人白细胞抗原-氨基酸残基配型标准与免疫反应性研究

目的 提出汉族人人白细胞抗原（ＨＬＡ）＿氨基酸残基配型标准，评价其免疫反应性和致敏性。方法 采用基因分型技术，分析大样本ＨＬＡ怕频率分布，提出适合于汉族人的Ⅰ类１０个组、Ⅱ类７个组共１７个组新的ＲｅｓＭ标准。前瞻性应用于首次尸肾移植１６３例。通过混合淋巴细胞培养（ＭＬＣ）、培养上清细胞因子、外周血免疫活性细胞和抗ＨＬＡ－ＩｇＧ抗体检测，并与六抗原配型标准比较，研究接受ＲｅｓＭ标准的免疫反应性和致敏

HLA-amino acid residue matching standard and immunogenic response

OBJECTIVE: To provide a standard for HLA-amino acid residue matching (Res M) for Chinese population and to evaluate its immunogenic response and sensitization to allograft. METHODS: Based on the setting up of DNA typing technique and the analysis of the distribution of HLA antigen frequencies, a new matching policy of Res M of 17 residues (10 amino acid residues for class I and 7 DR supertypic groups for class II) was presented and prospectively applied to 163 first-cadaver kidney transplants. Comparing with the 6-antigen matching program, the immunogenic response and sensitization of Res M to allograft were assayed using the mixed lymphocyte culture (MLC), cytokine in culture liquid, immune competent cells in the peripheral blood and specific anti-HLA IgG antibodies with PRA-STAT technique. RESULTS: The rate of Res-matched transplants increased significantly from 1.2% by Ag M to 39.9%. Immunogenic response and sensitization to allograft of recipients with Res-matched, containing index of stimulation (SI) of MLC, gamma-IFN representing Th1 cell, IL-10 representing Th2 cell, CD4+, CD8+, CD28+ T cell and the ratio of CD4/CD8, as well as the level of sHLA-IgG representing sensitization to allograft, were similar to those of Ag-matched transplants. Those parameters showed no difference between Res-matched and Ag-matched recipients, but showed significant difference in Res-mismatched or Ag-mismatched transplants. CONCLUSION: The New Res M can increase the rate of Res-matched transplants by a big margin, minimize the sensitization and immunogenic response to allograft, and be suitable to the clinical application to organ transplantation in Chinese Han population.