The HLA-DRB1*15 phenotype is associated with multiple red blood cell and HLA antibody responsiveness.

Autor: Verduin EP; Center for Clinical Transfusion Research.; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.; Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands., Brand A; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.; Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands., van de Watering LM; Center for Clinical Transfusion Research.; Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands., Roelen DL; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands., Kanhai HH; Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Doxiadis II; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands., Claas FH; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands., Schonewille H; Center for Clinical Transfusion Research.; Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2016 Jul; Vol. 56 (7), pp. 1849-56. Date of Electronic Publication: 2016 May 17.
DOI: 10.1111/trf.13648
Abstrakt: Background: Once a patient has produced a red blood cell (RBC) antibody, there is an increased risk of additional antibody formation after subsequent RBC exposure. Recently, we observed that HLA-DRB1*15 was overrepresented in 379 multiple RBC antibody responders compared to controls or 562 patients with a single RBC antibody (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.3-2.3). In this study we evaluated whether the HLA-DRB1*15 represents a responder phenotype against HLA and/or RBC antigens.
Study Design and Methods: HLA-DRB1*15 frequencies in single and multiple antibody responders were compared between three groups of individuals: 1) those with HLA antibodies, 2) those with RBC antibodies, and 3) those with both RBC and HLA antibodies.
Results: A total of 3959 immunized patients (female-to-male ratio, 2.3) had been HLA-DRB1 typed. Among the 3275 individuals with HLA antibodies, the frequency of the DRB1*15 phenotype differed significantly from 19.7% in patients with a panel reactivity (PRA) of not more than 20% to 26.9% in patients with PRA of more than 80% (OR, 1.5; 95% CI, 1.2-1.9). This association between DRB1*15 and multiresponsiveness was mainly due to pregnancy-induced HLA immunization. In the 257 individuals with RBC and HLA antibodies, the frequency of DRB1*15 was 4.2 times (95% CI, 1.1-16) higher in those with multiple RBC antibodies and HLA-PRA of more than 50% compared to only single RBC responders with PRA of less than 20%.
Conclusion: The HLA-DRB1*15 phenotype is associated with broad RBC and HLA immunization.
(© 2016 AABB.)
Databáze: MEDLINE
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