Author/Editor		Maček, Marjeta
Title		Granulocitni antigeni in njihov klinični pomen
Translated title		Granulocyte antigens and their role in clinical medicine
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 5
Publication year		2000
Volume		str. 227-33
Language		slo
Abstract		The neutrophil-specific antigens HNA-1 a, HNA-1b and HNA-1 c are the clinically most important antigens on the neutrophil membrane. They are identified as polymorphic forms of the FcyRIIIb receptor, which is determined biochemically and on the molecular level. Antibodies against granulocyte antigens can be produced following the transfusion of granulocytes, in pregnancy and following bone marrow transplantation. They cause alloimmune neonatal neutropenia, immune neutropenia after bone marrow transplantation, refractoriness to granulocyte transfusion and transfusion reactions such as TRALI (Transfusion-related acute lung injury) syndrome and febrile nonhemolytic transfusion reaction. If own granulocyte antigens are the target of the immune response, autoimmune neutropenia and drug-induced neutropenia occur. For the diagnosis of these clinical conditions the determination of granulocyte antibodies is essential. Granulocyte antibodies are mostly determined by the immunofluorescence test, agglutination test and MAIGA (monoclonal antibody-specific immobilisation of granulocyte antigens) assay. The latter allows determination of the granulocyte antibody specificity. Anti- gens HNA-1a, HNA-1b and HNA-1c can be genotyped by polymerase chain reaction with sequence-specific primers.
Summary		Nevtrofilno specifični antigeni HNA-la, HNA-1b in HNA-1c so klinično najpomembnejši antigeni na membrani nevtrofilca. So polimorfne oblike receptorja FcyIIIb, ki je raziskan na biokemični in genskomolekularni ravni. Protitelesa proti granulocitnim antigenom lahko nastanejo po transfuziji granulocitov, v nosečnosti ali po presaditvi kostnega mozga. Nastala protitelesa povzročajo aloimunsko nevtropenijo novorojenčka, imunsko nevtropenijo po presaditvi kostnega mozga, neodzivnost na transfuzije granulocitov in transfuzijske reakcije, kot sta sindrom TRALI (Transfusion-related acute lung injury) in febrilna nehemolitična transfuzijska reakcija. Če so tarča imunskega odziva lastni granulocitni antigeni, pa nastane avtoimunska nevtropenija in imunska nevtropenija zaradi zdravil. Za diagnostiko omenjenih stanj je zato nujna določitev prisotnosti granulocitnih protiteles. Granulocitna protitelesa ugotavljamo predvsem z imunofluorescenčnim in aglutinacijskim testom ter preiskavo MAIGA (Monoclonal antibody-specific immobilisation of granulocyte antigens). Slednja omogoča tudi določitev specifičnosti granulocitnih protiteles. Antigene HNA-1a, HNA-1b in HNA-1c lahko določamo s polimerazno verižno reakcijo s sekvenčno specifičnimi začetnimi verigami.
Descriptors		BLOOD TRANSFUSION GRANULOCYTES ISOANTIGENS ISOANTIBODIES NEUTROPENIA