高致敏肾移植受者HLAI类抗体表位分析

目的探讨高致敏肾移植受者的HLAI类抗体的致敏表位。方法采用酶联免疫吸附法动态测定54例高致敏肾移植受者的HLAI类抗体特异性,并指定可能的抗体公共表位。结果90.7%(49/54)的高致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、142145TTKH、83R、7174AQTD、127K、163R、163L、41T、6266RNTRN和4145ASPRT;在动态监测过程中,抗体公共表位分析结果稳定,与抗体特异性鉴定比较,能更准确地反映抗体谱。结论高致敏受者的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致敏受者致敏的主要原因;对高致敏受者进行抗体表位分析能够准确地预测可接受的供者抗原错配。

The epitope analysis of HLA class I specific 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 54 HSP were monitored continually by enzyme linked immunosorbent assay (ELISA). Results 90.7 % of HSP had public epitopes of HLA class I antibody. The common public epitopes were 163E, 142 145TTKH, 83R, 71 74AQTD, 127K, 163R, 163L, 41T, 62 66RNTRN and 41 45ASPRT. The public epitopes were stable in the course of continual monitoring, and it could 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.