HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease.
HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease.
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HLA同种免疫与镰状细胞疾病的多重输血患者中的RBC抗体有关。
DOI：
10.1002/pbc.22327
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发表时间：
2010-04
影响因子：
3.2
通讯作者：
Josephson, Cassandra D.
中科院分区：
文献类型：
--
作者：
McPherson, Marianne E.;Anderson, Alan R.;Castillejo, Marta-Ines;Hillyer, Christopher D.;Bray, Robert A.;Gebel, Howard M.;Josephson, Cassandra D.
对次要红细胞（RBC）抗原的同种免疫通常发生在镰状细胞病（SCD）中。同种异体免疫的患者表现出后续输血新的同种抗体形成的风险增加。对人类白细胞抗原（HLA）的同种异体免疫可在红细胞输注时发生，并可能导致干细胞或器官移植期间的移植物排斥反应。在多次输血的儿童SCD患者中HLA同种异体免疫的患病率和危险因素尚不清楚。对年龄3-21岁、有≥3次红细胞输注史的SCD患者进行了HLA同种异体免疫的横断面研究，以验证HLA同种异体免疫与红细胞同种异体免疫相关的假设。通过Flow Panel Reactive Antibody（FlowPRA®）测量针对I类和II类HLA的抗体。检测了73例SCD患者（30例RBC抗体）。25/73例（34%）患者检测到HLA抗体; 24/73例（33%）患者出现I类HLA抗体，3例（4%）患者出现II类HLA抗体。在有RBC抗体的患者中，16/30（53%）有HLA抗体，而9/43（21%）无RBC抗体的患者有HLA抗体（OR 4.32 [1.6-12.1]）。在多变量分析中，RBC抗原抗体是HLA同种异体免疫的独立预测因子（P =0.041）。RBC和HLA免疫的相关性在无慢性输血史的患者中最强。这项分析是第一次描述HLA同种异体免疫的儿童SCD患者接受主要是白细胞减少的红细胞输注，并证明HLA同种异体免疫的倾向与抗体的红细胞抗原。
Alloimmunization to minor red blood cell (RBC) antigens occurs commonly in sickle cell disease (SCD). Patients with alloimmunization demonstrate increased risk for new alloantibody formation with subsequent transfusion. Alloimmunization to human leukocyte antigens (HLA) can occur with RBC transfusion and may result in graft rejection during stem cell or organ transplantation. The prevalence and risk factors for HLA alloimmunization in multiply transfused pediatric SCD patients are unknown. A cross-sectional study of HLA alloimmunization in SCD patients aged 3–21 years with a history of ≥3 RBC transfusions was performed to test the hypothesis that HLA alloimmunization is associated with RBC alloimmunization. Antibodies to class I and class II HLA were measured by Flow Panel Reactive Antibody (FlowPRA®). Seventy-three SCD patients (30 with RBC antibodies) were tested. HLA antibodies were detected in 25/73 (34%) patients; class I HLA antibodies occurred in 24/73 (33%) and class II HLA antibodies occurred in 3 (4%). Among patients with RBC antibodies, 16/30 (53%) had HLA antibodies, while 9/43 (21%) patients without RBC antibodies had HLA antibodies (OR 4.32 [1.6–12.1]). In a multivariate analysis, antibodies to RBC antigens were an independent predictor of HLA alloimmunization (P =0.041). The association of RBC and HLA immunization was strongest among patients with no history of chronic transfusion therapy. This analysis is the first description of HLA alloimmunization in pediatric SCD patients who receive primarily leukoreduced RBC transfusions and demonstrates that HLA alloimmunization tendency is associated with antibodies to RBC antigens.
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影响因子：
8.8
作者：
Bray, R. A.;Nolen, J. D. L.;Gebel, H. M.
通讯作者：
Gebel, H. M.
影响因子：
2.9
作者：
Benson, K;Agosti, SJ;Leparc, GF
通讯作者：
Leparc, GF
影响因子：
2.9
作者：
COLES, SM;KLEIN, HG;HOLLAND, PV
通讯作者：
HOLLAND, PV
影响因子：
20.3
作者：
Hendrickson, Jeanne E.;Chadwick, Traci E.;Zimring, James C.
通讯作者：
Zimring, James C.
影响因子：
6.2
作者：
EVERETT, ET;KAO, KJ;SCORNIK, JC
通讯作者：
SCORNIK, JC