Human Leukocyte Antigen (HLA) testing
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Epidemiology
- seems Hans Chinese & persons of Thai descent at risk for drug hypersensitivity
Pathology
- HLA antigens are the principle mediators involved in transplant rejection[7]
Indications
- determination of transplant compatibility
- assessing risk of an adverse reaction to specific drugs (pharmacogenomics)
- evaluations of disease associations
- use in vaccine trials
- platelet transfusion support
Procedure
- currently, the majority of HLA typing is done by molecular methods using commercially available kits
- probe-based hybridization methods
- massively parallel sequencing
- some laboratories can query single nucleotide variants associated with certain HLA alleles vs directly testing for the allele.
HLA typing for solid organ transplantation
- for deceased donors, molecular typing of class I & II HLA loci (HLA A, B, Bw4, Bw6, C, DR, DR51, DR52, DR53, DQA1, DQB1, & DPB1) must be reported[8]
- for kidney, kidney-pancreas, pancreas, or pancreas islet candidates, molecular typing of a smaller subset of both class I & class II HLA loci (HLA A, B, Bw4, Bw6, & DR) must be reported before registering on the wait list[8]
- a final crossmatch is required before any transplant involving a kidney
- the crossmatch must identify all class I & class II antibodies using donor B-lymphocytes & must identify all class I anti-HLA antibodies using donor T-lymphocytes[8]
- crossmatching is done in specialized histocompatibility laboratories
- methods include complement-dependent cytotoxicity or flow cytometry
Hematopoietic stem cell transplantation
- high-resolution molecular typing of class I HLA loci (HLA A, B, C) & some class II HLA loci (HLA DRB1 & DPB1) is recommended for all individuals either receiving or donating an allogeneic hematopoietic stem cell transplantation[8]
- typing of other class II HLA loci may also be useful
- if umbilical cord blood is used as the source of hematopoietic stem cells, high-resolution molecular typing of all class I HLA loci (HLA A, B, C) & HLA-DRB1 is recommended
- typing of DQB1 & DPB1 may also be useful
Pharmacogenetics
- specific HLA-B alleles associated with drug hypersensitivity reactions
- HLA-B*5701 for abacavir sensitivity[8]
- HLA-B*1502 (HLA-B75) (carbamazepine, phenytoin)*
- HLA-B*5801 (allopurinol)
* susceptibility to Stevens-Johnson syndrome & toxic epidermal necrolysis[6]
Disease associations
- Ankylosing Spondylitis Genotyping (HLA-B27)
- Celiac disease: HLA-DQ2 &/or HLA-DQ8 present in nearly all patients
- Narcolepsy: HLA-DQB1*06:02 genotyping[8]
Notes
- the human leukocyte antigen (HLA) genes are located on a genetic region of the short arm of chromosome 6 known as the major histocompatibility complex[5]
More general terms
More specific terms
- HLA B testing
- HLA-A type
- HLA-A+B type
- HLA-A+B+C type
- HLA-C type
- Human Leukocyte Antigen (HLA) Class I serotyping
- Human Leukocyte Antigen (HLA) Class II serotyping
- human leukocyte antigen (HLA) genotyping
References
- ↑ Prescriber's Letter 15(2): 2008 Labs for HLA (Human Leukocyte Antigen) Testing Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240211&pb=PRL (subscription needed) http://www.prescribersletter.com
Prescriber's Letter 16(1): 2009 Labs for HLA (Human Leukocyte Antigen) Testing Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=250109&pb=PRL (subscription needed) http://www.prescribersletter.com - ↑ Khanna D et al 2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia Arthritis Care & Research, 64(10):1431-1446, October 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23024028 <Internet> http://onlinelibrary.wiley.com/doi/10.1002/acr.21772/abstract
- ↑ Labs that perform HLA testing American Red Cross, Philadelphia, PA (215) 451-4131
Blood Systems Laboratories Histocompatibility Testing Services Tempe, AZ (866) 342-4275 http://www.bloodsystemslaboratories.org
Calgary Laboratory Services-Tissue Typing Laboratory Calgary, Alberta (Canada) (403) 770-3652
City of Hope National Medical Center Histocompatibility Laboratory, Duarte, CA (626) 256-8621
The Histogenetics Laboratory, Inc., Ossining, NY (914) 762-0300 http://www.histogenetics.com
Kashi Clinical Laboratories, Beaverton, OR (888) 732-4018
Laboratory Corporation of America Holdings, Burlington, NC (800) 533-1037 http://www.labcorp.com
METIC Immunogenetics Consultants, Inc., Los Angeles, CA (323) 441-1111 http://www.metic.com
Quest Diagnostics Nichols Institute Chantilly, VA (800) 336-3718 http://www.questdiagnostics.com
Specialty Laboratories, Valencia, CA (800) 421-4449 http://www.specialtylabs.com
The Toronto Hospital Toronto, ON (Canada) (416) 340-4995
Vancouver Acute, Laboratory Reception, Vancouver, BC (Canada) (604) 875-4111 http://www.vch.ca - ↑ 4.0 4.1 Deprecated Reference
- ↑ 5.0 5.1 Moyer AM, Gandhi MJ. Human Leukocyte Antigen (HLA) Testing in Pharmacogenomics. Methods Mol Biol. 2022;2547:21-45. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36068459
- ↑ 6.0 6.1 Karnes JH, Rettie AE, Somogyi AA et al Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C9 and HLA-B Genotypes and Phenytoin Dosing: 2020 Update. Clin Pharmacol Ther. 2021 Feb;109(2):302-309. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32779747 PMCID: PMC7831382 Free PMC article. Review.
- ↑ 7.0 7.1 Kamal S, Kerndt CC, Lappin SL Genetics, Histocompatibility Antigen National Library of Medicine, NCBI Bookshelf: StatPearls https://www.ncbi.nlm.nih.gov/books/NBK541023/
- ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 ARUP Laboratories HLA Testing https://arupconsult.com/content/hla-testing