Establishment of a novel cell-based assay using HLA-transfected cells to detect HLA antibodies

The detection of HLA antibodies is important in clinical practice, such as platelet transfusion refractoriness and transfusion-related lung injury. However, difficulties are associated with the preparation of panel cells for conventional HLA detection systems using intact cells, such as the immunocomplex capture fluorescence analysis (ICFA). Based on an ICFA analysis, HEK293 cells stably transfected with the HLA-A locus were used instead of peripheral blood mononuclear cells (PBMC). The reactivity, sensitivity, and stability of transfectants were examined. All 20 antisera to HLA-A identified by LABScreen (R) Single Antigen class I (LS-SA1) were reactive to our modified-ICFA (m-ICFA) and showed the same specificities as those in LS-SA1, indicating the cell surface expression and correct antigenicity of the HLA-A locus in transfectants. The expression of HLA class I antigens was similar between transfectants frozen for 6 years and those prior to freezing. In the reaction of the anti-A24 or anti-A33 antibody vs each transfectant, the index of m-ICFA was higher than that of WAKFlow (R) ICFA. Our m-ICFA also showed that false negative reactions sometimes observed in capture assays may be avoided. By using HLA-A transfectants as ICFA targets, we herein developed m-ICFA. Our m-ICFA may avoid false negative reactions of capture assay like enzyme-linked immunosorbent assay and can also be carried out in almost any laboratory without cell culture facilities.

Automated summary

HLA antibody detection is crucial in clinical settings, and the use of HEK293 cells transfected with the HLA-A locus as targets in a modified-ICFA (m-ICFA) improves reactivity and specificity, showing potential in avoiding false negative reactions. The stability and correct antigenicity of the HLA-A locus in transfectants were demonstrated, with higher reactivity observed compared to conventional methods. The m-ICFA offers a practical and efficient alternative for HLA antibody detection in laboratories without cell culture facilities.