Title Senzibilacija na antigene sustava HLA Title (english) Sensitization to antigens of the HLA system Author Antonija Vidović Mentor Esma Čečuk-Jeličić (mentor)Committee member Leida Tandara (predsjednik povjerenstva)Committee member Slavica Dajak (član povjerenstva)Committee member Esma Čečuk-Jeličić (član povjerenstva)Granter University of Split Defense date and country 2015-09-30, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Uvod: Glavni sustav tkivne snošljivosti, (engl. Major Histocompatibility Complex, MHC) je najsloženiji poznati genetički sustav odgovoran za sintezu specifičnih antigena na površini gotovo svih stanica organizma. Zbog brojnih i važnih funkcija sustav HLA ima značajnu ulogu u transplantacijskoj imunologiji kako kod transplantacije solidnih organa (bubreg, jetra, srce) tako i kod transplantacije krvotvornih matičnih stanica. Prozvodnja antitijela HLA je odgovor organizma na unos stranih antigena HLA koji u organizam mogu dospjetit trudnoćama, transfuzijama ili transplantacijama. Prisutnost antitijela HLA u serumima bolesnika na listi čekanja ili kod senzibiliziranih trudnica izražava se kao postotak panel reaktivnih antitijela (engl. Panel Reactive Antibodies, PRA %)
Cilj rada: Svrha rada bila je utvrditi prisutnost anti HLA antitijela u serumima pacijenata koji su primali transfuziju i za posljedicu imali posttransfuzijske reakcije kao i prisutnost anti HLA antitijela u serumu višerotkinje.
Materijali i metode: Uzorci dvojice ispitanika su u Laboratorij za tipizaciju tkiva, Centra za transfuzijsku medicinu, KBC-a Split došli s Klinike za ortopediju zbog posttransfuzijskih reakcija sa svrhom utvrđivanja prisutnosti/odsutnosti anti HLA antitijela u serumu. Treća ispitanica je bila trudnica(višerotkinja). Za prisustvo/odsustvo anti HLA antitijela koristili smo test mikrolimfocitotoksičnosti (MLCT), te test križne probe (engl.cross match, CM).
Rezultati: Nakon izvedenog testa mikrolimfocitotosičnosti kod jednog od naših ispitanika koji su u Laboratorij za tipizaciju tkiva, Centra za transfuzijsku medicinu došli s posttransfuzijskim reakcijama, utvrdili smo prisutnost anti HLA antitijela 30/30 (100 %). Pacijent je tijekom operacije primao punu krv što je rezultiralo ovako visokim % PRA. U serumu trudnice otkrili smo monospecifična antitijela anti HLA-A2 budući se trudnica tijekom trudnoće senzibilizirala na antigen HLA-A2 koje je dijete naslijedilo od oca.
Zaključak: Antitijela HLA imaju središnju ulogu u preživljavanju transplantiranog organa i odgovorna su za njegovo odbacivanje. Transfuzije pune krvi ili trombocita su čest oblik alogene transplantacije i zato kod osoba koje su primile ABO podudarne ali HLA nepodudarne transfuzije krvi dolazi do senzibilizacije na aloantigene prisutne u krvi davatelja. Da bi se ta posljedica transfuzije izbjegla, potrebno je izabrati najpodudarnijeg davatelja ili dati filtriranu krv sa smanjenim brojem leukocita.
Ključne riječi: sustav HLA, senzibilizacija, antigeni HLA, anti HLA antitijela
Abstract (english) Introduction: Major histocompatibility complex is the most complexed genetic system responsible for tissue antigen synthesis on the surface of almost every cell in the human organism. Because of numerous and important roles in our organism, HLA system is very important in transplant immunology and transplantation of solid organs (kidney, liver, heart) as well as in blood stem cell transplantation. HLA antibody production is the organism's response to foreign antigens who are brought into the organism by pregnancy, transfusion or transplantation. Presence of antibodies in patients serums who are on the waiting list or in sensitized pregnant women is expressed as percentage Panel Reactive Antibodies.
Objective: The purpose of this paper was to establish the presence of anti HLA antibodies in serums of patients who have recieved a blood transfusion and had a post-transfusion reaction and the presence of anti HLA antibodies in the serum of a pregnant woman (multiple births).
Materials and methods: Samples of two patients were delivered from the Orthopedic Clinic to establish whether there was anti HLA antibodies in their serums. The third examinee was a pregnant woman (multiple births). Microlymphocytotoxicity test was used to establish the presence of anti HLA antibodies as well as cross match test.
Results: After the microlymphocytotoxicity test, one of our patients from the Orthopedic Clinic was 100 % positive for the anti HLA antibodies. Patient was given a full blood transfusion during his operation which resulted in such a high percentage of PRA. Monospecific antibodies anti HLA-A2 were discovered in pregnant woman's serum because the child she is bearing has inherited his father's antigen, HLA-A2, and she has become sensitized to it.
Conclusion: HLA antibodies have a central role in keeping the transplanted organ alive and they are also responsible for its rejection. Full blood transfusions or platelets transfusions are a common form of allogenic transplantation so that is why persons who have recieved matching ABO transfusions but non-matching HLA transfusions become sensitized to alloantigens present in the donor's blood. To avoid negative result of transfusions, a donor who is the most similar in HLA antigens to recipient should be chosen or the patient should be given a blood transfusion with decreased number of leukocytes.
Key words: HLA system, sensitation, HLA antigens, anti HLA antibodies
Keywords
sustav HLA
senzibilizacija
antigeni HLA
anti HLA antitijela
Keywords (english)
HLA system
sensitation
HLA antigens
anti HLA antibodies
Language croatian URN:NBN urn:nbn:hr:176:824409 Study programme Title: Medical Laboratory Diagnostics (university/undergraduate) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-05-06 08:22:34
