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HLA system-HLA Typing and Its Role in Tissue Transplantation
HLA system-HLA Typing and Its Role in Tissue Transplantation
MHC polymorphism
Organ transplantation
Major histocompatibility complex
Group of genes coding for a set of host surface molecules that bind to a
peptide fragments derived from pathogens and foreign antigens, and
display them on host cell surface for recognition by the appropriate T cells.
About 1000 kbp length. Comprises of three genes namely DP, DQ and DR genes
encoding DP, DQ and DR proteins respectively.
In addition MHC region also contain non classical genes such as DM, DO, LMP
and TAP that help in antigen processing and presentation.
CD4 or CD8 binding site α3 binds to CD8 molecules on Tc β2 binds to CD4 molecules on TH
cells cells.
Cytokines:
IFN-γ activates both MHC-I and II promoter genes.
IL-4 increases the expression of MHC II molecules in resting B cells.
Corticosteroids and prostaglandins decrease the expression of
MHC II molecules.
Firstly, “HLA” is the name for the gene cluster which tends to be inherited
en-bloc.
Second part -e.g. DR- is the name of the specific locus. There are 6 loci
normally referred to. These are A, B, C, DR, DQ and DP.
Third part, the number, e.g. 3, 17, 03, 0301, refers to the actual
antigen at the locus. For example, the DNA in the HLA-DR locus
tends to be different from person to person. This difference will
result in a different type of HLA-DR molecule. These different types
of HLA-DR molecules are given names, such as DR17.
The closer the HLA antigens on the transplanted organ match the recipient,
the more likely that the recipient’s body will not reject the transplant.
This match occurs 25% of the time between siblings who have the
same mother and father.
METHODS OF HLA TYPING
A. Phenotypic method:
Serology: Microcytotoxicity
Tissue typing: Mixed lymphocyte reaction
B. Genotypic methods:
PCR detecting HLA genes
PCR-RFLP (restriction fragment length polymorphism)
Variable number tandem repeat (VNTR) typing
Short tandem repeat (STR) typing
DNA sequence based typing
Karyosome analysis
Serology: Microlymphocytotoxic test:
3. Paternal testing
HLA typing can be used alongside other test for paternity testing.
4. Infertility (recurrent pregnancy loss):
Infertility due to recurrent pregnancy loss can be attributed to
immune factors (40%) one of which is presence of certain common
HLA antigens between the parents.
5. Phylogenetic studies:
Some HLA haplotypes have distinctive geographical distribution
and are found only in some population. These haplotypes can be
used to trace human migration.
ORGAN TRANSPLANTATION
Based on the genetic relationship between the donor and the recipient:
Autograft: Self tissue transferred from one part of the body site to
another in the same individual (e.g. transfering healthy skin to a
burned area in burned patients).