某地区无偿献血者中性粒细胞特异性抗体筛查分析

目的探讨河南地区无偿献血者中性粒细胞特异性(HNA)抗体的分布和特异性,分析HNA抗体引起的免疫性输血不良反应。方法随机收集女性标本156例,男性标本80例,采用LABScreen Multi试剂盒对标本HNA抗体进行检测。结果 236例无偿献血者中,女性HNA抗体检出阳性率为5.77%(9/156),男性为5.00%(4/80)。其中HNA 1A者7例,HNA4A者4例,同时检出HNA 1A和HNA 4A、HNA 1A和HNA 1C各1例。结论 HNA抗体分布无性别差异,研究HNA抗体的分布和特异性,可为指导临床用血安全和相关政策的制定提供有力的理论基础。     

Red blood cell alloantibody frequency, specificity, and properties in a population of male military veterans

BACKGROUND: The prevalence of red blood cell (RBC) alloantibodies among general, hospital‐based patients typically has averaged approximately 1 percent in various studies. The frequency and properties of RBC alloantibodies in military veterans has never been examined. STUDY DESIGN AND METHODS: Transfusion records of 18,750 military veterans at a Department of Veterans Affairs (VA) medical center were retrospectively reviewed. For patients with RBC alloantibodies, the following were collected: sex, race/ethnicity, decade of birth, transfusion history, alloantibody specificity, reaction phase(s), and whether alloantibodies were detected at the initial type and screen or later. RESULTS: The RBC alloantibody prevalence was 2.4 percent among predominantly male military veterans. Alloantibody prevalence varied with decade of birth, ranging up to 3.3 percent (1911‐1920). The 10 most frequent alloantibodies in males, as a percentage of total male antibodies, were K (21.9%), E (19.4%), D (9.1%), Le^a (7.4%), Fy^a (5.4%), c (4.8%), C (4.6%), P₁ (3.9%), Jk^a (3.7%), and Le^b (3.5%). Investigation of D alloimmunization in men revealed that antibody development occurred before VA care in 80 percent (39/49) of cases. For alloimmunization during VA care, anti‐D was mostly associated with the transfusion of D+ platelets (7/10). The majority of alloantibodies in males reacted at the antiglobulin (AG) phase, even anti‐Le^a, ‐Le^b, M, ‐Lu^a, and ‐P₁. CONCLUSION: Military veterans have a relatively high prevalence of RBC alloantibodies, including anti‐D, despite a large male predominance and lack of pregnancy‐related alloimmunization. Alloantibody prevalence was highest in World War II veterans. The majority of male alloantibodies reacted with AG, even those traditionally considered to be clinically insignificant.     

The frequency of human platelet antigen (HPA) genotypes in the Polish population

The human platelet antigens (HPA1–5) in the Polish population were investigated using the PCR with sequence specific primers (SSP). The HPA gene frequency was: 1a — 0.874, 1b — 0.126; 2a — 0.898, 2b — 0.102; 3a — 0.592, 3b — 0.408; 4a — 1.00, 4b — 0.00; 5a — 0.937, 5b — 0.063. The HPA2 and HPA5 differed from those observed in some other European populations — German and both German and Austrian, respectively. The HPA5 alleles frequency was most similar to those observed in the Finnish population. The modification of SSP described allowed the genotyping of HPA1–4 under the same PCR conditions.     

Causes of disqualification in a volunteer blood donor population

The causes of disqualification in a volunteer blood donor population for a period of two years were analyzed. Of 138,436 prospective volunteer blood donors, 24,327 (17.6%) donors were disqualified. Phlebotomy was unsuccesful in 721 (0.5%) donors and blood was drawn from 113,388 (81.9%) eligible donors. The majority of rejections were due to medical history findings (61.0% of all rejections). The ten leading causes of disqualification were: low hemoglobin/hematocrit, medication, allergies, signs and symptoms, high blood pressure, illness in last month, hepatitis and hepatitis exposure, malaria and travel overseas, atypical antibodies, and high serum bilirubin. Hepatitis B surface antigen was detected in 82 donors out of 114.746 donors tested (0.07%).     

Decreasing seroprevalence of human immunodeficiency virus type 1 in a regional blood donor population

Blood banks have intensified their efforts to discourage donations from individuals at risk for the human immunodeficiency virus (HIV-1). Since the onset of HIV-1 donor screening in April 1985, a marked reduction in seroprevalence has been seen at the authors' institutions: from 51 cases per 100,000 donors in 1985 to 13 per 100,000 in the first 6 months of 1988. Data from 3.5 years have been analyzed for temporal trends in the association of HIV-1 seroprevalence with donation site (urban vs. non-urban) and donor gender. The association of HIV-1 seropositivity with an urban donation site decreased through 1987 as the urban-to-nonurban donation odds ratio declined from 6.48 in 1985 to 2.54 in 1987. Despite this decrease, both men and women who donated in urban areas had a significantly higher seroprevalence than those in nonurban areas. Male donors had a higher overall HIV-1 seroprevalence than female donors. However, the male-to-female odds ratio declined from 2.94 in 1985 to 1.96 in 1988, and male gender was no longer significantly associated with HIV-1 seropositivity. This change in the donor profile appears to reflect declining numbers of seropositive men who acknowledge risk factors and greater numbers of women with no identified risks for HIV-1. This study documents a dramatic decrease in HIV-1-seropositive donors and suggests that the deferral of high-risk individuals has become increasingly successful.     

四川地区汉族群体HLA基因频率分布

目的 检测四川汉族人群HLA-A、-B、-DRB1位点基因多态性,获得完整、准确的四川汉族HLA分子遗传学数据.方法 应用PCR-SSP技术对1877名四川汉族健康人群进行HLA-A、-B、-DRB1位点基因分型.结果 四川汉族人群中共检出HLA-A等位基因16个,HLA-B等位基因37个,HLA-DRB1等位基因14个.其中最常见的HLA-A等位基因为A＊11、A＊02、A＊24,基因频率分别为31.3%、29.4%、18.6%;HLA-B常见的等位基因为B＊40、B＊46、B＊15,基因频率分别为16.9%、13.7%、13.1%;HLA-DRB1常见的等位基因为DRB1＊09、DRB1＊12、DRB1＊04,基因频率分别为17.1%、13.8%、13.0%.结论 四川汉族人群HLA-A、-B、-DRB1基因具有显著多态性,大样本的DNA分型有助于HLA低频率基因的检出.     

人类白细胞抗原抗体在非血缘脐血移植中的作用

随着非血缘脐血移植(UC BT)在临床越来越多的应用,以及相关检测技术的发展,患者体内的脐血人类白细胞抗原(HLA)抗体对UCBT疗效的影响受到广泛关注.笔者拟就近年关于HLA抗体,尤其是供者特异性HLA抗体(DSA)对UCBT影响的研究进行综述.     

Heterophile antibodies. Part I. The specificity of agglutinating and hemolytic sheep red blood cell antibodies in human sera

Absorption and agglutination inhibition studies carried out on human sera with intact red blood cells, secretory substances and soluble red blood cell membrane extracts show that antibodies against sheep red blood cells possess at least two types of specificities. The agglutinating type has specificities in common with human anti-A and anti-B, while the hemolytic antibody does not. Comparative titration studies clearly demonstrate that there is no correlation in the distribution of these two varieties of sheep red blood cell antibodies. Guinea pig and rat erythrocytes share human A- and B-like determinants with sheep red blood cells. Rabbit, horse and goose red blood cells do not possess these blood group factors.     

Analysis of donor-deferral pattern in a voluntary blood donor population

SUMMARY. A reterospective analysis of records of the deferred donors from 1 October 1992 to 31 December 1993 was performed. Of 14,269 prospective blood donors (13,030 males and 1,239 females), 2,431 (16.4%) donors were disqualified for various reasons: 8-1% of the donors were deferred for non-pathological causes while 91-9% were deferred for medical reasons. The most common cause for non-pathological deferral was volunteers attending below the minimum acceptable age (5-2%). Abnormal findings on physical examination accounted for 57-2% of the deferrals in which low body weight was the most common finding (32-3%) followed by low Hb (18-6%). A past history of jaundice was the leading cause for deferral on medical interview.
Numerous prospective donors are currently being deferred based on empirically derived criteria. By developing strategies to identify and rationalize donor selection criteria, the blood transfusion services should be able to decrease unnecessary deferrals.     

Prevalence of Babesia antibody in a selected blood donor population

Human babesiosis, a parasitic disease transmitted by the tick, Ixodes dammini, was confined previously to limited areas of the northeastern United States. It is a rare but potentially life-threatening complication of transfusion. Red cells and platelets prepared from asymptomatic donors have been implicated in transfusion-transmitted cases. More cases of babesiosis are being reported as the range of the vector expands in the United States. Blood donors from an endemic area were tested for antibody to Babesia microti during the summer. Only 3.7 percent of the 779 donors were seropositive, compared with 4.7 percent (p greater than 0.05) of donors from a nonendemic area. An epidemiologic survey of seropositive and matched seronegative controls demonstrated no significant differences that would assist in screening donors.     

The frequency of granulocyte-specific antibodies in postpartum sera and a family study of the 6B antigen

We examined sera from 2313 postpartum women as a potential source of granulocyte specific antibodies. Lymphocyte cytotoxic (LC) antibodies were detected in 397 (17.2%) specimens and granulocyte agglutinating (GA) antibodies in 291 (12.6%). Only two GA positive sera had reactivity for previously defined granulocyte specific antigens (one NA1 and NB1 ). One additional serum had GA reactivity similar to a serum previously reported by van Rood and called anti-6B. The frequency of granulocyte specific antibodies (0.1 percent) in our study indicates that the productivity of random screening of parous sera for granulocyte specific antibodies is low. A four-generation family study of the 6B antigen demonstrated a parallel association between HLA-B7 and B40 and 6B reactivity in the LC, GA, and granulocyte immunofluorescence (GIF) assay. This illustrates that the granulocyte reactivity of anti-6B is not granulocyte specific but is HLA related. This report provides additional evidence that HLA antibodies such as anti-B7 (6B) can react with granulocytes bearing these antigens in the GA and GIF assays currently used to identify granulocyte specific antibodies.     

Human neutrophil antigen frequency data for Malays,Chinese and Indians

BackgroundHuman neutrophil antigens (HNAs) are implicated in several clinical disorders and their allelic variations have been reported for many populations. This new study was aimed to report the genotype and alleles frequencies of HNA-1, -3, -4 and -5 loci in Malays, Chinese and Indians in Peninsular Malaysia.MethodsA total of 222 blood samples were collected from healthy, unrelated Malay, Chinese and Indian individuals. Their HNA-1, -3 and -4 and HNA-5 loci were genotyped using polymerase chain reaction-sequence specific primer (PCR-SSP) or PCR-restriction fragment length polymorphism (RFLP) assays.ResultsAll HNA loci are polymorphic, except for HNA -4. Geneotypes HNA-1a/1b, -3a/3b and -4a/4a were observed most frequently at these three loci in all three ethnic groups. In contrast, HNA-5a/5b and -5a/5a were observed as the predominant genotypes in Malays vs. Chinese and Indians, respectively. The Malays, Chinese and Indians shared HNA -3a (0.505-0.527), HNA -4a (1.000) and -5a (0.676-0.854) as the most frequent alleles. However, HNA-1a was found to be the most common in Malays (0.506) and Chinese (0.504) and HNA-1b for Indians (0.525).ConclusionCombined with HNA data that have been published for Malay subethnic and Orang Asli groups, this study provides the first fully comprehensive HNA dataset for populations to be found in Peninsular Malaysia. Overall, our findings provide further evidence of genetic complexity in the region. This now publicly available HNA dataset can be used as a reliable reference source for improving medical outcomes.     

Prevalence of antibody to hepatitis C virus in a blood donor population

Blood samples from 2000 accepted blood donors and 343 deferred donors with antibody to hepatitis B core antigen (anti-HBc) and/or an alanine aminotransferase (ALT) elevation were evaluated for antibody to hepatitis C virus (anti-HCV). Sixteen (0.8%) of the 2000 sera initially reacted on enzyme-linked immunosorbent assay (ELISA); 12 (0.6%) were repeatably reactive. One repeatably reactive sample had an elevated ALT; two reacted on anti-HBc testing and had ALT elevations. When the repeatably reactive ELISA samples were tested by an immunoblot assay, four reacted, three were indeterminate, and five did not react. Among the 343 deferred donors, HCV antibodies were detected in 8 (3.8%) of 210 anti-HBc-reactive samples, 12 (11.8%) of 104 elevated-ALT samples, and 15 (52%) of 29 combined elevated-ALT and anti-HBc-reactive samples; 25 of 28 reacted on immunoblot. The anti-HBc-reactive sera were subdivided into groups according to strength of anti-HBc reactivity (weak or strong) and antibody to hepatitis B surface antigen status and then were compared for anti-HCV reactivity rates. The group of samples showing the greatest frequency of anti-HCV had strong anti-HBc reactivity. For blood donors, the anti-HCV test correlates with the surrogate tests for non-A, non-B hepatitis (anti-HBc and ALT); however, most anti-HCV-reactive units remain undetected by surrogate tests, so that implementation of anti-HCV screening should further reduce the transmission of HCV via transfusion.     

Epitope mapping of antibodies directed against the human neutrophil alloantigen 3a

BACKGROUND: Severe transfusion‐related acute lung injury is often caused by antibodies directed against the human neutrophil alloantigen (HNA)‐3a. HNA‐3a results from an amino acid exchange (Arg154Gln) in the first extracellular loop of the choline transporter‐like protein 2 (CTL2). The characteristics of the binding domain(s) of HNA‐3a antibodies are unknown. STUDY DESIGN AND METHODS: For epitope mapping, a library of 23 different HNA‐3a (R₁₅₄) and three HNA‐3b (Q₁₅₄) peptides covering different parts of the first extracellular loop of CTL2 (aa_55‐231) was synthesized in Escherichia coli and tested by Western blot with two HNA‐3a alloantibody–containing plasma samples and by enzyme immunoassay (EIA) with different HNA‐3a‐ (n = 21) and HNA‐3b‐ (n = 1) positive plasma samples. RESULTS: Despite promising Western blot results using highly reactive plasma samples, we found widely varying reactivities of different HNA‐3a plasmas in the EIA, with only 11 of 21 HNA‐3a antibodies binding to any of the tested HNA‐3a peptides and with no peptide recognized by more than nine of the 21 antibodies. The HNA‐3b plasma did not react with R₁₅₄ peptides in the EIA nor with R₁₅₄ or Q₁₅₄ peptides in Western blot experiments. Plasma reactivity profiles with the peptides did not correlate with those observed using granulocyte agglutination and granulocyte immunofluorescence tests. CONCLUSION: Binding of HNA‐3a alloantibodies depends on the conformation of the intact CTL2 protein and their binding sites may differ substantially. Peptide‐based assays for detection of HNA‐3a antibodies bear the risk to be insensitive and require systematic validation with a large panel of antibodies.