Serology versus ARMS-PCR in prospective HLA-class I typing for bone marrow transplantation.

While HLA class II alleles identification by means of complement mediated lymphocytotoxicity (serology) is almost replaced by DNA typing techniques, serology is still widely used for routine class I typing. The aim of this prospective study was to compare PCR-based Amplification Refractory Mutation System with serology in clinical HLA class I alleles assignment in patients receiving marrow transplants and their potential donors. The total discrepancy rate in 114 consecutively typed individuals for HLA-A and HLA-C alleles was only in favor of ARMS-PCR, whereas HLA-B typing was discrepant also in favor of serology.

Segregation of HLA genes in multicase narcolepsy families.

In the past 15 years, 411 sporadic narcolepsy patients have been diagnosed in the Hephata Klinik, Schwalmstadt, Germany. They were explored for presence or absence of excessive daytime sleepiness and narcolepsy in their relatives. A subset of 39 patients were explored for presence or absence of parasomnias.

Extensive HLA class II studies in 58 non-DRB1*15 (DR2) narcoleptic patients with cataplexy.

Narcolepsy is a sleep disorder that has been shown to be tightly associated with HLA DR15 (DR2). In this study, 58 non-DR15 patients with narcolepsy-cataplexy were typed at the HLA DRB1, DQA1 and DQB1 loci. Subjects included both sporadic cases and narcoleptic probands from multiplex families.

Diagnostic and prognostic significance of anticardiolipin antibodies in patients with recurrent spontaneous abortions.

Problem: The role of ACA in unexplained RSA is controversial. In the present study, diagnostic and prognostic aspects were investigated.

Method: One hundred five nonpregnant patients with primary, 29 with secondary RSA, and 209 controls were investigated for IgG-ACA.

Immunotherapy with intravenous immunoglobulin for prevention of recurrent pregnancy loss: European experience.

Problem: Due to its strong "immunomodulating" effect in several well established disorders, high-dose intravenous immunoglobulins (IVIG) has been proposed as an alternative for immunotherapy with allogeneic leucocytes in patients with unexplained recurrent spontaneous abortion. This paper is intended to provide an overview on the European experience in this field.

Method: Five European pilot studies with a total of 172 patients as well as one controlled double-blind multicenter study including 64 patients were considered.

Immunogenetic and serological investigations in nonpregnant and in pregnant women with a history of recurrent spontaneous abortions. German RSA/IVIG Study Group.

In the context of a controlled multicenter study on intravenous immunoglobulin (IVIG) treatment of patients with a history of unexplained recurrent spontaneous abortions (RSA), a number of controversial immunological parameters were evaluated prior to and during pregnancy with respect to their diagnostic and/or prognostic significance. A total of 390 serum samples from 52 patients were investigated. Sharing of 2 or more HLA (A, B, DR, DQ) antigens was significantly more frequent in RSA couples than in controls.

Intravenous immune globulin in recurrent abortion.

A specific effect of intravenous immune globulin (IVIG) on the outcome of pregnancy in patients with a history of habitual abortion has been postulated as an alternative to immunotherapy with allogeneic leucocytes. The results of different pilot studies have been promising, demonstrating a successful outcome of pregnancy in approximately 80% of treated patients. However, the evaluation and interpretation of the study results has to take into account that the probability of a successful pregnancy in women with a history of three spontaneous abortions is about 60% without treatment.

[Serologic detection of HLA antigens and HLA antibodies].

The discovery of the HLA system as well as the progress of knowledge over several decades were based on serological methods. Today, methods of molecular biology tend to replace serological tests for HLA typing, particularly for class II alleles. However, HLA serology is still indispensable in all domains where HLA antibodies play a role.

[New possibilities of donor selection for bone marrow and organ transplantation by HLA typing and genomic DNA].

For one year we determined HLA class II antigens from all patients with renal and haematological disorders and their healthy family members both by using serological methods and DNA typing (SSO, SSP). The rate of discrepancies between the results of serological DR typing and DRB1 typing was 10.8% (13/120).

HLA antigens in Peyronie's disease.

This study presents data on HLA phenotypes of 52 unrelated patients suffering from idiopathic Peyronie's disease. This first investigation on HLA class II antigens detected an association of HLA-DR3 and -DQw2 in this disorder. HLA typing was done from ACD-stabilized peripheral blood using the modified lymphocytotoxicity test.

HLA phenotypes and multiple basal cell carcinomas.

Background: Previous investigators noted an association of multiple basal cell carcinomas (BCC) with certain HLA antigens; however, these findings were contradictory, and the associations were only weak.

Objective: The aim of the study was to objectify the previously found associations.

Methods: Serologic HLA typing for class I and class II antigens was performed in 49 unrelated patients with 5 or more BCCs.

Quantitation of HLA class II antigens on B-cell lines.

By quantitation of elutable immunoglobulin G in a recently described ELISA, the number of HLA class I and II molecules on B-cell lines was determined using monomorphic monoclonal antibodies. An average number of 183,000 binding sites per cell for HLA class I-, 99,000 for HLA-DR-, 63,000 for DQ- and 42,000 for DP-specific monoclonal antibodies were determined. The small amount of HLA class II molecules can in part explain the difficulties observed in HLA class II typing or in detection of class II antibodies using the lymphocytotoxicity text.

A deletion in the second exon of an HLA-DRB1 allele found in a DR2-negative narcolepsy patient.

In this report, we describe a new allele of the HLA-DRB 1 gene carrying a form of mutation that has not been observed before. It appeared in an HLA-DR2-negative narcolepsy patient who, besides HLA-DR4, revealed a serologic HLA-DR blank segregating with HLA-DQ1. Oligotyping showed that the new allele belongs to the HLA-DR8 group.

Heparin-associated thrombocytopenia: no association of immune response with HLA.

Heparin-associated thrombocytopenia (HAT) is a severe adverse reaction of heparin therapy. Patients with the immunologic type of HAT are at risk of developing arterial and venous thromboembolic complications caused by an antibody which activates platelets in the presence of heparin. Yet, there are no means to identify patients at risk of developing HAT before heparin administration.

Alloimmune neonatal neutropenia is a potential side effect of immunization with leukocytes in women with recurrent spontaneous abortions.

Alloimmunization of a mother against granulocytes causing alloimmune neonatal neutropenia (ANN) in her newborn was found likely to be attributed to previous intradermal injections of paternal lymphocytes. Immunotherapy with leukocytes which was performed for recurrent spontaneous abortions hence provides the possibility of granulocyte alloimmunization and increases the risk of the occurrence of ANN.

Influence of treatment with mouse immunoglobulin on the rate of viable neonates in the CBA/J x DBA/2 J model.

In the CBA/J (H-2k) x DBA/2J (H-2d) murine model, the protective value of pooled murine immunoglobulin i.p. was compared with that of serum taken 7 days after termination of CBA/J (H-2k) x BALB/c (H-2d) pregnancy.

[Granulocyte-specific and HLA antibodies in pregnancy: incidence and clinical value].

Postpartum sera of 1,016 unselected women were examined for granulocyte-specific and HLA antibodies. A total of 11 out of 1,016 sera (1.1%) were only reactive with neutrophils.

HLA association of idiopathic Peyronie's disease: an indication of autoimmune phenomena in etiopathogenesis?

HLA typing for class I and class II antigens was done in 52 unrelated patients suffering from idiopathic Peyronie's disease. The controversially discussed association with the HLA-B7 cross-reacting group could not be confirmed. Marked deviations of antigen frequencies were observed for HLA-A1, B8, Cw7, DR3 and DQw2 compared to healthy local controls.

Autoimmunization against the neutrophil-specific NA1 antigen is associated with HLA-DR2.

A significant association of autoimmune neutropenia (AIN) in infants due to NA1-specific autoantibodies and HLA-DR2 is reported. Nineteen of 26 infants presenting with AIN and NA1 autoantibodies possessed the DR2 antigen, while only one out of six children with AIN, but non-NA1-specific autoantibodies, was DR2 positive. Furthermore, one adult patient with primary biliary cirrhosis and periods of neutropenia due to NA1 autoantibodies also carried the DR2 antigen.

HLA typing and lymphocytotoxic crossmatches using conventional techniques or immunobeads. A comparative study.

In a prospectively designed comparative study, HLA class I and class II typing was performed after B/T lymphocyte separation by nylon wool (NIH technique) or using immunomagnetic beads (IMB technique). Samples from 70 healthy individuals (group A) and from 47 patients with potential typing problems (group B) were examined. Complete typing failures occurred more frequently with NIH than with IMB.

Incidence and specificity of HLA-DP antibodies in pregnancy sera.

A total of 630 human pregnancy sera were investigated for HLA-DP antibodies (ab) by monoclonal antibody-specific immobilization of leukocyte antigens (MAILA) using monoclonal antibody (mAB) B7/21.2 and selected B-lymphoblastoid cell lines from the Tenth International Histocompatibility Workshop reference panel. DP-specific abs were detected in 86 of 330 sera (26.