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Association between HLA‐DRB1*01 and HLA‐DRB1*15 with alloimmunisation in transfusion‐dependent patients with thalassaemia
Author(s) -
Ebrahimi Mina,
Dayer Dian,
Jalalifar Mohammad Ali,
Keikhaei Bijan,
Tahan Nejad Asadi Zari
Publication year - 2020
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/tme.12677
Subject(s) - medicine , human leukocyte antigen , genotyping , odds ratio , hla drb1 , immunology , confidence interval , gastroenterology , isoantibodies , allele , antigen , genotype , gene , biology , biochemistry
Abstract Background Alloantibody production is one of the most challenging complications in transfusion‐dependent thalassaemia patients. Haemolytic anaemia, an increase in blood consumption, difficulty in haematopoietic stem cell transplantation and reduced quality of life are consequences of alloimmunisation. The most predisposed antigens (Ags) for alloantibody development are Rh and Kell blood group Ags. Objective The aim of the present study is to evaluate any correlation between HLA‐DRB1 alleles and Rh and Kell alloantibodies. Materials and Methods Fifty‐two non‐responders (control) and 54 responders (case) were enrolled in this study. Alloantibody detection was performed using the tube method. Genotyping of HLA‐DRB1*01 and HLA‐DRB1*15 was conducted by single‐specific primer‐polymerase chain reaction. Results In the responder group, 77.8% were hyper‐responders (more than one alloantibody), and only 22.2% were mono‐responders. Most detected alloantibodies were Anti‐K (94.4%), followed by Anti‐E (64.8%), Anti‐C (29.6%) and Anti‐D (25.9%). There was a significant difference in HLA‐DRB1*15 between responder and non‐responder groups, 73.7% vs 26.3%, respectively. ( P = .029, OR = 3.290; 95%CI). Our results showed that HLA‐DRB1*15 was more frequent in hyper‐responders than mono‐responders (92.9% vs 7.1%) ( P = .007). The greatest HLA‐DRB1*15 was seen in Anti‐K ( P = .014, odds ratio [OR = 3.784]; 95% confidence interval [CI]) and Anti‐E ( P = .011, OR = 3.609; 95%CI) alloantibodies. There is no association between HLA‐DRB1*01 and alloimmunisation. Conclusion Our findings showed that there is a significant correlation between HLA‐DRB1*15 and Anti‐K and Anti‐E alloantibodies. These findings can be useful in detecting susceptible thalassaemic patients and improving transfusion management.