Epitope analysis for clinical application

Abstract

Recent advances in histocompatibility testing have contributed to improved organ transplantation outcomes: advances in HLA typing technology have enabled nearly complete determination of alleles and imaging of three-dimensional structures based on amino acid sequences of HLA antigens. Furthermore, the fluorescent bead method using Luminex has become the mainstream for HLA antibody testing, and detection of specificity for HLA alleles has been realized. These advances have given rise to the method of epitope analysis. Although HLA allele mismatch was conventionally used in the risk assessment of organ transplantation, many studies in Japan and overseas have reported that more detailed assessment is now possible using epitope analysis. However, epitope analysis is still not routinely performed in clinical practice. The reasons for this include a lack of knowledge about epitopes, the complexity of analysis methods, and a lack of uniformity in methods. However, having a basic knowledge of analysis methods may be of help when there is a doubt about the interpretation of antibody test results. The content of this paper is intended to encourage a routine introduction to epitope analysis. Therefore, the technical content will be limited to a description of only basic knowledge, and will be outlined mainly in the form of case descriptions.