title: Analysis of Pregnancy-Induced Anti-HLA Antibodies Using Luminex Platform.
abstract: BACKGROUND
  The impact of pregnancy on the incidence of HLA sensitization is poorly explored, and most of the data were obtained by use of a complement-dependent cytotoxicity (CDC) assay with an incidence of 18% to 30%. In many cases, antibodies cannot be detected by CDC as their level fades in time. However, this state of "latent" sensitization can still have a significant clinical impact in a subsequent transplantation setting.
  
  
  METHODS
  Pregnancy-induced HLA sensitization was analyzed in 69 mothers without a history of transfusions or transplants. The mothers and their offspring were typed for HLA-A, HLA-B, and HLA-DR. Sera from the mothers were studied using the Luminex screening test to detect anti-HLA class I and class II antibodies. Positive and borderline sera were further analyzed using single antigen kits.
  
  
  RESULTS
  Thirty-four sera (49.3%) were positive in the screening test (52.9% for class I and 61.7% for class II antibodies). All of them tested positive for paternal alloantigens by single antigen. Positive paternal alloantigens were also detected in 52.9% of class I and 36.3% of class II sera with borderline screening. Interestingly, in a further analysis, the mean of the MFIs of paternal alloantigens that resulted negative was calculated and compared with that of neutral alloantigens and that of maternal self-antigens; in both cases, differences were highly significant (288 vs 153, P < .0001; 288 vs 102, P < .0001; respectively).
  
  
  CONCLUSIONS
  This study shows a high incidence of pregnancy-induced HLA sensitization and suggests that HLA typing of partners of women who have been pregnant may contribute to a better risk assessment in the transplantation setting.
authors.affiliation: Unidad de Investigación, Hospital Universitario Puerta del Mar, Cádiz, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Vilches
authors.affiliation: UGC de Hematología e Inmunología, Hospital Universitario Puerta del Mar, Cádiz, Spain. Electronic address: antonioj.nieto.sspa@juntadeandalucia.es.
authors.forename: A
authors.initials: A
authors.lastname: Nieto
mesh_terms: D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D015235:HLA-B Antigens / Q000276:immunology*; D006684:HLA-DR Antigens / Q000276:immunology*; D006648:Histocompatibility / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000276:immunology*
chemical_list: D006680:HLA Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D007518:Isoantibodies