Abstract

The one-way mixed lymphocyte reaction (MLR-1) response was measured in both directions in 50 HLA-A, B, DR and DQ identical pairs and the role of DP studied in MLR stimulation. DR, DQ and DP typing was performed at the allele level by the polymerase chain reaction-sequence specific oligotyping (PCR-SSO) technique. The group consisted of 19 potential bone marrow transplant recipients and 34 matched unrelated donors. When more than one matched donor was available for a patient, donor/donor MLR-1 was also studied. DP identity was observed in 3 out of 50 pairs (6%), however due to homozygosity no incompatibility was present in the stimulating cells in 21 out of 100 cases (21%). There was a significant difference in the range of relative responses (RR) between zero DPB1 mismatches and one (p = 0.002) and two (p = 0.02) DPB1 mismatches: 52.4% of cases in the zero DPB1 mismatch group had RR < 1.0% compared with 31.6% and 27.3% in the one and two DPB1 mismatches. Stimulation by DPB1∗0201 and 0301 gave the highest RR (12.9 ± 22.5 and 17.5 ± 17.0, respectively) while stimulation with DPB1∗0401 and 0402 resulted in low levels of T cell response (1.3 ± 8.2 and 0.6 ± 11.5, respectively). When the responses were restricted to DPB1∗0401 homozygotes to standardise for responder type similar results were obtained (DPB1∗0201 v DPB1∗0402 p = 0.008). The protein products of the DPB1∗0201 and 0402 alleles differ by a single amino acid at position 69 (DPB1∗0402—Lysine, DPB1∗0201—glutamic acid). A further analysis was performed therefore scoring responders and stimulators as glutamic acid positive (E+) or negative (E−). There was a highly significant increase in the response to E+ stimulators compared with E− stimulators (p = 0.004). There was also a significant difference in the distribution of relative responses between the E+ stimulator group and the subgroups of E− responders/E− stimulators (p = 0.012) and E+ responders/E− stimulators (p = 0.009). However the amino acid difference at position 69 does not explain all responses due to DP in the MLR-1 as evidenced by the strong responses observed in cases where DPB1∗0301 (lysine pos.) was the only difference on the stimulator cells. The results indicate that not all DP incompatibilities elicit a measurable T cell MLR response, but where a response does occur residue 69 in the first domain of DP appears to be pivotal. These results may have implications with respect to GVHD in bone marrow transplantation.

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