment length polymorphism method and who completed at least 1-year of follow-up. The DRB1, DQB1, and DPB1 alleles were analyzed together and transplant recipients were subdivided into groups with matching (one to four alleles matched in the high risk or one to five alleles matched in the low risk) and without matching (no allele matched) for HLA class II. A significantly higher rate of 1-year rejection-free graft survival was revealed in high-risk transplant recipients with matching, compared with those without matching (P=0.0238). We have shown that matching for at least one HLA class II allele was actually beneficial in high-risk transplants. An analysis of matching for each allele separately, detected that only HLA-DPB1 matching was significantly associated with a higher rate of 1-year rejection-free graft survival in high-risk transplant recipients with matching (one or two alleles matched) compared with those without matching (no allele matched) (P=0.0139). In particular, matching for one DPB1 allele was significantly beneficial compared with no matching (P=0.0140). There was no significant effect of HLA-DRB1 and -DQB1 matching (P=0.3177 and P=0.2878, respectively). Furthermore, a strong association between DPB1 matching and 1-year rejection-free graft survival was observed in DRB1-incompatible high-risk transplant recipients (P=0.0308). Nevertheless, no significant effect of DPB1 matching was detected in DQB1-incompatible transplant recipients. Our findings indicate that HLA class II DNA typing is clinically relevant for corneal transplant recipients and that especially HLA-DPB1 matching has a beneficial effect in high-risk corneal transplantation.
在一项单中心回顾性研究中，我们分析了1991年1月至1996年4月期间人类白细胞抗原（HLA）Ⅱ类等位基因配型对角膜移植结果的影响。该研究纳入了81名角膜移植排斥反应高风险和低风险的受者，这些受者采用聚合酶链反应-限制性片段长度多态性方法进行分型，且均完成了至少1年的随访。对DRB1、DQB1和DPB1等位基因进行联合分析，并将移植受者分为HLAⅡ类基因配型组（高风险组中1至4个等位基因匹配，低风险组中1至5个等位基因匹配）和非配型组（无等位基因匹配）。结果显示，高风险移植受者中，配型组的1年无排斥反应移植存活率显著高于非配型组（P = 0.0238）。我们已经表明，至少一个HLAⅡ类等位基因配型在高风险移植中确实有益。单独对每个等位基因配型进行分析发现，在高风险移植受者（1或2个等位基因匹配）中，只有HLA - DPB1配型与1年无排斥反应移植存活率显著相关，相比非配型组（无等位基因匹配）（P = 0.0139）。特别是，一个DPB1等位基因配型与非配型相比有显著益处（P = 0.0140）。HLA - DRB1和 - DQB1配型无显著影响（分别为P = 0.3177和P = 0.2878）。此外，在DRB1不匹配的高风险移植受者中，观察到DPB1配型与1年无排斥反应移植存活率之间有很强的相关性（P = 0.0308）。然而，在DQB1不匹配的移植受者中未检测到DPB1配型的显著影响。我们的研究结果表明，HLAⅡ类基因DNA分型对角膜移植受者具有临床相关性，特别是HLA - DPB1配型在高风险角膜移植中具有有益作用。
