人类白细胞抗原-II 抗体诱导的输血相关急性肺损伤:抗体分型和来源分析

IF 1.8 4区 医学 Q3 HEMATOLOGY Vox Sanguinis Pub Date : 2024-09-01 Epub Date: 2024-06-26 DOI:10.1111/vox.13703
Zou Yu, Zheng Mao, Liao Xiuyun, Jiang Tianhua
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引用次数: 0

摘要

背景和目的:探讨人类白细胞抗原(HLA)-II抗体诱导的输血相关急性肺损伤(TRALI),并分析抗体分型和来源:探讨人类白细胞抗原(HLA)-II抗体诱导的输血相关急性肺损伤(TRALI),并分析抗体分型和来源:我们回顾性分析了两名疑似TRALI白血病患者的临床症状和体征,这两名患者来自同一名女性供体。我们对这两名患者、血小板捐献者、她的丈夫和两个孩子进行了 HLA 表型分析。结果:结果:两名白血病患者的临床表现与 TRALI 相似,我们对他们进行了及时的呼吸机支持治疗。血小板捐献者的血浆中含有高滴度的 HLA-II 抗体。这些抗体分别针对 HLA-DRB3*03:01、HLA-DRB1*09:01、HLA-DRB1*12:02、HLA-DRB3*01:01 和 HLA-DRB1*12:01:01G,与两名患者的 HLA 抗原具有特异性。高分辨率HLA基因分型结果表明,供体的HLA-II抗体来自于怀孕期间丈夫抗原的免疫刺激:本研究描述了两例由来自同一女性献血者的 HLA-II 抗体引起的 TRALI。对有多次妊娠史的献血者进行适当管理至关重要。
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Transfusion-related acute lung injury induced by human leucocyte antigen-II antibodies: Analysis of antibody typing and source.

Background and objectives: To explore transfusion-related acute lung injury (TRALI) induced by human leucocyte antigen (HLA)-II antibodies, and to analyse antibody typing and source.

Materials and methods: We retrospectively analysed the clinical symptoms and signs of two leukaemia patients with suspected TRALI from the same female donor. HLA phenotyping was performed on the two patients, the platelet donor, her husband and her two children. The HLA and human neutrophil antigen antibodies in the donor's plasma were identified.

Results: The clinical manifestations of two leukaemia patients were those of TRALI, and we treated them with timely ventilator support. A high titre of HLA-II antibodies was in the plasma of the platelet donor. The antibodies were directed at HLA-DRB3*03:01, HLA-DRB1*09:01, HLA-DRB1*12:02, HLA-DRB3*01:01 and HLA-DRB1*12:01:01G, which were specific to the HLA antigens of the two patients. High-resolution HLA genotyping suggested that the donor's HLA-II antibodies were derived from immune stimulation by the husband's antigens during pregnancy.

Conclusions: This study described two cases of TRALI caused by HLA-II antibodies from the same female donor. Appropriate management of blood donors with a history of multiple pregnancies is crucial.

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来源期刊
Vox Sanguinis
Vox Sanguinis 医学-血液学
CiteScore
4.40
自引率
11.10%
发文量
156
审稿时长
6-12 weeks
期刊介绍: Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections: 1) Transfusion - Transmitted Disease and its Prevention: Identification and epidemiology of infectious agents transmissible by blood; Bacterial contamination of blood components; Donor recruitment and selection methods; Pathogen inactivation. 2) Blood Component Collection and Production: Blood collection methods and devices (including apheresis); Plasma fractionation techniques and plasma derivatives; Preparation of labile blood components; Inventory management; Hematopoietic progenitor cell collection and storage; Collection and storage of tissues; Quality management and good manufacturing practice; Automation and information technology. 3) Transfusion Medicine and New Therapies: Transfusion thresholds and audits; Haemovigilance; Clinical trials regarding appropriate haemotherapy; Non-infectious adverse affects of transfusion; Therapeutic apheresis; Support of transplant patients; Gene therapy and immunotherapy. 4) Immunohaematology and Immunogenetics: Autoimmunity in haematology; Alloimmunity of blood; Pre-transfusion testing; Immunodiagnostics; Immunobiology; Complement in immunohaematology; Blood typing reagents; Genetic markers of blood cells and serum proteins: polymorphisms and function; Genetic markers and disease; Parentage testing and forensic immunohaematology. 5) Cellular Therapy: Cell-based therapies; Stem cell sources; Stem cell processing and storage; Stem cell products; Stem cell plasticity; Regenerative medicine with cells; Cellular immunotherapy; Molecular therapy; Gene therapy.
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