Prevalence and immunogenicity of HNA-3a and -3b antibodies and antigens

摘要/摘要 输血相关性急性肺损伤(TRALI)，目前是输血的主要原因- 相关死亡，是由输注含有白细胞抗体的血液产品引发的 和/或对易感患者的生物反应调节剂。尽管许多不同的白细胞 已证明抗体可诱导TRALI，针对白细胞抗原HNA-3a的抗体有 尤其容易引起非常严重的，往往是致命的反应。不幸的是，事实并非如此 可以对献血者进行常规的抗HNA-3a筛查，因为它的分子特性对 多年来，调查人员没有察觉，因为海航-3a被认为是中性粒细胞特异性的细胞 很难在血清学研究中使用。因此，人们对抗海航-3a抗体在中国的流行情况知之甚少。 献血者和这种抗原的免疫原性知之甚少。人们对此知之甚少 识别HNA-3b的抗体，HNA-3a的等位基因，尽管从理论上讲，它们应该和 导致TRALI作为抗HNA-3a。我们最近表明，海航-3a是通过胆碱转运体携带的- 与蛋白2(CTL2)相似，HNA-3a/b基因多态几乎肯定是由 R&gt；Q154(R=HNA-3a，Q=HNA-3b)在10- 跨膜CTL2蛋白。 这些发现提示了开发一种实用的检测抗HNA-3a和抗-3b的方法。 适用于常规捐献者筛查。在本应用程序中，我们建议生成重组和 含有R154和Q154的CTL2和CTL2片段的合成及其反应特征 对抗一组海航-3特异性抗体。被发现对以下各项最敏感和最特异的构造 将大量生产抗CTL2检测，形成原型固相 免疫测定法，用于筛选7000份输血、非输血和产妇血清样本 男性和女性，以确定这些人群中抗HNA-3a的流行率。Q154 这些构建物的版本应该提供关于抗HNA-3b的可比信息。 预计所取得的发现将首次确定抗-HNA-3a和抗-HNA-3a的流行率。 HNA-3b在献血人群中的表达；2)HNA-3和HNA-3b的免疫原性鉴定 (通过输血或在以下情况下暴露于抗原时诱导抗体的可能性 怀孕)和3)建立一个基础，以确定是否对献血者进行常规筛查 反海航-3a和反海航-3b是有根据的。

Summary/Abstract Transfusion-associated acute lung injury (TRALI), currently the leading cause of transfusion- associated fatality, is triggered by transfusion of blood products containing leukocyte antibodies and/or biological response modifiers to susceptible patients. Although many different leukocyte antibodies have been shown to induce TRALI, those specific for the leukocyte antigen HNA-3a are especially prone to cause very severe, and often fatal reactions. Unfortunately, it has not been possible to screen blood donors routinely for anti-HNA-3a because its molecular properties have for many years eluded investigators and because HNA-3a was thought to be neutrophil-specific, a cell difficult to use in serologic studies. Thus, very little is known about the prevalence of anti-HNA-3a in blood donors and the immunogenicity of this antigen is poorly understood. Even less is known about antibodies that recognize HNA-3b, the allele of HNA-3a, although they should, in theory, be as likely to cause TRALI as anti-HNA-3a. We recently showed that HNA-3a is carried on choline transporter- like protein 2 (CTL2) and that the HNA-3a/b polymorphism is almost certainly determined by an R>Q154 (R=HNA-3a, Q = HNA-3b) amino acid substitution in the first extracellular loop of the 10- membrane-spanning CTL2 protein. These findings suggest ways to develop a practical assay for detection of anti-HNA-3a and anti-3b suitable for routine donor screening. In this application, we propose to generate recombinant and synthetic CTL2 and CTL2 fragments containing R154 and Q154 and characterize their reactions against a panel of HNA-3-specific antibodies. Constructs found to be most sensitive and specific for anti-CTL2 detection will be produced in quantity, formatted into a prototype solid phase immunoassay, and used to screen 7,000 serum samples from transfused, non-transfused and parous males and females to determine the prevalence of anti-HNA-3a in these populations. The Q154 version of these constructs should provide comparable information about anti-HNA-3b. Findings made are expected to 1) define, for the first time, the prevalence of anti-HNA-3a and anti- HNA-3b in blood donor populations; 2) characterize the immunogenicity of HNA-3 and HNA-3b (likelihood of an antibody being induced upon exposure to antigen through transfusion or during pregnancy) and 3) establish a basis for determining whether routine screening of blood donors for anti-HNA-3a and anti-HNA-3b is warranted.