HLA: Transplant Immunology

Question 1

Selected roles of MHC in humans

Answer 1

• Highly polymorphic
• Regulation of immune responsiveness and cell to cell interaction
• Role in autoimmune disease
• Role in tissue transplant (solid organ and hematopoietic stem cell)

Question 2

Class I Ags

- Cells on which they can be found

Answer 2

All nucleated cells

Question 3

Class I Ags

- Ags present

Answer 3

HLA A, B, C

Question 4

Class I Ags

- How Ags are presented

Answer 4

From inside the cell

Question 5

Class I Ags

- Type of cells they are recognized by

Answer 5

CD8+ cytotoxic T cells`

Question 6

Class I Ags

- Structure

Answer 6

Heterodimer w/ 2 protein chains (alpha heavy chain, B2 microglobulin)

Question 7

Class II Ags

- Cells on which they can be found

Answer 7

Immunocompetent cells

Question 8

Class II Ags

- Ags present

Answer 8

HLA DR, DQ, DP

Question 9

Class II Ags

- How Ags are presented

Answer 9

From outside the cell

Question 10

Class II Ags

- Type of cells they’re recognized by

Answer 10

CD4+ helper T cells

Question 11

Class II Ags

- Structure

Answer 11

2 noncovalently associated glycoprotein chains (alpha chain, beta chain)

Question 12

Theory of complement dependent cytotoxicity (CDC) test methodology

Answer 12

?

Question 13

3 sources of HLA CDC typing reagents

Answer 13

• Multiparous women
• Multi-transfused or transplanted persons
• Monoclonal Abs

Question 14

Limitations of CDC/microcytotoxicity test

Answer 14

• Uses human-derived reagents → limited supply, perishable
• Requires live, healthy PB lymphocytes
• HLA types depend on non-standardized reagents, HLA alleles expressed on cell surface
• Unable to distinguish all HLA types

Question 15

4 steps involved in DNA typing of HLA Ags

Answer 15

1. DNA extraction
2. DNA amplification
3. Detection
4. Interpretation

Question 16

Serological phenotyping

- Nomenclature

Answer 16

A1, A2, B8, B44, etc.

Question 17

Genotyping

- Nomenclature

Answer 17

A01, A02, B08, B44, etc.

Question 18

Inheritance of HLA genes

Answer 18

25% complete match to sibling
50% being a half match to a sibling
25% mismatched to a sibling

Question 19

Autoimmune diseases that have an association w/ certain HLA phenotypes

Answer 19

• Acute anterior uveitis
• Ankylosing spondylitis
• Goodpastures syndrome
• Juvenile diabetes mellitus
• Juvenile rheumatoid arthritis
• Nacrolepsy
• Celiac disease
• Rheumatoid arthritis