Marcadores genéticos HLA e desenvolvimento de anticorpos anti-HLA em candidatos ao transplante renal da região Norte/Noroeste do Estado do Paraná

• Ano de defesa: 2013
• Autor(a) principal: Saito, Patricia Keiko
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual de Maringá; Brasil; Programa de Pós-Graduação em Ciências da Saúde; UEM; Maringá, PR; Centro de Ciências da Saúde
• Palavras-chave em Português: Antígenos leucocitários (HLA); Anticorpos anti-HLA; Insuficiência renal; Transplante; Polimorfismo genético; Biologia molecular; Histocompatibilidade; Transplante renal; Região Norte/Noroeste do Estado do Paraná; Brasil.; Transplantation; HLA antigens; Genetic polymorphism; Alleles; Antibodies; North/Northwest of Parana State; Brazil.; Ciências da Saúde; Medicina
• Link de acesso: http://repositorio.uem.br:8080/jspui/handle/1/2066

The HLA systems (Human Leukocyte Antigen) have a prominent role among the biological systems involved in the rejection process. In this study, we evaluated the HLA class I (HLAA,- B and-C) and class II (HLA-DRB1,-DQA1 and-DQB1) allele, phenotype and haplotype and anti-HLA antibodies frequencies, in patients with chronic kidney disease (CKD), renal transplant candidates from Northern/Northwestern of Parana State, Southern Brazil. HLA typing was performed by the method of polymerase chain reaction-sequence specific primers (PCR-SSO) associated with Luminex technology. The determination of panel reactive antibodies (PRA) and the specificities of anti-HLA antibodies were performed by kits LS1PRA and LS2PRA (One Lambda, Inc.) associated with Luminex technology. HLA-A,-B and -DRB1 gene frequencies were studied in 522 patients (319 Caucasians, 69 blacks and 134mestizos). Twenty HLA-A, 32 HLA-B and 13 HLA-DRB1 allelic groups were identified. HLA-A*02 (25.4%), HLA-B*44 (10.9%) and HLA-DRB1*13 (13.9%) allelic groups and HLAA*01 B*08 DRB1*03 haplotype (2.3%) were the most frequent. Significant differences (p < 0.05) were observed in the allele frequencies HLA-A*68, -B*08 and -B*58 among ethnic groups. HLA-A, -B, -C, -DRB1, -DQA1 and -DQB1 gene frequencies were studied in 366 patients (220 caucasians, 95 blacks and 51 mestizos). A total of 20 HLA-A, 30 HLA-B, 14 HLA-C, 13 HLA-DRB1, 6 HLA-DQA1 and 5 HLA-DQB1 allelic groups were identified. Of the 88 allelic groups, 19 were found with a frequency greater than 10%. Significant differences (p < 0.05) were observed in the allele frequencies HLA-A*68 and -C*07 among ethnic groups. The most frequent haplotype was HLA-A*08 C*01 B*07 DRB1*03 DQA1*05DQB1*02 (2.4%). The humoral immune response to HLA antigens was assessed in 269 patients, 182 (67.7%) patients had PRA positive. Potential risk factors for the development of anti-HLA antibodies (pregnancies, blood transfusions and previous transplants) showed no significant differences between PRA positive and negative groups. Only gender wasstatistically different between these groups (p < 0.05). Among patients with PRA positive, 62 (34.1%) were class I positive and class II negative; 39 (21.4%) were class I negative and class II positive and 81 (44.5%) were class I and II positive. The HLA-A*02 (24.2%), HLA-B*44 (10.6%) e HLA-DRB1*11 (13.6%) allelic groups and anti-HLA-A34 (24.7%); B57 (20.9%); C15 (3.3%); C16 (3.3%); DR51 (29.1%); DQ8 (31.3%) e DP14 (1.6%) antibodies were the most common. This study allowed the knowledge of HLA diversity and profile of anti-HLA antibodies in CKD patients in organ transplant waiting list from Northern/Northwestern of Parana State.