MİNÖR DOKU UYGUNLUK ANTİJENLERİNİN KARAKTERİZASYONU VE ALLOGENEİK HEMATOPOETİK KÖK HÜCRE NAKLİNDEKİ ROLÜ: TÜRKİYE’DE TEK MERKEZ DENEYİMİ

Yıl 2022, Cilt: 5 Sayı: 3, 130 - 134, 16.11.2022

Fatma Savran Oğuz , Çiğdem Kekik , Rustu Oguz , Demet Kıvanç , Deniz Sargın , Sevgi Kalayoğlu-beşışık

https://doi.org/10.26650/JARHS2022-1130823

Öz

Amaç: Minör doku uygunluk antijenleri (mHAg), polimorfik esansiyel peptitlerden
oluşan epitoplar olup sınıf I ve II HLA allele çeşitleri ile sınırlı olan
bir T hücresi yanıtı ortaya çıkarırlar. Son yıllarda, farklı popülasyonlarda
polimorfik bölgelerin dağılımı hakkında kapsamlı araştırmalar yapılmıştır.
Alıcı ve verici arasındaki mHAg uyumsuzluğu, HLA tam uyumlu transplantasyona
rağmen güçlü bir hücresel immün yanıtı başlatabilir. Çalışmamızda
çeşitli hematolojik hastalıklar nedeniyle hematopoietik kök hücre transplantasyonu
(AKHN) yapılan hastalarda mHAg sıklığının belirlenmesi
amaçlanmıştır.
Gereç ve Yöntem: Çalışma popülasyonu 200 sağlıklı bireyi, allojenik AKHN
adayları olarak HLA’sı tiplendirilmiş olan 150 hastayı ve 20 allojenik AKHN
alıcısı/donörünü içermektedir. mHAg’lar, polimeraz zincir reaksiyonu (PZR)
ve diziye özgü primer (SSP) yöntemleri kullanılarak belirlendi.
Bulgular: Hastaların alel frekansları ve genotipleri sağlıklı grup ile karşılaştırıldığında,
immünojenik veya immünojenik olmayan alel frekansları açısından
fark anlamlı değildi. Sağlıklı grupta immünojenik homozigot H aleli (HH
genotipi) olan bireyler daha azdı ve bu fark istatistiksel olarak anlamlıydı.
Çalışma popülasyonumuz küçük olmasına rağmen, 20 transplant hastasından
ve donöründen alınan verilere göre, 10 hastanın %50’sinin minör uyumsuzluk
kaynaklı Graft versus host hastalığı (GVHH) olduğu gözlendi.
Sonuç: Sağlıklı Türk popülasyonunda ve malign hematolojik hastalığı olan
hastalarda mHAg frekanslarının belirlenmesinin immün yanıtın anlaşılmasına
katkı sağlayacağını düşünmekteyiz.

Anahtar Kelimeler

Minör Histo Uygunluk Antijenleri, Allojenik Hematopoietik Kök Hücre Nakli, Graft-versus-host hastalığı

Destekleyen Kurum

İstanbul Üniversitesi Bilimsel Araştırma Projeleri Birimi

Proje Numarası

292/05012005

CHARACTERIZATION OF MINOR HISTOCOMPATIBILITY ANTIGENS AND THEIR ROLE IN ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: SINGLE CENTER EXPERIENCE IN TURKEY

Öz

Objective: The minor histocompatibility antigens (mHAgs) are the
epitopes composed of polymorphic essential peptides, and they create T
cell response limited to a variety of class I and II HLA alleles. In recent
years, there has been extensive research on the distribution of
polymorphic regions in different populations. The incompatibility between
recipient and donor, may initiate a strong cellular immune response
despite HLA full-matched transplantation. We determined the frequency
of minor antigens among hematopoietic stem cell transplantation (HSCT)
recipients who underwent transplantation for various hematological
diseases.
Material and Methods: The study population included 200 healthy
individuals, 150 HLA-typed patients who were candidates for allogeneic
HSCT, and 20 recipients/donors with allogeneic transplants. Minor HAgs
identified by using polymerase chain reaction (PCR) and sequence specific
primer (SSP) methods.
Results: When the allele frequencies and genotypes of the patients were
compared with those of the healthy group, the difference was not
significant regarding to immunogenic or non-immunogenic allele
frequencies. The individuals with immunogenic homozygous H allele (HH
genotype) were a few more in the healthy group, and this difference
proved to be statistically significant. In fact, our study population
Insufficient though the number was, based on the data received from 20
transplant patients and donors, GvHD was observed in 5 of 10 patients
who had minor incompatibility.
Conclusion: We assume that determining the mHAg frequencies in the
healthy Turkish population and in patients with malignant hematological
diseases will likely contribute to the understanding of the immune
response. 

Anahtar Kelimeler

Minor Histocompatibility Antigens, Allogeneic Hematopoietic Stem Cell Transplantation, Graft-versus-host disease.

Proje Numarası

292/05012005

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