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The utility of second single antigen bead assay: Clearing the water or stirring up mud?
Human Immunology ( IF 2.7 ) Pub Date : 2020-10-06 , DOI: 10.1016/j.humimm.2020.09.002
Harold C Sullivan 1 , Scott M Krummey 1 , Howard M Gebel 1 , Robert A Bray 1
Affiliation  

Though solid-phase single antigen bead (SAB) testing has provided major advances to the HLA community and organ allocation, it has not been without limitations. In particular, false-positive reactions lead to interpretative challenges and the potential to preclude a transplant if the corresponding antigens are deemed unacceptable. Two different vendor platforms are commercially available for SAB testing, one more recent than the other. The aim herein was to assess the benefit of using the newer SAB platform in situations where the primary platform yielded suspicious (specifically, false positive) reactions. Therefore, 42 serum samples with commonly encountered false-positive patterns observed in our laboratory were tested with the newer platform. Cases were classified as resolved, equivalent, or divergent based on whether the second platform produced no reactivity, the same pattern, or a distinctly different pattern compared to the primary platform, respectively. Approximately 33% of cases were resolved, 46% were equivalent, and 21% were divergent. The project revealed advantages of adding a second SAB platform to the laboratory’s test menu including resolving challenging samples and including broader coverage of different alleles and unique class II alpha/beta subunit combinations. However, the challenges of validating, maintaining, and billing for another test method in the laboratory may be barriers to routine use.



中文翻译:

第二种单抗原珠试验的效用:清水还是搅泥?

尽管固相单抗原珠 (SAB) 测试为 HLA 社区和器官分配提供了重大进步,但也并非没有限制。特别是,假阳性反应会导致解释上的挑战,并且如果相应的抗原被认为是不可接受的,则可能会阻止移植。有两种不同的供应商平台可用于 SAB 测试,一种比另一种更新。本文的目的是评估在主要平台产生可疑(特别是假阳性)反应的情况下使用较新的 SAB 平台的好处。因此,在我们的实验室中观察到的 42 个具有常见假阳性模式的血清样本使用较新的平台进行了测试。案例被分类为已解决、同等、或不同,分别基于第二个平台与主要平台相比是否不产生反应性、相同的模式或明显不同的模式。大约 33% 的案例得到解决,46% 是等效的,21% 是不同的。该项目揭示了在实验室的测试菜单中添加第二个 SAB 平台的优势,包括解决具有挑战性的样本,包括更广泛的不同等位基因覆盖和独特的 II 类 α/β 亚基组合。然而,在实验室中验证、维护和计费另一种测试方法的挑战可能是常规使用的障碍。该项目揭示了在实验室的测试菜单中添加第二个 SAB 平台的优势,包括解决具有挑战性的样本,包括更广泛的不同等位基因覆盖和独特的 II 类 α/β 亚基组合。然而,在实验室中验证、维护和计费另一种测试方法的挑战可能是常规使用的障碍。该项目揭示了在实验室的测试菜单中添加第二个 SAB 平台的优势,包括解决具有挑战性的样本,包括更广泛的不同等位基因覆盖和独特的 II 类 α/β 亚基组合。然而,在实验室中验证、维护和计费另一种测试方法的挑战可能是常规使用的障碍。

更新日期:2020-11-19
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