On the HLA-B, -D Map Distance

HLA--A,--B,--C and--d typing and intra-familial MLC studies in 21 couples and their 91 children revealed three B, D recombinants in 165 informative haplotypes. This corresponds to a B,D map distance of 1.8 centiMorgans, which is somewhat higher than previous estimates based on intra-familial MLC chessboard experiments. All three recombinants are maternal.     

Appearance and Evolution of Anti-Da (B Cell-Specific) Antibodies after Planned Immunizations

Appearance and evolution of anti-Da antibodies has been followed in eight volunteers immunized by whole blood transfusions or leukocyte intradermal injections form a single donor incompatible for HLA--A,--B,--C and--D specificities. Several unabsorbed bleedings from each recipient were studied against the specific immunizer with three different complement-dependent lymphocytotoxicity (CdL) techniques: (1) standard NIH CdL on total peripheral blood lymphocytes (PBL); (2) VII Workshop standard CdL technique on B cell-enriched suspensions; (3) beta2 microglobulin blanketing test ("bb" test) on B cells. Results obtained with the "bb" test were confirmed with platelet-absorbed sera. The "bb" and the absorbed sera allow discrimination between anti-Da and anti-HLA--A,--B,--C antibodies. Stage of appearance and evolution are rather similar for an anti-HLA--A,--B,--C and anti-Da. An early appearance of antibodies positive only against B cells is due to weak anti-HLA--A,--B antibodies which react better with B cells than with total PBL. Immunogenicity of Da antigens seems to be of the same order as HLA--A, and--B. In fact, Da reactivity was present in all eight recipients studied. These reactivities always segregated in familes with these HLA haplotypes. On a small panel of unrelated D-typed donors, three sera showed a significant positive association with D alleles.     

HLA—Dw4 and Rheumatoid Arthritis

Forty-seven patients with a "definite" or "classical" rheumatoid arthritis according to the ARA criteria were typed for the serologically detectable HLA--A, --B, and --C antigens and 36 of these patients were typed for the HLA--D antigens, Dw1, 2, 3, 4, 6, 7, and 8 by the MLC technique. The frequency of Dw4 was increased to 44.4% in the patients compared to 17.2% in normal controls (P = 8 X 10(-4)). The frequency of Dw1 and Dw7 was also increased although this was only of borderline significance. The frequency of Dw2 was remarkably low, especially in females, which is of interest, as the same antigen has a low frequency in some other autoimmune diseases. No significant deviations of the frequencies of HLA--A, --B, and --C antigens were found in rheumatoid arthritis patients.     

Primed lymphocyte typing predicts MLC reactivity between unrelated individuals

The present study was carried out to evaluate the ability of primed lymphocyte typing (PLT) to predict mixed lymphocyte culture (MLC) reactivity between unrelated individuals. Eleven PLT cells generated against independent familial haplotypes, and one PLT cell generated against a homozygous typing cell (HTC), were tested for their response to cells of a random panel of 53 unrelated individuals. From Chi-square analysis of the response patterns of these 12 cells, nine "PLT specificities" could be defined. Most panel members (81.2%) types for 1 or 2 of these specificities; equal numbers (9.4%) types for 3 or none, respectively. Four of these 9 specificities were shown to be significantly correlated with HLA-Dw antigens defined by HTCs. Typing for these nine PLT specificities was found to be predictive of subsequent primary MLC reactivity between panel members: a) pairs of panel members sharing PLT specificities produced three-fold lower MLC results on the average than pairs of panel members disparate for PLT specificities (p less than 0.0001), and b) in MLC combinations, an increase in number of foreign PLT specificities presented by the stimulator cell was paralleled by a statistically significant increase in MLC reactivity. To the extent that low MLC reactivity is correlated with improved graft survival, the PLT method could have significant value in selecting histocompatible donors for organ transplantation.     

Low Responsiveness in MLC Induced by Certain HLA—A Antigens on the Stimulator Cells

An individual, BK, repeatedly gave typing responses against homozygous typing cells representing more than two HLA--D antigens. Family studies showed that she had inherited the HLA--Dw2 and Dw7 determinants, in agreement with results from primed lymphocyte typing. The HLA--A, B, C types of the stimulators giving rise to unexpected typing responses all involved the HLA--A1, A3 or A11 antigens. The hypothesis of this specificity in low-responsiveness was confirmed in the independent stimulator sample provided by the 7th workshop homozygous typing cell panel. The same pattern was observed when BK was tested as a responder towards related and unrelated heterozygous stimulators. Furthermore, in three-cell experiments it was found that BK cells were able to suppress the response to the Dw-identical individual, BS, towards stimulators carrying HLA--A1, A3, or A11. This effect of BK's cells appeared to be radiosensitive. We were not able to demonstrate suppressive supernatant factors in the relevant cultures, neither were we able to find circulating cytotoxic cells by the direct CML-technique, nor an accelerated cytotoxic response by the indirect CML-technique against targets carrying HLA--A1 or A3. This is the first demonstration of induction of suppressor cells in MLC by HLA--A, B, C antigens in the stimulator cells.     

HLA-D-DR relationships: PLT studies of HLA-D specificities associated with DR1, DR2, and DR4

The primed lymphocyte test (PLT) detects gene products of the HLA-D-DR region which activate the secondary (memory) response of MLC stimulated T cells. In the present study attempts were made to determine whether different HLA-D alleles associated with the same DR, such as DR1, 2, and 4 can be discriminated by PLT typing. PLTs were generated by using, as responders and primary MLC stimulators, HLA-D different HTCs which shared all DR groups (major DR, supertypic MT and second locus MB) or only the MT or MB groups. As secondary stimulators, lymphocytes from an HLA-D selected panel of 72 individuals were used. PLTs raised in DR identical responder-primary stimulator combinations were able to discriminate between the different HLA-D antigens associated with the same DR. In contrast, when priming was performed in combinations differing for the major DR group, the restimulation response was highly associated with the DR specificity of the primary stimulator, regardless of whether or not this was compatible with the responding HTC for the MT or MB groups.

This data indicate that the specificity of primed lymphocytes largely depends on the combinations used for priming and that the memory response can be activated by both HLA-D and DR antigens. The dissociation of HLA-D from DR by PLT typing might provide a useful tool for further analysis of this HLA region.     

HLA—D Typing with Homozygous Cells Identified in an American Indigenous Isolate. I. Population Studies

Lymphocytes from six individuals homozygous for their HLA--A, --B, --C and --D loci belonging to an American indigenous group, the Warao, have been used as typing cells to detect HLA--D determinants in 121 donors from the same indigenous isolate and in 71 donors of mixed ethnic origin living in Venezuela. Two determinants responsible for strong proliferation in mixed lymphocyte cultures have thus been identified. Four HLA--A2, B5 cells (r values between 0l72 and 0.57) identify a determinant provisionally called LD5a showing a gene frequency of 0.30 among the Warao and of 0.09 among the population of mixed ethnic origin. The nearest B locus antigen to this new specificity among the Warao is HLA--B5 (r value = 0.20). A second determinant identified by two HLA--A2, B15 sisters (r values of 0.71) shows a gene frequency of 0.15 among the Warao and of 0.03 among the mixed population. The latter is related to Dw8 as shown by results of the VI and VII Histocompatibility Workshops, and is weakly associated (r value of 0.28) to HLA--B15 among the American indigenous population tested.     

Lack of shared lymphocyte-stimulating determinants between H-2I and HLA-D/DR using mouse primed lymphocyte typing cells

A number of anti-H-2 alloantisera containing antibody reactive with I region gene products (Ia) of the major histocompatibility complex cross-react with determinants expressed by human peripheral blood B lymphocytes. Such data have led to the conclusion that Ia and DR antigens share cross-reacting determinants. We have attempted to generate mouse primed T lymphocyte populations specific for defined I region gene product determinants which concomitantly recognize DR determinants on human peripheral blood leukocytes in primed lymphocyte typing (PLT) analysis. Mouse PLT cells were generated in primary MLC using strain combinations identical to those in which positive mouse/human cross-reacting antisera have been obtained. The resulting PLT cells exhibited strong, yet specific, secondary MLC responses against mouse cells expressing the Ia determinants used as the primary stimulus. In contrast, when examined on panels of human peripheral blood leukocytes, no reactivity was detected. This lack of cross-reactivity suggests that mouse T cells primed toward Ia determinants do not regularly recognize cross-reacting determinants of DR or D-associated antigens expressed on human PBLs. Consequently, mPLT cells are not a useful reagent in defining HLA-D region polymorphism.     

Typing for HLA-D Determinants. Comparison of Typing Results using Homozygous Stimulating Cells and Primed Cultures

Typing for HLA-D determinants, using primed lymphocyte typing (PLT), has been compared to the results obtained using conventional homozygous stimulating cell primary MLC tests. The HLA-Dwl, -Dw2 and -Dw3 specificities were studied. Preliminary results indicate that these two methods essentially type for the HLA-D determinants and that reproducible results can be obtained employing the PLT technique after 24 hours of incubation in the secondary cultures.     

Further studies on psoriasis-associated HLA-Dw/DR7 using PLT cells primed against a familial psoriasis-linked HLA haplotype

The products of the HLA-D region and their correlation to psoriasis vulgaris was studied using the primed lymphocyte typing (PLT) assay. In families with one healthy and one psoriatic parent and one psoriatic child primary MLC (mixed lymphocyte culture) stimulation was carried out between responder cells from the healthy parent and stimulator cells from the psoriatic child. In this way 21 PLT reagents directed against putative psoriasis-associated lymphocyte activating determinants were produced. Three reagents that gave clear bimodal stimulation patterns against lymphocytes of 51 psoriasis patients were further tested against 78 controls. Specificity of these reagents was studied using homozygous typing cells (HTC's) as stimulators. Compiled data show that cells from DR7 positive psoriatic patients give higher restimulation of these PLT reagents than do cells from healthy DR7 positive controls. In addition, a higher frequency of psoriasis patients compared to controls gave significant restimulation. Therefore we concluded that these PLT reagents recognized at least partly different DR7 associated determinants in the psoriasis patients and in controls. The reason is either that psoriasis patients carry a different lymphocyte activating DR associated specificity or, alternatively, that restimulation was caused by products of a distinct psoriasis associated locus in linkage disequilibrium with D/DR7 or of a determinant recognized together with D/DR7 as a restriction element. These data further support the notion that psoriasis is a disease with primary HLA associations to both class I and class II MHC genes.     

HLA–D and –DR antigens on human amniotic fluid cells

Human amniotic fluid cells, known to express HLA-A, -B, and -C antigens, were tested for the presence of lymphocyte-stimulating antigens (LD or HLA-D) using modifications of the mixed lymphocyte culture (MLC) and primed lymphocyte typing (PLT) tests. Peripheral blood lymphocytes were co-cultured with various concentrations of allogeneic amniotic fluid cells, either growing as a monolayer culture in microtiter plates or suspended in medium following treatment with trypsin. The kinetics of such mixed lymphocyte amniotic fluid cell culture (MLAC) reactions were followed during days 3 to 8. Under none of these conditions did amniotic fluid cells significantly stimulate allogeneic lymphocytes, even after lymphocytes were specifically primed in the PLT assay to the HLA-D antigens segregating in the family of the amniotic fluid cell donor. Furthermore, in three-cell experiments, amniotic fluid cells failed to inhibit an ongoing MLC reaction, indicating that the absence of proliferative response to amniotic fluid cells is not due to active suppression. Taken together, these data strongly suggest that amniotic fluid cells either do not express HLA-D antigens or do not express them in a form that is detectable in either primary or secondary MLC.     

Cellular approach for detecting narcolepsy-specific alterations in DR2 haplocytes

In an attempt to detect disease-associated genetic variations and/or exogenously induced alterations in DR2 haplocytes of narcolepsy patients. primed lymphocytes (PLs) were generated in nine families against DR2 haplotypes of narcolepsy patients and healthy family members. Twenty-four PL reagents were obtained and restimulated by cells of unrelated narcolepsy patients and DR2/Dw2-positive healthy individuals. The mean restimulation rates triggered by cells of patients or healthy controls, respectively, never differed significantly. In primary MLC as well as PLT combinations of patients and their HLA-identical siblings no significant stimulation was observed in both directions. We conclude that narcolepsy-specific alterations of class II molecules cannot be cellularly detected or do not exist on peripheral lymphocytes.     

A study of HLA-DR2 associated HLA-Dw/LD specificities

HLA-Dw2 and Dw12 are both associated with HLA-DR2; however, these specificities account for only 86% (161/188) of the DR2 + haplotypes in our North American Caucasian panel. In an attempt to identify new DR2 associated antigenic clusters, we have generated four primed lymphocyte (LD) typing (PLT) reagents in haploidentical familial combinations against DR2 + Dw blank haplotypes. These reagents were positively restimulated by 11 of 16 DR2 + Dw blank cells tested, with good discrimination from Dw2 and Dw12 + cells, thus identifying a new antigenic cluster provisionally termed LD-MN2. We have compared the LD-MN2 specificity with the specificity LD-5a defined by two DR2 + HTCs, BAS and REM, (Layrisse, Caracas) which have been included in the pre-1984 Workshop Cluster DB9. Although none of our DR2 + cells gave typing responses to these two HTCs defining LD-5a, PLT studies did indicate an interrelationship between these specificities and with the specificity tb24 defined with the HTC, FJO (Betuel). The LD-5a HTCs, four LD-5a heterozygous cells, and two additional HTCs (WJR-Hansen, Seattle and FJO/tb24-Betuel, Lyon) significantly restimulated the anti-MN2 PLT reagents, though usually not as strongly as the MN2+ cells. MN2+ cells primed against the LD-5a HTCs were restimulated by only the LD-5a + cells. Dw2 + cells primed against FJO were restimulated by some, but not all MN2 + cells. These results suggest that MN2, tb24, and LD-5a share some determinants, not shared with most cells which type as Dw2 and Dw12, though differing by other stimulatory determinants. These studies emphasize the necessity of studying new antigenic clusters by both PLT and HTC methodologies as well as testing different ethnic groups.     

HLA-DQA1 and MLC among HLA (generic)-identical unrelated individuals

We modified a previously published PCR-RFLP for DQA1 typing (1) and examined the predictive value of HLA-DQA1 in mixed lymphocyte cultures (MLC) among matched (HLA generic types) pairs of unrelated individuals. There were 61/102 (60%) pairs with positive MLC, one-third of which could be predicted by DQA1* typing alone. DQA1 matching and MLC reactions were classified into 3 groups: 1) DQA1 mismatches showing positive MLC: 19/102 (19%); 2) DQA1 matches showing negative MLC: 41/102 (40%); 3) DQA1 identical showing positive MLC: 42/102 (41%). Five different HLA haplotypes that result from non-random association of HLA generic types (high delta haplotypes) were overrepresented in the individuals tested. One of these haplotypes carrying HLA-B7, DR2 was found associated with three different DQA1 alleles (*0201, *0103, *0102). The remaining four high delta haplotypes were associated with one DQA1 allele in all independent examples tested: HLA-A1, B8, DR3 with DQA1*0501; HLA-A26, B38, DR4 with DQA1*0301; HLA-A2, Bw62, DR4 with DQA1*0301 and HLA-A1, Bw57, DR7 with DQA1*0201. Forty per cent of the negative MLC were explained in part by the excessive number of individuals carrying two of these four haplotypes, which probably carry determinants in linkage disequilibrium with HLA. Nineteen per cent of HLA-identical (generic types) unrelated pairs show positive MLC reactions and all of them are DQA1* mismatched, suggesting that DQA1* allele typing should be used to screen samples prior to performing MLC.     

One-way positive cellular reactions between two HLA-A, B, C, D/DR genotypically identical brothers following active allogeneic immunization

The HLA-D/DR region in man encodes major determinants which stimulate T lymphocytes to proliferation. The genetic organization of this region is apparently complex and is at present largely unknown. One obstacle is the scarcity and quality of available typing reagents. In an attempt to obtain high quality anti-DR sera, a series of active immunizations was performed between highly selected, healthy unrelated donors and recipients.
One recipient (AR8) was immunized using cells incompatible for HLA-A2, B40 (w60), Cw3 and DIDRw6 and readily developed anti-A2 and B40 antibodies but no anti-C, DR, or other antibodies. When tested against his HLA genotypically fully identical brother using the cellular MLC, PLT, or CML techniques before immunization, results were mutually negative as expected. Following immunization, however, AR8 was able to mount MLC, PLT, and possibly CML responses against lymphocytes from the brother while the reverse combinations remained negative. When tested in the family the trait(s) thus identified seems to be maternally inherited.
These results suggest the existence of minor histocompatibility determinants encoded from regions not closely linked to HLA. The brother of AR8 and the immunizing donor thus seem to share one or more determinants not possessed by AR8.     

Mixed lymphocyte reactions for individuals with phenotypic identity for specific HLA-B,DR determinants: The role of linkage disequilibrium and of specific DR and other class II determinants

Although many patients who might benefit from therapeutic bone marrow transplantation lack HLA identical sibling donors, results from many centers now indicate that transplants involving donors other than identical siblings have been successful in a substantial number of cases. Most of these cases were selected because cells from the patient and donor were compatible in mixed lymphocyte culture. We have previously shown that the prediction of mixed lymphocyte culture nonreactivity by HLA-B,DR matching is far more successful if the matched donors shared antigen combinations known to possess significant positive linkage disequilibrium. We now also show that cells from donors with unrelated haplotypes having the specific DR determinants DR1, DR2, and DR3 are more likely than cells from donors with other haplotypes to be mutually compatible in mixed lymphocyte culture. However, even cells from donors with haplotypes with the highest levels of positive linkage disequilibrium frequently show significant mutual stimulation which can, in selected family studies, be attributed to determinants like SB that map between HLA-D/DR and GLO.     

A Screening Program for Anti-DR Typing Reagents

A total of 694 sera have been tested in a screening program aimed at identifying monospecific reagents for HLA--DR typing. All sera were first tested on a panel of enriched B and T cells without absorption on platelets. Only sera reacting more frequently on B than on T lymphocytes were absorbed on platelets and retested on the panel. This procedure saved a considerable amount of platelets and proved to be reasonably efficient. One-hundred-and-fifty sera were found to contain an anti-B cell antibody. Significantly less frequent B cell reactivity was found when HLA--A, --B, --C antibodies could not be detected. Twenty-five sera were demonstrated to be specific for well-defined DR antigens.     

Occurrence of paternal and maternal HLA-B/D recombinants in a single family

Two B/D recombinant offspring in one family were identified by HLA-A,B,C,D, and DR typing with the Eighth International Workshop sera and cells, intrafamily MLC and PLT test.

Restimulation of cells primed against the four parental haplotypes showed good discrimination between family members who shared the D alleles and those who did not. When the B/D recombinant haplotypes were primed, accelerated proliferative response was observed only with cells sharing the HLA-D region. Cells that shared with the priming cells the HLA-A to B interval but differed for the D region did not restimulate.

These results demonstrated the role of HLA-D disparity in evoking secondary proliferative response and showed that the determinant(s) mapping between HLA-A and B did not restimulate.     

The new HLA-DRw6- and 8- associated HLA-Dw HAG specificity defined by homozygous typing cell 9W 1802

Intrafamilial primary mixed lymphocyte culture (MLC) typing established that an HLA-A, B, C homozygous, DP heterozygous donor HAG was homozygous for HLA-Dw and behaved as a homozygous typing cell (HTC). Both haplotypes of the HTC were HLA-DR identical, but could not be assigned a clear DR specificity, giving reactions with sera containing antibodies against DRw6, DRw8 and TA10. MLC checkerboard studies failed to assign the HTC HAG specificity to any established or provisional cluster, suggesting that it defined a new Dw specificity. Primed lymphocyte typing (PLT) clones derived from intra-familial priming against either HAG haplotype displayed heterogeneous reactivity patterns. One clone was restimulated only by family members and unrelated donors positive for Dw HAG. Other clones were restimulated by determinants associated with either Dw8 or Dw6. Blocking of stimulation with monoclonal antibodies against different class II molecules suggested that while stimulatory determinants associated with Dw HAG and Dw8 were classifiable as HLA-D related, those associated with Dw6 were of a DP-like nature.