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目的探讨高致敏肾移植受者的HLAI类抗体的致敏表位。方法采用酶联免疫吸附法动态测定54例高致敏肾移植受者的HLAI类抗体特异性,并指定可能的抗体公共表位。结果90.7%(49/54)的高致敏受者具有可指定的抗体公共表位;最常见的公共表位是163E、142145TTKH、83R、7174AQTD、127K、163R、163L、41T、6266RNTRN和4145ASPRT;在动态监测过程中,抗体公共表位分析结果稳定,与抗体特异性鉴定比较,能更准确地反映抗体谱。结论高致敏受者的HLA抗体产生有明显的规律,对少数高频率、高免疫原性氨基酸残基的致敏是高致敏受者致敏的主要原因;对高致敏受者进行抗体表位分析能够准确地预测可接受的供者抗原错配。
Objective To investigate the sensitized epitopes of HLAI-like antibodies in highly sensitized kidney transplant recipients. Methods The specificity of HLA class I antibodies in 54 hypersensitive renal transplant recipients was determined by enzyme-linked immunosorbent assay (ELISA) and the possible antibody common epitopes were assigned. Results Highly sensitized recipients in 90.7% (49/54) had designated antibody common epitopes; the most common common epitopes were 163E, 142145TTKH, 83R, 7174AQTD, 127K, 163R, 163L, 41T, 6266RNTRN and 4145ASPRT; During the monitoring process, the result of the public epitope analysis of the antibody is stable, which can reflect the antibody spectrum more accurately when compared with the antibody specific identification. Conclusions There is a clear rule for the generation of HLA antibodies in highly sensitized recipients. Sensitization of a few high frequency and highly immunogenic amino acid residues is the main cause of sensitization in hypersensitive recipients. Antibody epitope analysis of highly sensitized recipients can accurately Predict acceptable donor antigen mismatch.