血清学指定HLA—B座位纯合型误差分析及HL—B座位表达变异检测的意义

目的：用DNA分型法对HLA-B座位抗原纯合型进行分型，探明是否存在HLA-B基因发生变异引起结果差异。方法：经血清学鉴定HLA-B座位纯合型样本75例，用PCR—SSP法进行DNA分型和表达变异筛查。结果：75例血清学鉴定为纯合型后经DNA分型证实有12例存在第二基因，经PCR—SSP法进行变异筛查发现有1例存在第四外显子额外胞嘧啶插入，经DNA分型发现的第二基因实为沉默基因。结论：用PCR—SSP法进行HLA-B基因分型可弥补血清学方法的不足，同时筛查表达变异使分型结果更加准确，能有效地指导临床应用。     

应用顺序特异性引物聚合酶链反应检测华南人群HLA-B座位第4外显子变异

目的：为探明中国华南人群中因HLA-B座位发生基因突变而引起表达变异存在的可能性。方法：用顺序特异性引物聚合酶链反应（PCR-SSP）对75例经血清血分型为纯合型样本再次分型，对有差异的结果使用PCR-SSP方法检测第四外显子突变情况。结果：75例血清学指定为纯合型标本经DNA分型证实有12例为杂合型。12例结果有差异的样本经PCR-SSP法表达变异的筛查发现有1例存在第四外显子额外胞嘧啶插入，经DNA分型发现的第二基因为沉默基因。结论：应用PCR-SSP方法可检测HLA-B等位基因突变，该突变导致HLA-B基因表达无效，进行HLA基因表达变异的检测可提高HLA分型的准确性，更加有效的指导临床进行器官和骨髓的选配。     

中国南方汉族人群HLA-Cw座位基因多态性分析

目的 分析中国南方汉族人群HLA－Cw座位基因多态性。方法 采用ARMS／PCR技术对60名随机选择的南方汉族健康个体作HLA－Cw基因分型。结果 共检出12种HLA－Cw等位基因或等位基因组（allele group)，其中HLA－Cw*07、＊01、＊03为该人群最常见HLA－Cw基因，频率之和为0．6932；证实该群体中HLA－Cw＊08频率为0．1056，检出率明显高于血清学分型；检出HLA－Cw*1202、＊1203、＊14、＊15等4种经典血清学分型不能鉴定的HLA－Cw基因，频率之和为0．0673。结论 提供了中国南方汉族人群HLA－Cw座位基因频率正常值，证实ARMS／PCR作HLA－Cw分型具有准确、快捷的优点。     

西安地区HLA-B15、B40抗原多态性的分析

目的 :研究西安地区HLA B15及B4 0的分布特征。方法 :采用PCR/SSP及DynalPCR/SSOP分型方法 ,对西安地区 36 0 1份血样进行分型。结果 :36 0 1份西安地区血样中 ,HLA B15和B4 0基因的频率最高 ,两者合计占HLA B基因位点总数的5 7.91%。B15和B4 0的基因频率分别为 0 .14 83和 0 .14 14。B15、B4 0基因各位点基因频率在不同地区人群之间有显著性差异 (P <0 .0 1)。结论 :西安地区人群中 ,HLA B15和B4 0基因的频率分布特征与其他地区人群存在差异     

中国彝族人群HLA-Cw位点基因多态性研究

目的　应用DNA分型技术 ,分析中国彝族人群在HLA Cw位点的等位基因分布频率 ,为进一步研究HLA Cw与HIV感染及其发病进程的关联提供背景资料。方法　设计合成 2 6条特异性分型引物和 1对内对照引物 ,组成 2 4个PCR反应 ,建立PCR SSP分型方法 ,对 10 2例随机选取的无亲缘关系的中国彝族健康人作HLA Cw基因分型。结果　在彝族健康人群中共检测到HLA Cw位点的12种等位基因 ,其中HLA Cw 0 1、Cw 0 7和Cw 0 8为主要分布型别 ,基因频率分别为 0 .3 3 3 3、0 .2 5 0 0和 0 .1765 ,检出了HLA Cw 12、Cw 13 0 1、Cw 14和Cw 15等血清学方法不能鉴定的HLA Cw基因 ;统计分析表明HLA Cw位点的基因型分布符合Hardy Weinburg平衡 (χ2 =65 .983 1,df=66,P >0 .0 5 )。结论　证实了PCR SSP法用于HLA Cw基因分型的可靠性和适用性 ,在DNA水平上提供了中国彝族群体的HLA Cw基因分布频率资料     

顺序特异性引物聚合酶链反应技术对HLA-DR DNA的分型

目的：应用顺序特异性引物聚合酶链反应技术(PCR—SSP)进行临床肾移植供受者HLA—DR位点DNA的分型。方法：设计并合成HLA—DR位点16对特异性引物和1对阳性对照引物，建立PCR—SSP法，对52份临床肾移植供受者的外周血淋巴细胞样本进行DR位点基因的分型。结果与微量PCR—SSP基因分型试剂盒分型方法比较。结果：所有临床样本的PCR—SSP基因分型均获得成功，结果与微量PCR—SSP基因分型试剂盒分型方法完全相同，分型时间3h，特异性和重复性100％。结论：应用合成引物为临床肾移植供受者进行HLA—DR位点PCR—SSP基因分型简便快捷，重复性好，适合于临床应用。     

HLA-B40组等位基因多态性和血清学分型不明确标本分析

目的：利用DNA分型技术调查上海汉族人群HLA－B40组等位基因多态性并比较配型标本中HLA－B40抗原血清学和DNA分型的结果：方法：采用反向PCR－SSOP技术进行DNA分型，可检出HLA－B＊4001－4011等11个等位基因，结果：所有标本DNA分型均获成功，无假阳性和假阴性结果出现，质控DNA分型结果与UCLA结果相符，上海地区汉族人群共检出B＊4001－4003，4005－4007，4011等等位基因，未检出B＊4004，4008－4010等等位基因，296名无关个体中HLA－B40＊组等位基因频率为0．1402，血清学方法检测HLA－B40组抗原错误率为12．82％（10／78），结论：该技术用于HLA－B40分型分辨率高，分型结果较血清学方法更加精确，可确保HLA分型的准确。     

人类白细胞抗原HLA-B/DR座位间基因重组一家系

目的 了解一家系人类白细胞抗原(human leucocyte antigen,HLA)复合体HLA-B/DR座位间的基因重组.方法 采集拟进行造血干细胞移植的1例急性淋巴细胞白血病患者(男,16岁)及其父母和3个姐姐的外周血标本,首先对其HLA Ⅰ、Ⅱ类A、B、DRB13个位点采用聚合酶链反应-序列特异寡核苷酸探针技术(polymerase chain reaction-sequence specific oligonucleotide,PCR-SSO)和聚合酶链反应-序列特异性引物技术(polymerase chain reaction sequence specific primer,PCR-SSP)进行低分辨基因分型,然后用基于测序的分型方法(sequencing-based typing,SBT)进行高分辨基因分型,再进行遗传家系分析研究,确定HLA基因重组相关位点.结果 HLA高分辨基因分型的结果证实患者的2条单倍型分别为A*3101-B*1301-DRB1*0701和A*3303-B*4403-DRB1*1302;其父亲的2条单倍型为A*3001-B*1302-DRB1*0701和A*3101-B*1301-DRB1*1501.从遗传家系分析显示,患者所携有的父源A*3101-B*1301单倍体是源自父亲的1条染色单体,而DRB1*0701则源自父亲的另1条染色单体,这表明父亲的2条染色单体在减数分裂时HLA-B和-DRB1基因座位间发生了交换,重组后的单倍型又完整地遗传给了患者.结论 发现了1个中国汉族人群HLA-B/DR基因座位间的基因重组家系.     

用顺序特异引物聚合酶链反应技术对HLA-B基因分型

目的采用顺序特异引物聚合酶链反应技术（ＰＣＲ－ＳＳＰ）建立汉族人群ＨＬＡ－Ｂ基因分型方法。方法肾移植供受者临床样本ＤＮＡ３１９份，Ｂ基因标准系列ＤＮＡ６２份。设计合成Ｂ座位５２个特异性引物和１对阳性对照引物，组成４１个ＰＣＲ反应，建立ＰＣＲ－ＳＳＰ方法。一步法完成对Ｂ座位的基因分型。结果经双盲验证，并与血清学方法比较。结果所有临床样本和标准ＤＮＡ，ＰＣＲ－ＳＳＰ基因分型均获得成功。可准确分辨ＨＬＡ－Ｂ座位等位基因４１个，实际检出汉族人群Ｂ抗原特异性３２个。无假阳性和假阴性，４０份样本的重复率１００％，总耗时５小时。分型结果经双盲验证完全符合。与血清学分型结果比较显示：７８份血清学空白中１７例存在第二个基因，２６份血清学分型结果错误。总误差率１３．５％。结论用ＰＣＲ－ＳＳＰ技术行ＨＬＡ－Ｂ基因分型，分辨率高、特异性强、重复性好、相对简捷快速，分型结果较血清学方法更加精确可靠，适合于临床应用。     

用PCR-SSP作HLA-B位点分型及B22亚型分析

目的:用DNA分型弥补血清学HLAB位点分型的欠缺并了解南方汉族B22亚型分布情况。方法:采用标准细胞作参照,建立B位点的PCRSSP分型方法;并对血清学B22阳性标本进行B22亚型分析。结果:104株标准细胞PCRSSP分型结果与已知结果完全一致,17例白血病人及同胞分型与血清学一致,1例不符;B22亚型以B5401最多,B5601较少,1例分型格局异常,可能为新B22等位基因或错配的DNA双链。结论:PCRSSP可用于B位点的DNA分型,比血清学更直观精确,操作简便,不受疾病状态影响。     

采用 PCR-SSP法检测HLA-B27基因

目的：建立顺序特异引物聚合酶链反应（ＰＣＲ－ＳＳＰ）方法检测ＨＩＡ－Ｂ２７基因并与血清学方法比较。方法：设计合成Ｂ２７特异物３个和内源性阳性对照２个,建立ＰＣＲ－ＳＳＰ方法,用于Ｂ２７基因分型。血清学分型为一步法单克隆抗估方法。临床样本１００份,不源于可疑强直性脊柱炎患者。快速酚氯仿法提取模板ＤＮＡ。结果：１００例临床样本ＰＣＲ－ＳＳＰ行Ｂ２７基因分型均获成功。总耗时４ｈ。其中Ｂ２７阴性５８例,阳     

Comprehensive, serologically equivalent DNA typing for HLA-B by PCR using sequence-specific primers (PCR-SSP)

Abstract: Polymorphic products of HLA class I genes from the human major histocompatibility complex (MHC) are traditionally assigned by serology with additional heterogeneity detectable using one-dimensional isoelectric focusing (1D-IEF). With the increased availability of HLA class I DNA sequence information it has become feasible to genotype for class I by polymerase chain reaction utilising sequence-specific primers (PCR-SSP). We describe here a comprehensive HLA-B PCR-SSP typing system based on available HLA nucleotide sequences which can detect all serologically defined antigens in most heterozygous combination in 48 one-step PCR reactions. In addition, four new unsequenced variants have been identified. DNA samples from 57 International Histocompatibility Workshop reference cell lines and 160 control individuals have been typed by the HLA-B PCR-SSP technique. 3/57 cell line types and 12/160 normal control individuals types were discrepant with the reported serological types. The SSP system has been designed to be higher resolution than serology but is not a complete allele-specific PCR although many single alleles can be identified. The system is entirely complementary to previous published PCR-SSP systems for HLA-Class II and HLA-Class I in that the same PCR conditions and controls are used which allows us to do one step PCR-SSP for all relevant HLA loci in under 3 hours in a system suitable for the typing of cadaver donors.     

A modified PCR‐SSP method for the identification of ABO blood group antigens

The ABO blood group antigens are carbohydrate molecules synthesized by the glycosyltransferases encoded by the ABO gene on chromosome 9. Kidney transplantation across the ABO barrier generally leads to rapid humoral graft rejection due to the presence of naturally occurring antibodies to the A and B antigens. We have developed a method for ABO typing our cadaveric organ donors by the polymerase chain reaction using sequence‐specific primers (PCR‐SSP). The method uses 12 primers in eight PCR mixtures and is performed under the same conditions as our routine HLA‐A, B, C PCR‐SSP typing. The PCR‐SSP‐based types of 166 regular blood donors and 148 cadaveric organ donors all showed total concordance with their serologically assigned ABO groups. Six individuals possessing the ABO A subgroups (A3, Ax and Aend) all typed as A1 by PCR‐SSP, as expected. PCR‐SSP is an appropriate method for ABO typing of cadaveric organ donors and, importantly, enables both ABO and HLA typing to be performed on the same DNA material.     

HLA—A,B血清学分型与DNA分型的比较

目的：比较１３６例样本ＨＬＡ－Ａ，Ｂ血清学分型与ＤＮＡ分型结果。方法：应用聚合酶链反应－序列特异性引物（ＰＣＲＳＳＰ）技术，设计３８对引物，检测常见的ＨＬＡ－Ａ，Ｂ基因。结果：１３６例样本中有６０例血清学分型与ＤＮＡ分型结构不符合（４４．１％）；ＨＬＡ－Ａ特异性血清学分型错误率在纯合子中分别占２３．３％与９．４％（共１１．２％），在ＨＬＡ－Ｂ中分别占４７．４％与１８．４％（共２０．６％）；ＨＬＡ－Ａ特异性血清学分型假阴性６．６％，假阳性２．５％，错误指认特异性２．１％，ＨＬＡ－Ｂ错异性则分别为６．７％，３．６％，１０．３％。结论：ＩＬＡ－Ａ纯合子血清学分型错误率明显高于杂合子（Ｐ〈０．０５）；ＨＬＡ－Ｂ纯合子血清学分型错误率也明显高于杂合子（Ｐ〈０．００５）；ＨＬＡ－Ｂ特异性血清学分型错误率显著高于ＨＬＡ－Ａ特     

HLA-B27基因检定技术

用聚合酶链反应和血清学方法检测ＨＬＡ－Ｂ２７，并进行比较。方法：采用ＰＣＲ技术７８例可疑为强直性脊椎炎患者样本的ＨＬＡ－Ｂ２７基因，并与血清学比较。结果：３６例具有Ｂ２７基因者中２４例同时作血清学试验，５例血清学难以判定结果，并与ＰＣＲ结果不一致。     

Validation of DNA-based HLA-A and HLA-B testing of volunteers for a bone marrow registry through parallel testing with serology

A total of 42,160 individuals were typed for HLA-A and HLA-B by both serology and PCR-based typing. The HLA assignments included all of the known serological equivalents. The majority of the individuals (99.9%) were from U.S. minority population groups. The serologic typing was performed between 1993 and 1997 at the time of recruitment for the National Bone Marrow Program (NMDP) registry. The polymerase chain reaction (PCR)-based typing was carried out in two phases. In phase I, DNA typing was performed by PCR using sequence-specific oligonucleotide probes (PCR-SSOP) or PCR using sequence-specific primers (PCR-SSP) without knowledge of the serologic assignments. Discrepancies were identified between the serologic and DNA assignments in 24% of the volunteers (8% of volunteers differed for only HLA-A assignments, 13% for HLA-B, and 3% for both HLA-A and -B) and a potential explanation was assigned each discrepant serology/DNA pair. In phase II, a random sampling scheme was used to select a statistically significant number of individuals for repeat DNA typing from each of these categories. The categories included antigens missed by serology, nonexpressed (null) alleles, PCR amplification failures, misassignment of antigens and nomenclature issues. Only a single individual was found to carry a null allele. DNA-based testing correctly typed nearly 99% of the donors at HLA-A, more than 98% at HLA-B, and more than 97% at both HLA-A and -B validating this methodology for registry typing.     

A case of maternal–foetal chimerism identified during routine histocompatibility testing for hematopoietic stem cell transplantation

This report describes a case of maternal‐foetal chimerism identified in a boy diagnosed with SCID, who underwent HLA testing in preparation for HSCT. The first analysis was carried out on DNA from peripheral blood and included HLA‐A, HLA‐B, HLA‐DRB1 typing using PCR‐SSO. The patient's HLA‐B typing results were noninterpretable. All samples were re‐typed for HLA‐B using PCR‐SSP, again resulting in noninterpretable typing of patient's HLA‐B. In both cases, several weak positive probes/reactions interfered with the interpretation when using commercial software. Next round of HLA typing, using PCR‐SSP and PCR‐SSO methods, included the patient's bone marrow sample and HLA‐C locus, but interpretation was again not possible. The PCR‐STR analysis performed on both peripheral blood and bone marrow samples revealed seven STRs for which two maternal and one paternal allele were detected. Retrospective manual interpretation of HLA‐B and HLA‐C typing revealed that weak positive reactions were indeed owed to paternal HLA‐B and HLA‐C alleles and that the patient had both maternal and one paternal allele. Retyping of HLA‐B and HLA‐C loci and STR analysis on the patient's buccal cells sample revealed the expected one maternal/one paternal allele pattern. In summary, the combination of several different typing methods and manual interpretation were necessary to obtain the patient's HLA typing results.     

HLA class I null alleles and new alleles affect unrelated bone marrow donor searches

Unrecognized HLA null alleles or new alleles may affect the outcome of bone marrow transplants using unrelated donors. Some reports suggest that null alleles occur in the range of 0.003-0.07% (1, 2), which has led some transplant programs to stop performing serologic typing. We describe nine cases involving expression variants or new alleles. Three cases involved expression variants, including two null alleles and A*24020102L. One of the null alleles was a new variant of A*02. Seven cases involved new alleles. In five cases, there where discrepancies between HLA typing by serology and PCR-SSP. These included the three expression variants, one new B40 allele that typed serologically as B41 and one new B*07 allele that typed serologically as B42. Eight of these cases were found in the course of typing bone marrow transplant patients or potential unrelated donors since May of 2001 (total tested, 710 patients, 1914 donors). Thus, the incidence of null alleles was two in 2,624 (0.08%). Sequence-based typing (SBT) was performed on 676 of these samples. The decision to perform SBT was influenced by finding a serologic typing discrepancy in two cases. In one of those cases, SBT would probably have been performed at a later time, prior to final selection of a donor. Thus, the incidence of new alleles was between 4 and 6 of 676 (0.59-0.89%). We conclude that new HLA alleles and null alleles are uncommon but not extremely rare, and they continue to affect a significant number of unrelated donor searches.     

HLA-A位点PCR-SSP基因分型和血清学分型的比较

目的：建立优化ＨＬＡ－Ａ位点ＰＣＲ－ＳＰ分型方法。方法：采用普通扩增仪和Ｅｐｐｅｎｄｏｒｆ管对细胞系ＤＮＡ和３７个健康正常人进行基因分型,血清学检测采用标准淋巴细胞毒试验方法。结果：发现引物浓度和浓度比、ＤＮＡ的纯度及酶的选用,是影响ＨＬＡ－Ａ位点ＰＣＲ－ＳＳＰ分型准确性的重要因素。该方法对３７个标本的基因分型结果与血清学结果相符合。结论：ＰＣＲ－ＳＳＰ方法具有简便准确的优点,可以作为ＨＬＡ－Ａ位