ⓘ Panel-reactive antibody


ⓘ Panel-reactive antibody

A panel-reactive antibody is a group of antibodies in a test serum that are reactive against any of several known specific antigens in a panel of test cells or purified HLA antigens from cells. It is an immunologic test routinely performed by clinical laboratories on the blood of people awaiting organ transplantation. In this test recipient cells confort to random cells of donor population and estimation risk of acute rejection. The PRA score is expressed as a percentage between 0% and 100%. It represents the proportion of the population to which the person being tested will react via pre-existing antibodies against human cell surface antigens, which include human leukocyte antigen|HLA" and other polymorphic antigen systems. A PRA score greater than 6 is in danger, and over 20 requires a desensitization process, but its intensity varies. These antibodies target the surface antigens of target cells, such as HLAs. In other words, it is a test of the degree of alloimmunity in a graft recipient and thus a test that quantifies the risk of transplant rejection. Each population has a different demographic prevalence of particular antigens, so the PRA test panel constituents differ from country to country.

Traditional test PRA is carried out using groups of lymphocytes from the donor capacity of the population. Since the late 1990-ies, the cleaned panel with the HLA-antigen was used to replace the cell panel for the test gear, based on the assumption that HLA is the major target system antigen alloantibody response. However, non-HLA antibodies, the effect on the test-great were ignored. Ref:human leukocyte antigen antibodies for monitoring transplant patients. Surg Today. 2005.358:605-12)

Great value great usually means that the individual is primed to react immunologically against a large proportion of the population. Individuals with a high value of PRA is often called "aware", which means that they have been exposed to "foreign" or "not-self" proteins in the past and he has developed antibodies to them. These antibodies develop after transplantation, blood transfusion and pregnancy. Organ transplantation in recipients who are "sensitive" to the organs significantly increases the risk of rejection, which leads to increasing demands immunosuppressants and decreasing graft survival. People with high scores so great to wait longer for the body to which they do not have existing antibodies.

Significant efforts have been made to identify treatments to reduce PRA in sensitized candidates for transplantation. In certain circumstances, plasmapheresis, intravenous immunoglobulin, rituximab, and other "antibody-directed" immune therapy can be used, but this is an area in which an active investigation is ongoing.

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