长期输血状细胞病患者的RH基因型和红细胞合免疫率:美国的一项多站点研究
Narek Israelyan1, Sunitha Vege2, David F Friedman3,4
1Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Transfusion
|January 30, 2024
概括
红细胞配免疫在状细胞病 (SCD) 患者中是常见的,原因是RH变异性等位基因. 分子Rh抗原匹配可以改善预防这些输血反应.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 遗传学 遗传学 是一个
背景情况:
- 红细胞配免疫是状细胞病 (SCD) 患者的重要并发症,增加了输血反应风险.
- 由于SCD患者和黑人捐赠者中RH变异基因的高频率,ABO,Rh和K抗原的标准预防性匹配不足.
研究的目的:
- 在接受慢性输血治疗的儿科和年轻成人SCD患者中比较RH基因型和与免疫率.
- 调查RH变异基因对SCD中非免疫化的影响.
主要方法:
- 使用RHD和RHCE BeadChip阵列和有针对性的测试进行RH基因型鉴定.
- 分析了美国五所医院的342名SCD患者的合免疫率.
- 基于特定的RHCE等位基的合免疫率的比较,包括编码部分抗原的等位基.
主要成果:
- 在各个机构 (5% - 41%) 中,疫苗接种率差异很大.
- 观察到RH变异基因的高患病率:33%的RHD和57%的RHCE.
- 具有编码部分e抗原的RHCE等位基因的患者表现出更高的抗-e合免疫率.
结论:
- 免疫率的变化强调了需要改善SCD的预防策略.
- 变异RH等位基因的高患病率表明,分子Rh抗原匹配对于最佳的合免疫预防至关重要.
- 供体细胞上的Rh抗原变异也可能有助于非免疫化.
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