高度致敏肾移植受者致敏氨基酸残基的研究

目的探讨高度致敏肾移植受者的致敏氨基酸残基。方法采用ELISA法连续测定85例高敏肾移植受者的HLA-Ⅰ类抗体特异性,并指定可能的抗体公共表位(氨基酸残基)。结果89.4%的高敏受者具有可指定的抗体公共表位;最常见的公共表位是:163E,142-145TTKH,127K,83R,71-74AQTD,163R,163L和41T。在连续监测过程中,抗体公共表位分析结果稳定,比抗体特异性鉴定能更准确地反映抗体谱。结论高敏受者的HLA抗体产生有明显的规律,对少数高频率高免疫原性氨基酸残基的致敏是高敏受者致敏的主要原因。对高敏受者进行抗体表位分析能够准确地预测可接受的供体抗原错配。

THE ANALYSIS OF SENSITIZED AMINO ACID RESIDUES OF HLA ANTIBODY IN HIGHLY SENSITIZED RENAL TRANSPLANT RECIPIENTS

Objective To investigate the epitope of HLA class-Ⅰ specific antibody in the serum of highly sensitized patients (HSP). Methods The specificities and epitopes of HLA class-Ⅰ specific antibody from 85 HSP were monitored continually by enzyme-linked immunosorbent assay (ELISA). Results 89.4% of HSP had public epitopes of HLA class-I antibody. The common public epitopes were 163E,142-145TTKH,127K, 83R, 71-74AQTD, 163R, 163L and 41T. The public epitopes were stable in the course of continual monitoring, and it can reflect antibody spectrum more accurately than antibody specificity analysis. Conclusion Most HSP produce HLA class-I antibodies in a fairly predictable fashion, these antibodies direct against a small number of high frequency public amino acid residues with high immunogenicity. Analysis of public epitopes of HLA antibodies is very useful to predict acceptable mismatches.