결론

본 연구 결과 정해진 조건 내에서 특정 농도의 FSL 용액을 이용하여 원하는 항원량을 표현하는 적혈구 kodecyte 를 재현성 있게 제조할 수 있음을 확인하였다. 정도관리 물질로서 실기 워크숍 참가자들에게는 ABO 아형 적혈구에서 관찰되는 3+ 응집 미만의 응집을 보이는 적혈구를 제공하여 효율적인 ABO 아형 판정 실습에 도움을 줄 수 있었고 여러 검사실에 외부정도관리 물질로서 발송하여 ABO 아형의 판정뿐만 아니라 항혈청 시약의 점검도 가능하게 하였다. 결론적으로 제조된 적혈구 kodecyte 는 국내 검사실 질 향상에 큰 도움을 줄 것으로 생각된다.

참고문헌

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– ABSTRACT – prevent potentially fatal consequences and to maintain laboratory confidentiality. So far, both quality control and proficiency testing (PT) of ABO subgrouping have been challenging with specimens from blood donors or volunteers because of antigenic diversity. The purpose of the present study was to explore whether modified blood red cells (RBCs) bearing synthetic analogs of blood group A or B antigens, Funtion–Spacer–Lipid (FSL) structure, can aid in quality control. The antigenicity of the modified RBCs (RBC kodecytes) were measured by hemagglutination assays and flow cytometry, and the storage periods of RBC kodecytes in several media were assessed. The quality control materials were evaluated in both a workshop and an educational trial of external PT. In tube test, RBC kodecytes exhibited agglutination grade of w+ to 4+ by reagent ABO antibodies; the cells were prepared in solution of 0.005 ‒ 0.04 mg/mL synthetic blood group A antigen (FSL–A) or

0.05 ‒ 0.4 mg/mL synthetic blood group B antigen (FSL–B) solutions. Both A and B kodecytes were agglutinated to grade 4+ by anti–H lectin regardless of the concentration of the FSL solution. The A kodecytes did not react with anti–A1 lectin. The kodecyte suspensions showed a stability in solution similar to that of natural RBCs. The workshop allowed all participants to evaluate the phenotypes of cells expressing blood group A to an agglutination grade <3+. The survey materials were composed of suspension of O RBCs and RBC kodecytes expressing weak A (Aw) and weak B (Bw) prepared with 0.02 mg/mL FSL–

A solution and 0.15 mg/mL FSL–B solution. Of the 43 participants responded to the PT trial, 15 (35%) and 29 (67%) laboratories reported the Aw kodecytes as Aw and Bw kodecytes as Bw, repectively. The clonal characteristic of the antisera used affected the reactivities of the the quality control materials and the outcomes of ABO subgrouping. The study confirmed that RBCs expressing low levels of various antigens are able to be constructed using synthetic glycolipid and O RBCs. RBCs with modified antigenicities were confirmed as valuable survey materials. The survey revealed that the availability of the PT materials allowing subgrouping improves the quality of laboratory analyses although the analyses of monoclonal antibody are not sufficient. Surface modified RBCs of varying antigenicities are more useful than donor RBCs in performing quality control and will improve laboratory outcomes.

Keywords: ABO subgroup, Function–Spacer–Lipid, kodecyte, quality control, laboratory proficiency testing