DNA 유전자형 검사를 이용한 혈소판 항원 panel의 제작경험

Abstract

Background : The serum should be tested with a platelet panel for identification of platelet specific alloantibodies. Such platelet panels are not available from commercial sources and can usually be made using platelets from local donor population. We prepared the platelet panel by DNA genotyping for 5 major platelet specific antigens and evaluated the detection ability of panel with clinical samples from patients showing the refractoriness to platelet transfusion. Methods : DNA genotyping of five major platelet specific alloantigens(PlA, Ko, Bak, Pen, Br) was performed for ninety three donors by reverse dot blot hybridization technique. For the evaluation of the panel we prepared, we used the anti-platelet antibody positive sera detected by modified antigen capture ELISA. Results : The most frequently encountered genotypes of platelets are PlA1 /PlA2, Kob/Kob, Baka/ Bakb, Pena /pena, Brb / Brb(36% of ninety three donor platelets tested). PlA2 and Penballeles were not identified in this study. Two cases of anti-Koa were identified using panel we prepared. Conclusion : The genotyping of platelet alloantigens circumvented the limitation of immunophenotyping by the general lack of quality typing antisera. It is impossible to make a good panel which was composed entirely of five major platelet specific alloantigen systems because the PIA2, Penb, and Bra are very rare alleles in Koreans. But our panel can be used for the identification of antibodies against Ko and/or Bak platelet antigen in patients with platelet alloimmunization.