1
|
Crocchiolo R, Rombolà G. Human Leucocyte Antigen System and Selection of Unrelated Hematopoietic Stem Cell Donors: Impact of Patient-Donor (Mis)matching and New Challenges with the Current Technologies. J Clin Med 2023; 12:jcm12020646. [PMID: 36675576 PMCID: PMC9862309 DOI: 10.3390/jcm12020646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
The selection of hematopoietic stem cell donors for allogeneic transplantation (allo-HSCT) is mainly driven by human leucocyte antigen (HLA) matching between patient and donor, with HLA-identical matched siblings being the preferred choice in most situations. Although other clinical and demographical variables matter, especially, donor age, which is unequivocally associated with better transplant outcomes, the histocompatibility criteria have a central role in the search for the best donor, particularly in the setting of unrelated allo-HSCT where HLA disparities between patient and donor are frequent. The present review is focused on the role of HLA incompatibilities on patient outcome according to the most recent literature, in an attempt to guide transplant physicians and search coordinators during the process of adult unrelated-donor selection. The technological progresses in HLA typing, i.e., with next-generation sequencing (NGS), now allow disclosing a growing number of HLA incompatibilities associated with a heterogeneous and sometimes unknown spectrum of clinical severity. Their immunogenic characteristics, i.e., their position inside or outside the antigen recognition domain (ARD), their permissiveness, their intronic or exonic nature and even the expected expression of the HLA loci where those mismatches occur, will be presented and discussed here, integrating the advances in the immunobiology of transplantation with survival and toxicity outcomes reported in the most relevant studies, within the perspective of improving donor selection in the current practice.
Collapse
Affiliation(s)
- Roberto Crocchiolo
- Servizio di Immunoematologia e Medicina Trasfusionale, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore, 3, 20162 Milano, Italy
- Correspondence: ; Tel.: +39-02-64443962
| | - Gianni Rombolà
- Laboratory of Immunogenetics and Transplant Immunology, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy
| |
Collapse
|
2
|
Cornaby C, Weimer ET. HLA Typing by Next-Generation Sequencing: Lessons Learned and Future Applications. Clin Lab Med 2022; 42:603-612. [PMID: 36368785 DOI: 10.1016/j.cll.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Caleb Cornaby
- McLendon Clinical Laboratories, UNC Hospitals, 101 Manning Drive, Chapel Hill, NC 27514, USA
| | - Eric T Weimer
- McLendon Clinical Laboratories, UNC Hospitals, 101 Manning Drive, Chapel Hill, NC 27514, USA; Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27514, USA.
| |
Collapse
|
3
|
Thuesen NH, Klausen MS, Gopalakrishnan S, Trolle T, Renaud G. Benchmarking freely available HLA typing algorithms across varying genes, coverages and typing resolutions. Front Immunol 2022; 13:987655. [PMID: 36426357 PMCID: PMC9679531 DOI: 10.3389/fimmu.2022.987655] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/10/2022] [Indexed: 11/02/2023] Open
Abstract
Identifying the specific human leukocyte antigen (HLA) allele combination of an individual is crucial in organ donation, risk assessment of autoimmune and infectious diseases and cancer immunotherapy. However, due to the high genetic polymorphism in this region, HLA typing requires specialized methods. We investigated the performance of five next-generation sequencing (NGS) based HLA typing tools with a non-restricted license namely HLA*LA, Optitype, HISAT-genotype, Kourami and STC-Seq. This evaluation was done for the five HLA loci, HLA-A, -B, -C, -DRB1 and -DQB1 using whole-exome sequencing (WES) samples from 829 individuals. The robustness of the tools to lower depth of coverage (DOC) was evaluated by subsampling and HLA typing 230 WES samples at DOC ranging from 1X to 100X. The HLA typing accuracy was measured across four typing resolutions. Among these, we present two clinically-relevant typing resolutions (P group and pseudo-sequence), which specifically focus on the peptide binding region. On average, across the five HLA loci examined, HLA*LA was found to have the highest typing accuracy. For the individual loci, HLA-A, -B and -C, Optitype's typing accuracy was the highest and HLA*LA had the highest typing accuracy for HLA-DRB1 and -DQB1. The tools' robustness to lower DOC data varied widely and further depended on the specific HLA locus. For all Class I loci, Optitype had a typing accuracy above 95% (according to the modification of the amino acids in the functionally relevant portion of the HLA molecule) at 50X, but increasing the DOC beyond even 100X could still improve the typing accuracy of HISAT-genotype, Kourami, and STC-seq across all five HLA loci as well as HLA*LA's typing accuracy for HLA-DQB1. HLA typing is also used in studies of ancient DNA (aDNA), which is often based on sequencing data with lower quality and DOC. Interestingly, we found that Optitype's typing accuracy is not notably impaired by short read length or by DNA damage, which is typical of aDNA, as long as the DOC is sufficiently high.
Collapse
Affiliation(s)
- Nikolas Hallberg Thuesen
- Evaxion Biotech, Copenhagen, Denmark
- Department of Health Technology, Section for Bioinformatics, Technical University of Denmark, Lyngby, Denmark
| | | | - Shyam Gopalakrishnan
- Section for Hologenomics, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | | | - Gabriel Renaud
- Department of Health Technology, Section for Bioinformatics, Technical University of Denmark, Lyngby, Denmark
| |
Collapse
|
4
|
Meneghini M, Perona A, Crespo E, Bemelman F, Reinke P, Viklicky O, Giral M, Palou E, Torija A, Donadeu L, Melilli E, Zuñiga J, Sefrin A, Lachmann N, Hu L, Hruba P, Guillot-Gueguen C, Brouard S, Grinyo J, Bestard O. On the clinical relevance of using complete high-resolution HLA typing for an accurate interpretation of posttransplant immune-mediated graft outcomes. Front Immunol 2022; 13:924825. [PMID: 36248818 PMCID: PMC9559221 DOI: 10.3389/fimmu.2022.924825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022] Open
Abstract
Complete and high-resolution (HR) HLA typing improves the accurate assessment of donor–recipient compatibility and pre-transplant donor-specific antibodies (DSA). However, the value of this information to identify de novo immune-mediated graft events and its impact on outcomes has not been assessed. In 241 donor/recipient kidney transplant pairs, DNA samples were re-evaluated for six-locus (A/B/C/DRB1/DQB1+A1/DPB1) HR HLA typing. De novo anti-HLA antibodies were assessed using solid-phase assays, and dnDSA were classified either (1) as per current clinical practice according to three-locus (A/B/DRB1) low-resolution (LR) typing, estimating donor HLA-C/DQ typing with frequency tables, or (2) according to complete six-locus HR typing. The impact on graft outcomes was compared between groups. According to LR HLA typing, 36 (15%) patients developed dnDSA (LR_dnDSA+). Twenty-nine out of 36 (80%) were confirmed to have dnDSA by HR typing (LR_dnDSA+/HR_dnDSA+), whereas 7 (20%) did not (LR_dnDSA+/HR_dnDSA−). Out of 49 LR_dnDSA specificities, 34 (69%) were confirmed by HR typing whereas 15 (31%) LR specificities were not confirmed. LR_dnDSA+/HR_dnDSA+ patients were at higher risk of ABMR as compared to dnDSA− and LR_dnDSA+/HR_dnDSA− (logRank < 0.001), and higher risk of death-censored graft loss (logRank = 0.001). Both LR_dnDSA+ (HR: 3.51, 95% CI = 1.25–9.85) and LR_dnDSA+/HR_dnDSA+ (HR: 4.09, 95% CI = 1.45–11.54), but not LR_dnDSA+/HR_dnDSA− independently predicted graft loss. The implementation of HR HLA typing improves the characterization of biologically relevant de novo anti-HLA DSA and discriminates patients with poorer graft outcomes.
Collapse
Affiliation(s)
- Maria Meneghini
- Kidney Transplant Unit, Nephrology Department. Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Perona
- Department of Medicine, Barcelona University, Barcelona, Spain
| | - Elena Crespo
- Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Frederike Bemelman
- Renal Transplant Unit, Department of Internal Medicine, Amsterdam University Medical Centers, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands
| | - Petra Reinke
- Berlin Center for Advanced Therapies (BeCAT), Berlin Institute of Health Center for Regenerative Therapies (BCRT) and Department of Nephrology and Intensive Care, Charité Universitätsmedizin Berlin, Berlin Institute of Health, Berlin, Germany
| | - Ondrej Viklicky
- Transplant Laboratory, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia
- Department of Nephrology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia
| | - Magali Giral
- Nantes Université, Inserm, Centre Hospitalier Universitaire (CHU) Nantes, Centre de Recherche en Transplantation et Immunologie UMR1064, Institut de Transplantation Urologie-Néphrologie (ITUN), Nantes, France
| | - Eduard Palou
- Histocompatibility Laboratory, Immunology Department. Hospital Clinic, Barcelona, Spain
| | - Alba Torija
- Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Donadeu
- Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Edoardo Melilli
- Kidney Transplant Unit, Nephrology Department, Bellvitge University Hospital, Barcelona, Spain
| | - Jose Zuñiga
- Kidney Transplant Unit, Nephrology Department. Vall d’Hebron University Hospital, Barcelona, Spain
| | - Anett Sefrin
- Berlin Center for Advanced Therapies (BeCAT), Berlin Institute of Health Center for Regenerative Therapies (BCRT) and Department of Nephrology and Intensive Care, Charité Universitätsmedizin Berlin, Berlin Institute of Health, Berlin, Germany
| | - Nils Lachmann
- HLA- Laboratory, Charité- Universitätsmedizin Berlin, Berlin, Germany
| | - Liu Hu
- Renal Transplant Unit, Department of Internal Medicine, Amsterdam University Medical Centers, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands
| | - Petra Hruba
- Transplant Laboratory, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia
- Department of Nephrology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia
| | - Cécile Guillot-Gueguen
- Nantes Université, Inserm, Centre Hospitalier Universitaire (CHU) Nantes, Centre de Recherche en Transplantation et Immunologie UMR1064, Institut de Transplantation Urologie-Néphrologie (ITUN), Nantes, France
| | - Sophie Brouard
- Nantes Université, Inserm, Centre Hospitalier Universitaire (CHU) Nantes, Centre de Recherche en Transplantation et Immunologie UMR1064, Institut de Transplantation Urologie-Néphrologie (ITUN), Nantes, France
| | - Josep Grinyo
- Department of Medicine, Barcelona University, Barcelona, Spain
| | - Oriol Bestard
- Kidney Transplant Unit, Nephrology Department. Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- *Correspondence: Oriol Bestard,
| |
Collapse
|
5
|
Hurley CK, Kempenich J, Wadsworth K, Sauter J, Hofmann JA, Schefzyk D, Schmidt AH, Galarza P, Cardozo MBR, Dudkiewicz M, Houdova L, Jindra P, Sorensen BS, Jagannathan L, Mathur A, Linjama T, Torosian T, Freudenberger R, Manolis A, Mavrommatis J, Cereb N, Manor S, Shriki N, Sacchi N, Ameen R, Fisher R, Dunckley H, Andersen I, Alaskar A, Alzahrani M, Hajeer A, Jawdat D, Nicoloso G, Kupatawintu P, Cho L, Kaur A, Bengtsson M, Dehn J. Common, intermediate and well-documented HLA alleles in world populations: CIWD version 3.0.0. HLA 2020; 95:516-531. [PMID: 31970929 PMCID: PMC7317522 DOI: 10.1111/tan.13811] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/25/2022]
Abstract
A catalog of common, intermediate and well-documented (CIWD) HLA-A, -B, -C, -DRB1, -DRB3, -DRB4, -DRB5, -DQB1 and -DPB1 alleles has been compiled from over 8 million individuals using data from 20 unrelated hematopoietic stem cell volunteer donor registries. Individuals are divided into seven geographic/ancestral/ethnic groups and data are summarized for each group and for the total population. P (two-field) and G group assignments are divided into one of four frequency categories: common (≥1 in 10 000), intermediate (≥1 in 100 000), well-documented (≥5 occurrences) or not-CIWD. Overall 26% of alleles in IPD-IMGT/HLA version 3.31.0 at P group resolution fall into the three CIWD categories. The two-field catalog includes 18% (n = 545) common, 17% (n = 513) intermediate, and 65% (n = 1997) well-documented alleles. Full-field allele frequency data are provided but are limited in value by the variations in resolution used by the registries. A recommended CIWD list is based on the most frequent category in the total or any of the seven geographic/ancestral/ethnic groups. Data are also provided so users can compile a catalog specific to the population groups that they serve. Comparisons are made to three previous CWD reports representing more limited population groups. This catalog, CIWD version 3.0.0, is a step closer to the collection of global HLA frequencies and to a clearer view of HLA diversity in the human population as a whole.
Collapse
Affiliation(s)
- Carolyn K. Hurley
- Department of OncologyGeorgetown UniversityWashingtonDistrict of Columbia
| | | | | | | | | | | | | | | | | | - Malgorzata Dudkiewicz
- Central Unrelated Potential Bone Marrow Donor and Cord Blood Registry POLTRANSPLANTWarsawPoland
| | - Lucie Houdova
- University of West Bohemia, New Technologies for the Information SocietyPilsenCzech Republic
| | - Pavel Jindra
- Czech National Marrow Donors Registry and University Hospital PilsenPilsenCzech Republic
| | | | - Latha Jagannathan
- DKMS BMST Foundation IndiaBangaloreIndia
- Bangalore Medical Services TrustBangaloreIndia
| | | | | | | | | | | | | | - Nezih Cereb
- DATRI Blood Stem Cell Donor RegistryChennaiIndia
| | - Sigal Manor
- Israel‐Ezer Mizion Bone Marrow Donor RegistryBnei BrakIsrael
| | - Nira Shriki
- Israel‐Ezer Mizion Bone Marrow Donor RegistryBnei BrakIsrael
| | | | - Reem Ameen
- Kuwait National Stem Cell RegistryJabriyaKuwait
| | - Raewyn Fisher
- New Zealand Bone Marrow Donor RegistryAucklandNew Zealand
| | | | | | - Ahmed Alaskar
- Saudi Stem Cell Donor Registry, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, RiyadhMinistry of National Guard Health AffairsRiyadhSaudi Arabia
| | - Mohsen Alzahrani
- Saudi Stem Cell Donor Registry, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, RiyadhMinistry of National Guard Health AffairsRiyadhSaudi Arabia
| | - Ali Hajeer
- Saudi Stem Cell Donor Registry, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, RiyadhMinistry of National Guard Health AffairsRiyadhSaudi Arabia
| | - Dunia Jawdat
- Saudi Stem Cell Donor Registry, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, RiyadhMinistry of National Guard Health AffairsRiyadhSaudi Arabia
| | | | | | - Louise Cho
- The Bone Marrow Donor ProgrammeSingapore
| | | | - Mats Bengtsson
- Tobias Registry of Swedish Bone Marrow Donors and Department of Immunology, Genetics and PathologyUppsala UniversityUppsalaSweden
| | - Jason Dehn
- National Marrow Donor ProgramMinneapolisMinnesota
| |
Collapse
|
6
|
Hurley CK. Naming HLA diversity: A review of HLA nomenclature. Hum Immunol 2020; 82:457-465. [PMID: 32307125 DOI: 10.1016/j.humimm.2020.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/06/2020] [Accepted: 03/22/2020] [Indexed: 11/29/2022]
Abstract
The development of a standardized HLA nomenclature has been critical in our understanding of the HLA system and in facilitating the clinical applications of HLA. The Nomenclature Committee for Factors of the HLA System, established in 1968, has overseen the development and usage of nomenclature based on serologic specificities, cellular responses, and DNA sequences. Their decisions have been guided by community consensus reached through 17 international workshops beginning in 1964 and continuing today. Two websites provide a curated database of the sequences of over 26,000 HLA alleles and a reference site for the current nomenclature. This review covers the major steps in the development of the HLA nomenclature as well as the efforts of other groups to extend its usefulness for research and clinical applications.
Collapse
|
7
|
Schmidt AH, Sauter J, Baier DM, Daiss J, Keller A, Klussmeier A, Mengling T, Rall G, Riethmüller T, Schöfl G, Solloch UV, Torosian T, Means D, Kelly H, Jagannathan L, Paul P, Giani AS, Hildebrand S, Schumacher S, Markert J, Füssel M, Hofmann JA, Schäfer T, Pingel J, Lange V, Schetelig J. Immunogenetics in stem cell donor registry work: The DKMS example (Part 1). Int J Immunogenet 2020; 47:13-23. [PMID: 31903698 PMCID: PMC7003907 DOI: 10.1111/iji.12471] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/06/2019] [Accepted: 12/06/2019] [Indexed: 01/27/2023]
Abstract
Currently, stem cell donor registries include more than 35 million potential donors worldwide to provide HLA-matched stem cell products for patients in need of an unrelated donor transplant. DKMS is a leading stem cell donor registry with more than 9 million donors from Germany, Poland, the United States, the United Kingdom, India and Chile. DKMS donors have donated hematopoietic stem cells more than 80,000 times. Many aspects of donor registry work are closely related to topics from immunogenetics or population genetics. In this two-part review article, we describe, analyse and discuss these areas of donor registry work by using the example of DKMS. Part 1 of the review gives a general overview on DKMS and includes typical donor registry activities with special focus on the HLA system: high-throughput HLA typing of potential stem cell donors, HLA haplotype frequencies and resulting matching probabilities, and donor file optimization with regard to HLA diversity.
Collapse
Affiliation(s)
- Alexander H. Schmidt
- DKMSTübingenGermany
- DKMS Life Science LabDresdenGermany
- DKMSClinical Trials UnitDresdenGermany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Latha Jagannathan
- DKMS BMST Foundation IndiaBangaloreIndia
- Bangalore Medical Services TrustBangaloreIndia
| | | | | | | | | | | | | | | | | | | | | | - Johannes Schetelig
- DKMSClinical Trials UnitDresdenGermany
- University Hospital Carl Gustav CarusMedizinische Klinik IDresdenGermany
| |
Collapse
|
8
|
Monos D, Drake J. Perspective: HLA functional elements outside the antigen recognition domains. Hum Immunol 2019; 80:1-4. [DOI: 10.1016/j.humimm.2018.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|