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Del Angel-Pablo AD, Buendía-Roldán I, Mejía M, Pérez-Rubio G, Nava-Quiroz KJ, Rojas-Serrano J, Falfán-Valencia R. Anti-HLA Class II Antibodies Correlate with C-Reactive Protein Levels in Patients with Rheumatoid Arthritis Associated with Interstitial Lung Disease. Cells 2020; 9:E691. [PMID: 32168865 PMCID: PMC7140697 DOI: 10.3390/cells9030691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/26/2020] [Accepted: 02/29/2020] [Indexed: 01/08/2023] Open
Abstract
The pathogenesis of Rheumatoid Arthritis (RA) is not fully understood, probably influenced by genetic and environmental factors. Interstitial Lung Disease (ILD) is an extra-articular manifestation of RA, which contributes significantly to morbidity and mortality. The identification of anti-HLA antibodies has been useful in the transplantation field; however, its contribution to autoimmune diseases as RA has not been fully studied. We aimed to determine the presence of anti-HLA antibodies in RA patients with and without ILD and its possible association with clinical and biochemical markers. One-hundred and forty-seven RA patients, of which 65 had ILD (RA-ILD group), were included. Sera samples for Anti-HLA Class II LABScreen panel-reactive antibodies (PRA) were analyzed. In both groups, women predominated, and lung function was worse in patients with ILD. The anti-CCP+ (UI/mL) was higher in the RA group in comparison to RA-ILD (p < 0.001). Expositional risk factors (tobacco smoking and biomass-burning smoke) were higher in RA-ILD patients. PRA+ was identified in ~25% RA-ILD patients, while ~29% in the RA group. The CRP levels have a positive correlation with the percentage of reactivity (%PRA, p = 0.02, r2 = 0.60) in the RA-ILD group. In conclusion, anti-HLA antibodies correlate with C-reactive protein levels in RA patients with ILD.
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Affiliation(s)
- Alma D. Del Angel-Pablo
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, 14080 Mexico City, Mexico; (A.D.D.A.-P.); (G.P.-R.); (K.J.N.-Q.)
- Sección de Estudios de Posgrado e Investigación Escuela Superior de Medicina, Instituto Politécnico Nacional, 11340 Mexico City, Mexico
| | - Ivette Buendía-Roldán
- Translational Research Laboratory on Aging and Pulmonary Fibrosis, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, 14080 Mexico City, Mexico;
| | - Mayra Mejía
- Interstitial Lung Disease and Rheumatology Unit, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, 14080 Mexico City, Mexico;
| | - Gloria Pérez-Rubio
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, 14080 Mexico City, Mexico; (A.D.D.A.-P.); (G.P.-R.); (K.J.N.-Q.)
| | - Karol J. Nava-Quiroz
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, 14080 Mexico City, Mexico; (A.D.D.A.-P.); (G.P.-R.); (K.J.N.-Q.)
| | - Jorge Rojas-Serrano
- Interstitial Lung Disease and Rheumatology Unit, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, 14080 Mexico City, Mexico;
| | - Ramcés Falfán-Valencia
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, 14080 Mexico City, Mexico; (A.D.D.A.-P.); (G.P.-R.); (K.J.N.-Q.)
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Dunbar NM, Yazer MH, Bravo MD, Kamel HT, Gorlin J, Norris PJ, Williamson PC, Vassallo RR. An association between ABO group and HLA antibody detection. Transfusion 2016; 57:313-318. [PMID: 27807878 DOI: 10.1111/trf.13901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/06/2016] [Accepted: 09/06/2016] [Indexed: 01/25/2023]
Abstract
BACKGROUND US blood centers can screen female plateletpheresis donors with a history of one or more pregnancies for both Class I and Class II anti-HLA antibodies using one of two platforms. One is a flow-based assay that yields a quantitative result and the other an enzyme-linked immunosorbent assay (ELISA) that yields either a positive or a negative result (above or below cutoff). STUDY DESIGN AND METHODS The results of HLA antibody screening tests were analyzed by donor ABO group. Results from large and small American blood collection centers using both platforms were analyzed. Positivity rates were compared by chi-square test and the results stratified by parity using the Mann-Whitney test. RESULTS No differences in parity were noted among donors of different ABO groups, but a significantly higher rate of HLA antibody positivity was observed among group O donors for the ELISA (31% of group O donors vs. 21% of non-group O donors, p < 0.0001). The higher rate of positivity was primarily due to Class I reactivity. This difference in antibody frequency was not observed at centers using the flow-based assay. CONCLUSION Centers using the ELISA may have a higher rate of permanent deferral from plateletpheresis donation among group O female donors. Although the reasons for the higher rate of reactivity on Class I ELISA testing are unknown, this could result from test system characteristics or differences in group O donor antibody strength or specificity.
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Affiliation(s)
- Nancy M Dunbar
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Mark H Yazer
- The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania
| | | | | | - Jed Gorlin
- Innovative Blood Resources/Memorial Blood Centers, St Paul, Minnesota
| | | | | | - Ralph R Vassallo
- Blood Systems, Inc., Scottsdale, Arizona.,Biomedical Excellence for Safer Transfusion (BEST) Collaborative, Lebanon, New Hampshire
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Jackman RP, Lee JH, Pei R, Bolgiano D, Lebedeva M, Slichter SJ, Norris PJ. C1q-binding anti-HLA antibodies do not predict platelet transfusion failure in Trial to Reduce Alloimmunization to Platelets study participants. Transfusion 2016; 56:1442-50. [PMID: 27079754 DOI: 10.1111/trf.13598] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/21/2016] [Accepted: 01/29/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND In the Trial to Reduce Alloimmunization to Platelets (TRAP) study, 101 of 530 subjects became clinically refractory (CR) to platelets (PLTs) without lymphocytotoxicity assay (LCA)-detectable anti-HLA antibodies. The LCA only detects complement-binding antibodies and is less sensitive than newer assays. Utilizing a more sensitive bead-based assay that does not distinguish between complement-binding versus non-complement-binding antibodies, we have previously shown that while many LCA-negative (LCA-) patients do have anti-HLA antibodies, these low- to moderate-level antibodies do not predict refractoriness. As complement can contribute to PLT rejection, we assessed if previously undetected complement-binding antibodies account for refractoriness among LCA- patients. STUDY DESIGN AND METHODS Samples from 169 LCA- (69 CR, 100 non-CR) and 20 LCA-positive (LCA+; 10 CR, 10 non-CR) subjects were selected from the TRAP study serum repository. Anti-Class I HLA immunoglobulin (Ig)G and C1q-binding antibodies were measured in serum or plasma with bead-based detection assays. Levels of C1q-binding antibodies were compared between CR and non-CR subjects and correlated with corrected count increments (CCIs). RESULTS While some of the LCA- subjects had detectable C1q-binding anti-Class I HLA antibodies, and some LCA+ subjects did not, levels were significantly higher among LCA+ subjects. C1q-binding anti-Class I HLA antibody levels did not differ significantly between CR and non-CR among either the LCA- or the LCA+ subjects. Furthermore, there was no significant correlation observed between CCIs and either C1q-binding or any anti-HLA IgG antibodies. CONCLUSIONS This work confirms that low- to moderate-level anti-Class I antibodies do not drive PLT rejection, suggesting a role for antibody-independent mechanisms.
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Affiliation(s)
| | - Jar-How Lee
- Thermo Fisher Scientific, Canoga Park, California
| | - Rui Pei
- Thermo Fisher Scientific, Canoga Park, California
| | | | - Mila Lebedeva
- Blood Systems Research Institute, San Francisco, California
| | - Sherrill J Slichter
- Bloodworks Northwest (formerly Puget Sound Blood Center).,University of Washington School of Medicine, Seattle, Washington
| | - Philip J Norris
- Blood Systems Research Institute, San Francisco, California.,University of California, San Francisco, California
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Anti-human leukocyte antigen antibodies are present in blood of blood donors: is therapy with blood preparations safe for graft recipients? Transplant Proc 2014; 46:2565-71. [PMID: 25380867 DOI: 10.1016/j.transproceed.2014.09.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Blood products infusions are often administrated to graft recipients. Post-transfusion reactions of anti-human leukocyte antigen antibodies (anti-HLA) are responsible for transfusion-related acute lung injury, but cases of graft rejection after blood product infusions were recently also proven. METHODS The aim of this study was to assess, with the use of the very sensitive Luminex technology and traditional lymphocytotoxic test, the prevalence and cytotoxic activity of anti-HLA in blood donors with different medical histories to evaluate a potential risk of post-transfusion immune complications. Data were analyzed according to different normalized background cutoffs (1.5, 2.2; and the high cutoffs-10.8 for I class and 6.9 for II class anti-HLA). RESULTS We observed that anti-HLA may be present in 36% of donors, and even in up to 73.6% of risk groups. Significant risk factors included female sex (23.9% to 64.2% for different cutoffs) and pregnancy history (30% to 72.5%), regardless of the cutoff used in analysis, whereas sera from female donors showed lower cytotoxicity (panel reactive antibodies). Anti-HLA were also detected in men (3.7% to 37%), in donors after a transfusion (0% to 62.5%), and even with no known risk factors (3.8% to 26.9%). CONCLUSIONS Luminex technology is a sensitive tool in anti-HLA detection, but consensus in measurement interpretation for blood donors is needed. Selection of blood products on the basis of medical history can be a useful alternative for routine testing of blood donors. The clinical significance of treatment of graft recipients with blood products requires further study; until then, more attention should be paid to possible complications.
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From Donor to Recipient: Current Questions Relating to Humoral Alloimmunization. Antibodies (Basel) 2014. [DOI: 10.3390/antib3010130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Zhao QS, Xia N, Zhao N, Li M, Bi CL, Zhu Q, Qiao GF, Cheng ZF. Localization of human mesenchymal stem cells from umbilical cord blood and their role in repair of diabetic foot ulcers in rats. Int J Biol Sci 2013; 10:80-9. [PMID: 24391454 PMCID: PMC3879594 DOI: 10.7150/ijbs.7237] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 12/04/2013] [Indexed: 12/18/2022] Open
Abstract
The aim of this study is to explore the localization of human mesenchymal stem cells from umbilical cord matrix (hMSCs-UC) and the role of these cells in the repair of foot ulcerate tissue in diabetic foot ulcers in rats. A diabetic rat model was established by administering Streptozotocin. Diabetic foot ulceration was defined as non-healing or delayed-healing of empyrosis on the dorsal hind foot after 14 weeks. hMSCs-UC were delivered through the left femoral artery. We evaluated the localization of hMSCs-UC and their role in tissue repair in diabetic foot ulcers by histological analysis, PCR, and immunohistochemical staining. A model for diabetes was established in 54 out of 60 rats (90% success rate) and 27 of these rats were treated with hMSCs-UC. The area of ulceration was significantly and progressively reduced at 7 and 14 days following treatment with hMSCs-UC. This gross observation was strongly supported by the histological changes, including newly developed blood vessels and proliferation of inflammatory cells at 3 days post-treatment, significant increase in granulation tissue at 7 days post-treatment and squamous epithelium or stratified squamous epithelium at 14 days post-treatment. Importantly, human leukocyte antigen type-I (HLA-1) was confirmed in ulcerated tissue by RT-PCR. The expression of cytokeratin 19 was significantly increased in diabetic model rats, with no detectable change in cytokeratin 10. Additionally, both collagens I and III increased in model rats treated with hMSCs-UC, but the ratio of collagen I/III was less significant in treated rats compared with control rats. These results suggest that hMSCs-UC specifically localize to the target ulcerated tissue and may promote the epithelialization of ulcerated tissue by stimulating the release of cytokeratin 19 from keratinocytes and extracellular matrix formation.
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Affiliation(s)
- Qing-Song Zhao
- 1. Department of endocrinology and Metabolism, the Fourth affiliated Hospital of Harbin Medical University
| | - Nan Xia
- 1. Department of endocrinology and Metabolism, the Fourth affiliated Hospital of Harbin Medical University
| | - Nan Zhao
- 1. Department of endocrinology and Metabolism, the Fourth affiliated Hospital of Harbin Medical University
| | - Ming Li
- 1. Department of endocrinology and Metabolism, the Fourth affiliated Hospital of Harbin Medical University
| | - Chang-Long Bi
- 1. Department of endocrinology and Metabolism, the Fourth affiliated Hospital of Harbin Medical University
| | - Qing Zhu
- 1. Department of endocrinology and Metabolism, the Fourth affiliated Hospital of Harbin Medical University
| | - Guo-Fen Qiao
- 2. Department of Pharmacology, Harbin Medical University; Harbin, China
| | - Zhi-Feng Cheng
- 1. Department of endocrinology and Metabolism, the Fourth affiliated Hospital of Harbin Medical University
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Romero R, Whitten A, Korzeniewski SJ, Than NG, Chaemsaithong P, Miranda J, Dong Z, Hassan SS, Chaiworapongsa T. Maternal floor infarction/massive perivillous fibrin deposition: a manifestation of maternal antifetal rejection? Am J Reprod Immunol 2013; 70:285-98. [PMID: 23905710 DOI: 10.1111/aji.12143] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 05/07/2013] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Massive perivillous fibrin deposition (MPFD) and maternal floor infarction (MFI) are related placental lesions often associated with fetal death and fetal growth restriction. A tendency to recur in subsequent pregnancies has been reported. This study was conducted to determine whether this complication of pregnancy could reflect maternal antifetal rejection. METHODS Pregnancies with MPFD were identified (n = 10). Controls consisted of women with uncomplicated pregnancies who delivered at term without MPFD (n = 175). Second-trimester maternal plasma was analyzed for panel-reactive anti-HLA class I and class II antibodies. The prevalence of chronic chorioamnionitis, villitis of unknown etiology, and plasma cell deciduitis was compared between cases and controls. Immunohistochemistry was performed on available umbilical vein segments from cases with MPFD (n = 4) to determine whether there was evidence of complement activation (C4d deposition). Specific maternal HLA-antibody and fetal HLA-antigen status were also determined in paired specimens (n = 6). Plasma CXCL-10 concentrations were measured in longitudinal samples of cases (n = 28 specimens) and controls (n = 749 specimens) by ELISA. Linear mixed-effects models were used to test for differences in plasma CXCL-10 concentration. RESULTS (i) The prevalence of plasma cell deciduitis in the placenta was significantly higher in cases with MPFD than in those with uncomplicated term deliveries (40% versus 8.6%, P = 0.01), (ii) patients with MPFD had a significantly higher frequency of maternal anti-HLA class I positivity during the second trimester than those with uncomplicated term deliveries (80% versus 36%, P = 0.01); (iii) strongly positive C4d deposition was observed on umbilical vein endothelium in cases of MPFD, (iv) a specific maternal antibody against fetal HLA antigen class I or II was identified in all cases of MPFD; and 5) the mean maternal plasma concentration of CXCL-10 was higher in patients with evidence of MPFD than in those without evidence of MFPD (P < 0.001). CONCLUSION A subset of patients with MPFD has evidence of maternal antifetal rejection.
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Affiliation(s)
- Roberto Romero
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, Bethesda, MD, USA
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Jackman RP, Deng X, Bolgiano D, Utter GH, Schechterly C, Lebedeva M, Operskalski E, Luban NL, Alter H, Busch MP, Slichter SJ, Norris PJ. Leukoreduction and ultraviolet treatment reduce both the magnitude and the duration of the HLA antibody response. Transfusion 2013; 54:672-80. [PMID: 23808544 DOI: 10.1111/trf.12317] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 04/12/2013] [Accepted: 05/14/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Both leukoreduction and ultraviolet (UV) light treatment of blood products have been shown to reduce the incidence of HLA antibody development in recipients, but the impact of these treatments on the magnitude and persistence of the antibody response is less clear. STUDY DESIGN AND METHODS Longitudinal samples from 319 subjects taken from four different study cohorts were evaluated for HLA antibodies to determine the effects of leukoreduction and UV treatment on HLA antibody generation and persistence. RESULTS Subjects receiving leukoreduced or UV-treated blood products were less likely to generate Class I HLA antibodies, and those receiving leukoreduced blood were also less likely to generate Class II HLA antibodies. Among those receiving nonleukoreduced blood, 55% developed Class I HLA antibodies and 51% developed Class II HLA antibodies compared with 28% (Class I) and 15% (Class II) for those receiving leukoreduced blood and 36% (Class I) and 54% (Class II) for those receiving UV-treated blood. Among alloimmunized subjects, leukoreduction resulted in a significant twofold reduction in the magnitude of Class I HLA antibodies, and UV treatment resulted in a significant threefold reduction in the magnitude of Class II HLA antibodies. Both treatments resulted in shorter persistence of Class I HLA antibodies. CONCLUSIONS These data demonstrate that leukoreduction and UV treatment of blood products results not only in a reduction in the incidence of HLA antibody production, but also in lower and more transient HLA antibody levels among sensitized transfusion recipients.
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Affiliation(s)
- Rachael P Jackman
- Blood Systems Research Institute, San Francisco, California; Puget Sound Blood Center, Seattle, Washington; University of California, Davis, California; National Institutes of Health, Bethesda, Maryland; University of Southern California, Los Angeles, California; Children's National Medical Center, Washington, DC; Department of Laboratory Medicine, University of California, San Francisco, California; Department of Medicine, University of California, San Francisco, California; University of Washington School of Medicine, Seattle, Washington
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Low-level HLA antibodies do not predict platelet transfusion failure in TRAP study participants. Blood 2013; 121:3261-6; quiz 3299. [PMID: 23393051 DOI: 10.1182/blood-2012-12-472779] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the Trial to Reduce Alloimmunization to Platelets (TRAP) study, 101 of 530 participants became refractory to platelet transfusions without evidence of HLA or human platelet antigen (HPA) antibodies. We used a more sensitive bead-based assay to detect and quantify HLA antibodies and a qualitative solid-phase enzyme-linked immunosorbet assay for HPA to determine whether low-level antibodies could predict refractoriness in longitudinal panels from 170 lymphocytotoxicity assay (LCA)(-) and 20 LCA(+) TRAP participants. All TRAP recipients who previously tested LCA(+) were HLA antibody(+), using the bead-based system. Levels of HLA or HPA antibodies did not predict refractoriness among LCA(-) recipients, although higher levels of HLA antibodies were associated with refractoriness among LCA(+) recipients. These data demonstrate that weak to moderate HLA antibody levels detectable by modern binding assays are not associated with platelet refractoriness.
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On the role of HLA antibodies in hematopoietic stem cell transplantation. ACTA ACUST UNITED AC 2012; 81:1-11. [DOI: 10.1111/tan.12040] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Implementation and outcomes of a transfusion-related acute lung injury surveillance programme and study of HLA/HNA alloimmunisation in blood donors. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2012; 10:351-9. [PMID: 22395353 DOI: 10.2450/2012.0089-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 11/07/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-associated mortality. Antibodies against human leucocyte antigens (HLA) and human neutrophil antigens (HNA) are often detected in the implicated donors. We investigated the incidence and aetiology of TRALI in Lombardy. Moreover, we determined the rate of HLA and HNA alloimmunisation and the HNA genotype in a cohort of local blood donors. MATERIALS AND METHODS During a 2-year observational study in eight blood transfusion services, suspected TRALI cases were collected and characterised by means of HLA and HNA antibody screening of implicated donors, donor/recipient cross-matching and HLA/HNA molecular typing. In addition, 406 Italian donors were evaluated for alloimmunisation and in 102 of them HNA gene frequencies were determined. RESULTS Eleven cases were referred to the central laboratory, of whom three were diagnosed as having TRALI, seven as having possible TRALI and one as having transfusion-associated circulatory overload. Seven TRALI cases were immune-mediated whereas in three we did not find either alloantibodies in implicated donors or a positive reaction in the cross-match. The most frequently implicated blood component was red blood cells (in 5 males and in 1 female), whereas four cases of TRALI were associated with transfusion of fresh-frozen plasma (in 3 females and in 1 male). The frequency of reported TRALI/possible TRALI cases was 1:82,000 for red blood cells and 1:22,500 for fresh-frozen plasma. No cases were observed for platelets. Overall, the frequency of HLA or HNA alloimmunisation in blood donors was 29% for females and 7% for males. The latter could be related, at least in part, to natural antibodies. HNA gene frequencies showed that HNA-1b is more frequent than HNA-1a in our sample of donors. DISCUSSION The recently adopted national policy to prevent TRALI, i.e. using only plasma donated by males, would have had a positive impact in our setting.
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Carrick DM, Johnson B, Kleinman SH, Vorhaben R, Chance SC, Lee JH, Roback JD, Pandey S, Sun Y, Busch MP, Norris PJ. Agreement among HLA antibody detection assays is higher in ever-pregnant donors and improved using a consensus cutoff. Transfusion 2011; 51:1105-16. [PMID: 21087285 PMCID: PMC3089710 DOI: 10.1111/j.1537-2995.2010.02938.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND HLA antibodies might contribute to the pathogenesis of transfusion-related acute lung injury (TRALI). HLA antibody detection methods include ELISA, flow cytometry, and multiplex bead-based assays, as well as the older lymphocytotoxicity assay, and it is not obvious how to compare results across platforms. STUDY DESIGN AND METHODS Five hundred twenty-five serum samples were selected from 7841 donors in the Leukocyte Antibody Prevalence Study (LAPS) repository based on risk for the development of HLA antibodies, using the number of pregnancies as the risk factor. Subjects included 81 males and females with 0 (n = 187), 1 (n = 67), or 2+ pregnancies (n = 190). Replicate frozen serum aliquots were sent blinded to four different HLA antibody assay manufacturers for detection using five different assays. RESULTS The flow cytometry and multiplex bead based-assays typically resulted in a larger proportion of HLA antibody positive samples compared with ELISA based assays. Latent variable analysis was used to derive a new set of consensus cutoffs, which yielded similar sensitivities across test platforms and increased concordance amongst assays. Assay agreement was higher in ever pregnant females than in males and never-pregnant females. CONCLUSIONS Different assays resulted in varied positivity rates when the manufacturer's suggested cutoffs were used, demonstrating that care needs to be taken when comparing clinical outcomes data generated using different HLA antibody assays and testing platforms. The method used here, involving latent variable analysis, presents one possible approach to calculating comparable cutoffs that result in broad agreement across assays with respect to positivity designation.
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Affiliation(s)
- Danielle M Carrick
- Blood Systems Research Institute and Blood Centers of the Pacific, San Francisco, California 94118, USA
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Giannoli C, Nguyen TKT, Dubois V. [HLA and transfusion: new approaches with Luminex™ technology]. Transfus Clin Biol 2011; 18:218-23. [PMID: 21397543 DOI: 10.1016/j.tracli.2011.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 01/27/2011] [Indexed: 10/18/2022]
Abstract
The major histocompatibility complex is a multigenic system highly polymorphic coding for human leukocyte antigen (HLA) molecules, which are the strongest antigens for immune response and play a major role in allograft rejection. Class I antigens are expressed on almost all nucleated cells and platelets, whereas HLA class II antigens are mostly on antigen presenting cells. During transfusion, anti-HLA antibodies can induce transfusion incidents like fever, transfusion-related acute lung injury TRALI and refractoriness to the platelets transfusion. Identification of HLA class I antibodies is very important to find HLA compatible platelets concentrates. Since the end of 1960s, the complement-dependent microlymphocytotoxicity assay has been the standard internationally recognized method for cross matching and screening of HLA antibodies. It became necessary to improve the test sensitivity because some clinical relevant antibodies were not detected. Sensitive methods appeared in the 1990 s: flow cytometry, enzyme-linked immunosorbent assay and now Luminex™. This latter is the most sensitive method with single HLA antigen panel assays to generate the most informative reactivity pattern of antibodies. The high sensitivity and specificity of the Luminex™ technology performed to screen HLA antibodies allows the best selection of platelets donors. When no compatible concentrates are available for highly immunized recipients, the cross-matching method could be used to select a platelet concentrate.
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Affiliation(s)
- C Giannoli
- Laboratoire d'histocompatibilité, site de Lyon, EFS Rhône-Alpes, 1-3, rue du Vercors, 69007 Lyon, France.
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