THE VASCULAR ENDOTHELIAL CELL ANTIGEN SYSTEM
THE VASCULAR ENDOTHELIAL CELL ANTIGEN SYSTEM
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DOI：
10.1097/00007890-198503000-00016
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发表时间：
1985-01-01
期刊：
影响因子：
6.2
通讯作者：
CLARKE, J
中科院分区：
文献类型：
--
作者：
CERILLI, J;BRASILE, L;CLARKE, J
血管内皮细胞（VEC）具有明显的免疫原性，并表达血管内皮细胞特有的抗原。外周血单核细胞也表达这种 VEC 抗原系统的观察使得前瞻性测试变得可行。针对供体 VEC/单核细胞抗原系统的预制抗体通常会导致 HLA 相同组合中的移植物排斥，但专门针对供体单核细胞（单核细胞特异性抗原）的抗体似乎是良性的。显然，VEC抗原系统是HLA相同的活体相关供体组合中的重要免疫原，并且该抗原系统在非HLA相同的组合中可能同样重要。针对供体 VEC/单核细胞抗原的抗体的鉴定经常被同时产生的抗 HLA 抗体所掩盖。初步的家族分离研究支持 VEC/单核细胞抗原系统和主要组织相容性复合体之间遗传联系的概念。一组进行了 153 次连续、前瞻性单核细胞交叉配血，结果为 .apprx。单核细胞交叉配型呈阳性的发生率为 7%，而传统交叉配型呈阴性。可以想象，这种对供体 VEC/单核细胞抗原敏感的患者频率可能占所观察到的活体相关供体早期移植物损失的 70%。在对一致的 VEC 和单核细胞呈阳性反应的情况下，与供体的单核细胞交叉匹配呈阳性仍然是移植的禁忌症。
Vascular endothelial cells (VEC) are clearly immunogenic and express antigens unique to vascular endothelial cells. The observation that peripheral blood monocytes also express this VEC antigen system made prospective testing feasible. Preformed antibody to the VEC/monocyte antigen system of the donor usually leads to graft rejection in HLA-identical combinations, but antibody directed against donor monocytes exclusively (monocyte-specific antigens) appears to be benign. Clearly the VEC antigen system is an important immunogen in HLA-identical living-related donor combinations, and this antigen system may be equally important in the non-HLA-identical combinations. The identification of antibody directed against the VEC/monocyte antigens of the donor is frequently masked by the concurrent development of anti-HLA antibody. Preliminary family segregation studies support the concept of genetic linkage between the VEC/monocyte antigen system and the major histocompatibility complex. A group of 153 consecutive, prospective monocyte crossmatches performed have yielded .apprx. a 7% incidence of positive monocyte crossmatches, with traditional crossmatches being negative. This frequency of patients sensitized to the VEC/monocyte antigens of the donor could conceivably account for up to 70% of the observed early graft loss in living-related donors. A positive monocyte cross match to the donor in the presence of positive reactivity to concordant VEC and monocytes remains a contraindication to transplantation.