• 대한임상검사과학회지
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• 제48권1호
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• pp.36-40
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• 2016

적혈구 동종면역은 수혈자와 공여자간의 적혈구 항원의 차이이다. 수혈을 위해서는 혈구형과 혈청형이 일치하지 않으면 적혈구 항체 선별 검사가 필요하며 불일치의 원인을 해명하는 것이 필수적이다. 적혈구 항체 선별검사는 임상적으로 유의한 항체를 검출하고, 신속 정확하며, 신뢰할 수 있는 방법으로 수혈에 앞서 우선적으로 하는 것을 권장한다. 본 연구자들은 다빈도로 검출된 E, D, M, E+c, C+e 항체에 대한 선별검사를 보고하였다. 따라서 이러한 결과로 항-D, 항-E의 항체가 신생아 용혈성 질환, 지연형 용혈성 수혈부작용 반응의 위험요인으로 인식하고자 한다. 또한 혈액안전관리를 적용하기 위해 적합한 항체선별검사가 요구되고, 수혈 위험요인의 선별에 있어 더 나은 효율성을 제공할 것이며 향후에 각 국가에 따라 실질적인 검출빈도를 찾는 연구가 필요할 것으로 사료된다.

• 대한임상검사과학회지
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• 제45권4호
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• pp.164-169
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• 2013

Red cell alloantibodies other than naturally occurring anti-A or anti-B are called unexpected red cell antibodies, and can be detected by performing an antibody screening. The frequency and distribution of unexpected antibody identified in Asan Medical Center were analyzed. We investigated a total of 135,238 cases of antibody screening test in AMC for 3 years from 2010 to 2012. Using column agglutination techniques, antibody identification tests were performed for the cases with positive antibody screening. Among 135,238 cases, 854 (0.6%) cases showed positive results of antibody screening test. In the order of frequency, 284 (33.3%) anti-Rh, 89 (10.4%) anti-MNS, 62 (7.3%) anti-Lewis, 34 (4.0%) anti-Kidd, 10 (1.2%) anti-Duffy, and 9 (1.1%) anti-P were identified. Multiple antibodies were detected in 199 (23.3%) cases. Among 381 subjects investigated for transfusion history, 299 (78.5%) had history of transfusion while 82 (21.5%) had unknown history. Thus the incidence of unexpected antibody was higher in the group with history of transfusion than the group without (p<0.001). Also, among 435 subjects investigated for the history of pregnancy, 46 (10.6%) had no history while 389 (89.4%) had history of pregnancy, showing higher incidence of unexpected antibody in the group with history of pregnancy than the group without pregnancy (p<0.001). Evaluated amounts and frequency of antigen exposure due to transfusion and pregnancy is suggested to increase the frequency of identification of unexpected antibody.

• 대한의생명과학회지
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• 제12권1호
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• pp.35-42
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• 2006

Alloimmunization to red blood cell (RBC) antigens may cause a delayed hemolytic transfusion reactions (DHTR) and a delayed serologic transfusion reactions (DSTR). In the present study, the frequency of alloimmunization and its clinical significance were evaluated. Also, transfusions were correlated with antibody formation. Alloimmunization rate was 0.63%. Alloimmunization rate in multiple transfused patients was 24.5%. The most common clinically significant alloantibodies of alloimmunized patients were found to be Rh antibodies (52.6%). Nine patients out of 38 (23.7%) became undetectable after the first detection. To be positive at antibody screening test after RBC transfusion was mean transfused numbers: 3.7 units, mean transfused periods: 56 days, mean transfused frequencies: 1.7 times. The results from antibody specificity and RBC transfusions were comparatively analyzed and it shows that Rh system antibodies were longer than other antibodies (P<0.05). In case of disease group, malignant diseases was longer than other diseases (P<0.05). In order to prevent the formation of RBC alloimmunization, irregular antibody screening tests were performed at propriety intervals in multiple transfused patients.

• Biotechnology and Bioprocess Engineering:BBE
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• 제7권3호
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• pp.150-154
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• 2002

Monoclonal antibodies (Mabs) have been used as diagnostic and analytical reagents since hybridoma technology was invented in 1975. In recent years, antibodies have become increasingly accepted as therapeutics for human diseases, particularly for cancer, viral infection and autoimmune disorders. An indication of the emerging significance of antibody-based therapeutics is that over a third of the proteins currently undergoing clinical trials in the United States are antibodies. Until the late 1980's, antibody technology relied primarily on animal immunization and the expression of engineered antibodies. However, the development of methods for the expression of antibody fragments in bacteria and powerful techniques for screening combinatorial libraries, together with the accumulating structure-function data base of antibodies, have opened unlimited opportunities for the engineering of antibodies with tailor-made properties for specific applications. Antibodies of low immunogenicity, suitable for human therapy and in vivo diagnosis, can now be developed with relative ease. Here, antibody structure-function and antibody engineering technologies are described.

• BMB Reports
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• 제38권3호
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• pp.290-293
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• 2005

In order to investigate the epitope of basic fibroblast growth factor (bFGF) and its immunogenicity, the epitopes of bFGF were screened from the phage display library with monoclonal antibody GF22, which can neutralize the bio-activity of bFGF. By three rounds of screening, the positive phage clones with bFGF epitopes were selected, which can effectively block the bFGF to bind with GF22. Sequence analysis showed that the epitopes shared a highly conservative sequence (Leu-Pro-Pro/Leu-Gly-His-Phe/Ile-Lys). The sequence of PPGHFK was located at 22-27 of the bFGF. The specific immuno-response of mouse could be highly induced by phage clones with the epitopes. And the anti-bFGF activity induced by LPGHFK was 3 times higher than the original sequence, which showed that the mimetic peptide LPLGHIK might be used as a tumor vaccine in the prevention and treatment of tumor.

• 대한임상검사과학회지
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• 제42권2호
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• pp.63-70
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• 2010

Antibody screening and identification tests before blood transfusion are important because unexpected red antibodies can cause acute or delayed hemolytic transfusion reactions. Although a tube method was used for detecting unexpected antibodies, a column agglutination method has recently been used because of its simple procedure and a high detection of warm antibodies. This study investigated the frequency and distribution of unexpected antibodies in transfusion candidates during the recent 5 years, and transfusion characteristics in the identified cases. From January 2005 to December 2009, 46,923 sera of the cases from E hospital were screened and 98 sera were identified by the DiaMed-ID System. 272 cases (0.58%) showed positive results out of all 46,923 cases that underwent unexpected antibodies screening. Among them, unexpected antibodies were identified in 98 cases. The anti-Rh antibodies included in warm antibodies were the most frequently detected in 47 cases (47.96%). Anti-Lewis and anti-MNSs antibodies were detected in 11 cases (11.22%) and 6 cases (6.12%), respectively. Unidentified antibodies were detected in 6 cases (6.12%). Among the patients with unexpected antibodies, 43 cases (43.88%) had a history of previous transfusion. Anti-E was the most frequently detected antibody (4/14 cases, 30.77%) in the cases who had a previous history of transfusion and showed different screening results from negative to positive, This study may provide the basic data for the frequency and characteristics of red cell antibodies.

• 대한수혈학회지
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• 제23권2호
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• pp.127-135
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• 2012

배경: 대부분의 임상검사가 자동화되는 추세이나 혈액은행 검사는 여전히 수작업에 의존하고 있다. 여러 자동화장비가 개발되어 활용되고 있으며 최근 면역혈액검사를 위한 자동화장비인 IH-1000 (Bio-Rad Laboratories, Hercules, CA, USA)이 소개되었다. 이번 연구에서는 IH-1000 장비의 ABO 및 Rh 혈액형 검사와 비예기항체 선별검사에 대한 성능을 평가하려고 한다. 방법: 2011년 10월에 의뢰된 373건의 ABO 및 RhD 혈액형 검사와 303건의 비예기항체 선별검사를 대상으로 하였다. ABO 및 RhD 혈액형 검사는 슬라이드법과 시험관법을 사용하였고 비예기항체검사는 미세원주응집법(DiaMed-ID system)을 사용하여 IH-1000의 결과와 비교하였다. 결과: ABO 및 RhD 혈액형 검사에서는 두 방법 간 100%의 높은 일치율을 보였고 비예기항체 선별검사에서는 두 방법에서 모두 양성을 보인 검체가 10건(anti-E+c 4건, anti-E 3건, anti-D 1건, anti-M 1건, anti-Xg 1건)이었고 모두 음성을 보인 검체는 289건으로 98.7%의 일치율을 보였다. IH-1000의 민감도 및 특이도는 각각 90.9%였다. 결론: IH-1000은 기존에 사용하던 수기법과 비교하여 ABO 및 Rh 혈액형 검사와 비예기항체 선별검사에서 높은 일치도를 보였다. 따라서 혈액은행에서의 수혈 전 일상검사에 자동화 장비인 IH-1000을 사용할 수 있을 것으로 생각된다.

• 보험의학회지
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• 제12권
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• pp.50-55
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• 1993

1) 생명보험(生命保險)에서의 Screening은 사정조건(査定條件)이며 충분(充分)한 기능(機能)을 갖인 기구(器具)이다. 2) Screening 기술(技術)은 의학적(醫學的)으로 충분(充分)히 명시(明示)되여 있으며 장래(將來)에도 일반적(一般的)인 임상적(臨床的)인 Rule에 따라야 한다. 3) Screening Parameter는 연령(年齡)이나 Risk-Group에 의(依)한 질병(疾病)의 Pattern에 따라야 한다. 4) Screening Parameter에서의 예후(豫後)의 추론(推論)은 임상의학적관찰(臨床醫學的觀察)과 Rule를 모두 고처(考處)하는 한(限)에서는 합법적(合法的)이다. 5) 민감(敏感)한 성격(性格)의 Screening 기술(技術)은 일관성(一貫性)있게 취급(取扱)하기 의(依)해서는 대단(大端)히 특별(特別)한 Rule를 필요(必要)로 한다. 6) HIV-항체시험(抗體試驗)과 같은 Screening-Parameter는 그들의 새로운 시험범위내(試驗範圍內)에서는 계속적(繼續的)인 과학적(科學的) Feedback를 필요(必要)로 한다. 7) 유전의학적시험(遺傳醫學的試驗은 생명보험(生命保險) Screening에서는 아직 사용(使用)하고 있지 않지만 생명보험의학(生命保險醫學)에서는 장래(將來)의 역할(役割)과 가능성(可能性)에 대(對)해서 검토(檢討)해야 될 것이다. 8) 보험업계(保險業界)의 Screening은 가능한(可能限) 역선택(逆選擇)을 배제(排除)하고 보험청약자(保險請約者)나 보험자(保險者)의 쌍방(雙方)에서 평균여명(平均餘命)을 짧게하는 어떠한 결함(缺陷)에도 같은 지식(知識)으로 대비(對備)해야 한다. 9) Screening에서의 Informed Consent, Counselling과 Confidentiality는 현재나 더욱 발전된 장래에서도 알맞게 취급하지 않으면 않된다.

• 대한임상검사과학회지
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• 제49권4호
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• pp.390-394
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• 2017

비예기항체(unexpected antibody)는 ABO 혈액형 항체와는 달리 존재 여부를 미리 예측할 수 없는 항체로 주로 임신이나 수혈 등에 의해 다른 적혈구 항원에 노출됨으로써 발생하는 면역항체로서, 비예기항체는 해당 항원을 가진 수혈된 적혈구를 파괴하여 급성 및 지연성 용혈성부작용이나 신생아용혈성질환 등의 수혈부작용을 유발할 수 있다. 2014년 1월부터 2016년 12월까지 3년간 제주특별자치도 종합병원에 비예기항체 선별검사가 의뢰된 10,360명의 혈청 검체를 대상으로 하였으며, 의뢰된 비예기항체 선별결과 양성 결과를 보인 87 검체를 대상으로 조사하였다. 비예기항체가 선별되었던 87건 중 비예기항체 동정검사를 수탁검사기관으로 의뢰한 41 검체(0.40%) 대상으로 분석한 결과 비특이항체가 8건(19.51%), 자가항체가 3건(7.32%)이었다. 이들을 제외하고 항체가 동정된 것은 anti-E가 8건(19.51%), anti-E, anti-c 복합항체가 6건(14.63%), $anti-Le^a$, $anti-Le^b$ 복합항체가 3건(7.32%), $anti-Le^a$와 $anti-Le^b$가 각각 2건(4.88%)으로 조사되었다. 단일항체로는 anti-D, $anti-Di^a$, $anti-Fy^b$, $anti-Jk^a$, $anti-Jk^b$, anti-M, anti-P1이 각각 1건(2.44%)로 나타났으며 복합항체로는 anti-C+anti-D, anti-E+anti-c+$anti-Jk^b$가 각각 1건(2.44%)로 조사되었다. 단일항체가 동정된 검체는 19건(46.34%), 복합항체가 동정된 검체는 11건(26.83%)로 나타났다. 제주지역의 종합병원은 제주시와 서귀포시에 위치한 종합병원 7개 기관이 있으며, 모두 비예기항체 선별검사를 시행하고 있으며, 검사방법으로는 모든 검사실에서 Ortho BioVue system을 이용한 원주응집법으로 검사를 시행하고 있다. 하지만 비예기항체 동정검사는 외부수탁기관에 의뢰하고 있는 실정이다. 이번 연구는 최근 3년간 제주도내 종합병원 1개 기관에서의 동정된 비예기항체 빈도와 분포를 분석하였지만, 점차적으로 제주도내 다문화가정과 외국인 근로자가 증가 추세에 있어 향후 제주지역에 분포한 다수의 종합병원에서 동정되는 비예기항체의 빈도와 분포를 비교 분석한다면 의미가 있는 연구가 될 것이라고 사료된다.

• Journal of Microbiology and Biotechnology
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• 제24권3호
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• pp.408-420
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• 2014

Yeast surface-displayed antibody libraries provide an efficient and quantitative screening resource for given antigens, but suffer from typically modest library sizes owing to low yeast transformation efficiency. Yeast mating is an attractive method for overcoming the limit of yeast transformation to construct a large, combinatorial antibody library, but the optimal conditions have not been reported. Here, we report a large synthetic human Fab (antigen binding fragment) yeast surface-displayed library generated by stepwise optimization of yeast mating conditions. We first constructed HC (heavy chain) and LC (light chain) libraries, where all of the six CDRs (complementarity-determining regions) of the variable domains were diversified mimicking the human germline antibody repertoires by degenerate codons, onto single frameworks of VH3-23 and $V{\kappa}1$-16 germline sequences, in two haploid cells of opposite mating types. Yeast mating conditions were optimized in the order of cell density, media pH, and cell growth phase, yielding a mating efficiency of ~58% between the two haploid cells carrying HC and LC libraries. We constructed two combinatorial Fab libraries with CDR-H3 of 9 or 11 residues in length with colony diversities of more than $10^9$ by one round of yeast mating between the two haploid HC and LC libraries, with modest diversity sizes of ${\sim}10^7$. The synthetic human Fab yeast-displayed libraries exhibited relative amino acid compositions in each position of the six CDRs that were very similar to those of the designed repertoires, suggesting that they are a promising source for human Fab antibody screening.