HLA-DRB1和HLA-DQ基因多态性与红细胞同种免疫的关联性

doi:10.3969/j.issn.1671-2587.2025.04.020

临床输血与检验 ›› 2025, Vol. 27 ›› Issue (4): 563-571.DOI: 10.3969/j.issn.1671-2587.2025.04.020

HLA-DRB1和HLA-DQ基因多态性与红细胞同种免疫的关联性

宋文倩¹, 余婉珍², 梁晓华¹, 周世航¹

¹大连市血液中心血型研究室,大连辽宁 116001;
²大连医科大学检验医学院,大连辽宁 116001

收稿日期:2025-01-09 出版日期:2025-08-20 发布日期:2025-08-22
通讯作者: 梁晓华,主要从事血型免疫方面研究,（E-mail）liangxiaohua1968@126.com。共同通信作者：周世航,主要从事血型免疫方面研究,（E-mail）zshsail@163.com。
作者简介:宋文倩,主要从事血型免疫方面研究,（E-mail）wenqian_song@163.com。并列第一作者：余婉珍,主要从事血型免疫方面研究,（E-mail）2519315783@qq.com。

Association between HLA-DRB1 and HLA-DQ Gene Polymorphisms and Red Blood Cell Alloimmunization

SONG Wenqian¹, YU Wanzhen², LIANG Xiaohua¹, ZHOU Shihang¹

¹Blood Group Laboratory, Dalian Blood Center, Dalian 116001;
²Dalian Medical University, School of Laboratory Medicine, Dalian 116001

Received:2025-01-09 Online:2025-08-20 Published:2025-08-22

摘要/Abstract

摘要： 红细胞同种免疫是临床输血重要的免疫学问题,其本质为机体识别外源红细胞抗原并产生特异性抗体,严重时可导致溶血性输血反应或新生儿溶血症。该免疫反应可能依赖于HLA-Ⅱ类分子介导的抗原呈递机制,涉及树突状细胞处理抗原、CD4⁺ T细胞识别并激活、辅助B细胞产生IgG类抗体等环节。个体在暴露同种抗原后是否产生抗体与其接受剂量、免疫状态、炎症环境及遗传背景密切相关。HLA-Ⅱ基因的高度多态性决定了个体对特定红细胞抗原的应答差异,部分等位基因如HLA-DRB1^*04与HLA-DRB1^*15可增强肽段呈递能力,显著提高抗体生成风险,而某些HLA-Ⅱ类等位基因则表现出保护作用。本文系统梳理以HLA-DRB1和HLA-DQ为代表的HLA-Ⅱ类基因与红细胞同种免疫抗体生成的关联及可能机制,旨在为临床个体化输血策略和免疫预测提供理论依据。

关键词: 红细胞, 同种免疫抗体, HLA, 基因多态性

Abstract: Red blood cell (RBC) alloimmunization is a significant immunological concern in clinical transfusion. It refers to the immune response wherein the recipient recognizes foreign RBC antigens and produces specific antibodies, potentially leading to hemolytic transfusion reactions or hemolytic disease of the fetus and newborn in severe cases. This immune process is possible dependent on the antigen presentation mechanism mediated by HLA class Ⅱ molecules, involving the presentation of antigens by dendritic cells, recognition and activation by CD4⁺ T cells, and subsequent help to produce IgG antibody by B cells. Whether an individual develops antibodies upon exposure to alloantigens is closely related to dosage,their immune status, inflammatory environment, and genetic background. The high polymorphism of HLA class Ⅱ genes underlies the inter-individual variability in immune responses to specific RBC antigens. Certain alleles, such as HLA-DRB1^*04 and DRB1^*15, have been shown to enhance peptide presentation capabilities, significantly increasing the risk of antibody formation. In contrast, some HLA class Ⅱ alleles may exhibit protective effects. Here we systematically reviewed the association and potential mechanisms between HLA class Ⅱ genes, represented by HLA-DRB1 and HLA-DQ, and the development of RBC alloantibodies. The aim is to provide a theoretical basis for individualized transfusion strategies and immune risk prediction in clinical practice.

Key words: Red blood cells, Alloimmune antibodies, HLA, Gene polymorphism

中图分类号:

R457.1

宋文倩, 余婉珍, 梁晓华, 周世航. HLA-DRB1和HLA-DQ基因多态性与红细胞同种免疫的关联性[J]. 临床输血与检验, 2025, 27(4): 563-571.

SONG Wenqian, YU Wanzhen, LIANG Xiaohua, ZHOU Shihang. Association between HLA-DRB1 and HLA-DQ Gene Polymorphisms and Red Blood Cell Alloimmunization[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2025, 27(4): 563-571.

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HLA-DRB1和HLA-DQ基因多态性与红细胞同种免疫的关联性

Association between HLA-DRB1 and HLA-DQ Gene Polymorphisms and Red Blood Cell Alloimmunization

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