ABO Antibody Development, a New Look at a Very Old Question.
ABO Antibody Development, a New Look at a Very Old Question.
复制标题
ABO 抗体开发，一个非常古老的问题的新视角。
DOI：
10.1097/tp.0000000000004659
复制
发表时间：
2023
期刊：
影响因子：
6.2
通讯作者：
Zorn,Emmanuel
中科院分区：
文献类型：
--
作者：
Zorn,Emmanuel
ABO血型系统是输血和移植医学的核心。该系统是由红细胞表面A和B抗原的存在或不存在以及血浆中对这些抗原反应的相应抗体决定的。一个多世纪前，卡尔·兰德斯坦纳（Karl Landsteiner）发现了ABO血型，并因此获得1930年的诺贝尔生理学或医学奖。然而，直到今天，ABO抗体形成的机制仍然不清楚。早期的研究表明，婴儿早期对发育中的微生物群的免疫反应产生了针对血型抗原的交叉反应抗体。这一普遍观点解释了为什么ABO抗体未完全发育的14个月以下婴幼儿可以成功接受ABO不相容的心脏移植，正如Lori West博士在2001年发表的一项开创性研究中所记载的那样。然而，尽管ABO抗体产生的时间有很好的文献记载，但其对暴露于微生物抗原决定因子的依赖性仍然是假设的。亚当博士和他在埃德蒙顿研究组的同事们在这期《移植》杂志上发表的研究为这个长期存在的问题提供了新的思路。这项在小鼠模型中进行的研究，使作者能够解决并从本质上挑出CD4+ T细胞、微生物群和性别在自然和诱导的a型血型抗原抗体发展中的作用。研究首次揭示了抗a抗体的自然产生不需要CD4+ T细胞。相反，CD4+ T细胞控制和削弱抗a抗体的产生。这种效应以前在抗gal抗体中有报道，但在抗abo抗体中没有报道。其次，出乎意料的是，CD4+ T细胞减缓天然抗a抗体产生的能力在女性中比在男性中更为明显。这种有趣的性效应
The ABO blood group system is central to blood transfusion and transplantation medicine. The system is determined by the presence or absence of the A and B antigens on the surface of red blood cells and corresponding antibodies reactive to these antigens in the plasma. The ABO system was discovered more than a century ago by Karl Landsteiner, for which he received the Nobel Prize in Physiology or Medicine in 1930. 1 Yet to this day, the mechanism underlying the development of ABO antibodies remains obscure. Early studies suggested that immune reactions to the developing microbiota in early infancy generated cross-reactive antibodies to blood group antigens. 2 This common view explained why infants and toddlers up to 14 mo of age whose ABO antibodies are not fully developed can successfully receive ABO-incompatible heart transplants, as documented by Dr Lori West in a seminal study published in 2001. 3 However, although the timing of ABO antibody production is well documented, its dependency on exposure to microbial antigenic determinants is still hypothetical.The study by Dr Adam and his colleagues of the Edmonton group led by Dr West published in this issue of Transplantation sheds new light on this long-standing question. 4 The investigation, conducted in a mouse model, allowed the authors to address and essentially single out the contribution of CD4+ T cells, microbiota, and sex in the natural and induced development of antibodies to blood group antigen type A. The study first revealed that natural production of anti-A antibodies did not require CD4+ T cells. On the contrary, CD4+ T cells controlled and weakened the development of anti-A antibodies. This effect had previously been reported for anti-gal antibodies but not for anti-ABO antibodies. 5 Secondly and unexpectedly, the capacity of CD4+ T cells to mitigate the development of natural anti-A antibodies appeared more pronounced in females than in males. This intriguing effect of sex had