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目的观察红细胞(RBC)经甲氧基聚乙二醇-琥珀酰亚胺丙酸酯(mPEG-SPA)修饰后对血型抗原的遮蔽作用,评估其解决自身免疫性疾病等所致配血困难的效果。方法以mPEG-SPA体外修饰正常人RBC,用微柱凝胶血型卡检测对A、B、RhD、RhC、RhE血型抗原的免疫遮蔽作用,并比较不同分子量不同浓度mPEG-SPA的遮蔽效果;观察修饰前后RBC的变形性、渗透脆性、自身溶血率,判断修饰对RBC功能的影响;比较修饰前后自身抗体阳性患者血清与相同ABO血型标本交叉配血时的凝集情况。结果mPEG-SPA修饰不影响RBC的变形性、渗透脆性、自身溶血率等特性,对A和B血型抗原基本没有遮蔽作用,而分子量20000的mPEG-SPA浓度达2mmol/L或分子量10000的mPEG-SPA为6mmol/L时,能有效地遮蔽RhD、RhC和RhE抗原,可有效消除受血者自身抗体和其他相应抗体所致的凝集现象。结论mPEG-SPA修饰可有效遮蔽Rh血型抗原并解决自身抗体所致的配血困难。
Objective To observe the masking effect of erythrocyte (RBC) on blood group antigen modified by methoxypolyethylene glycol-succinimidyl propionate (mPEG-SPA) effect. Methods The normal human RBCs were modified by mPEG-SPA in vitro. The immunocapillaries of A, B, RhD, RhC and RhE blood group antigen were detected by microcolumn gel blood card. The shielding effect of different concentrations of mPEG-SPA was compared. The changes of RBC deformability, osmotic fragility and hemolysis before and after modification were evaluated to determine the effect of modification on the function of RBC. The agglutination of serum with the same ABO blood group before and after modification was compared with each other. Results The mPEG-SPA modification did not affect the deformability, osmotic fragility and hemolysis of RBC. There was no masking effect on the A and B blood group antigens. However, mPEG-SPA with the molecular weight of 20,000 was 2 mmol / L or mPEG- When SPA is 6mmol / L, RhD, RhC and RhE antigen can be effectively shielded, which can effectively eliminate agglutination caused by autoantibodies and other corresponding antibodies in recipients. Conclusion mPEG-SPA modification can effectively shield the Rh blood group antigen and solve the autoantibodies caused by blood allocation difficulties.