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Test Code DIS Human Leukocyte Antigens (HLA) Class I and II Disease Association Typing, Low Resolution, Blood


Ordering Guidance


This test should be ordered if both human leukocyte antigen (HLA) Class I and Class II results are wanted for disease association.

 

If only needing patient's HLA Class I typing for disease association, order 1DIS / Human Leukocyte Antigens (HLA)-A-B-C Disease Association Typing Low Resolution, Blood.

 

If only needing patient's HLA Class II typing for disease association, order 2DIS / Human Leukocyte Antigens (HLA)-DR-DQ Disease Association Typing Low Resolution, Blood.



Specimen Required


Container/Tube: Yellow top (ACD solution A or B)

Specimen Volume: 6 mL

Collection Instructions: Send whole blood in original tube. Do not aliquot.

Additional Information: Specimen acceptability is based on extracted DNA concentration and not sample age.


Useful For

Identifying class I and II human leukocyte antigens (HLA) for potential disease associations or markers for drug hypersensitivity

Profile Information

Test ID Reporting Name Available Separately Always Performed
1DIS HLA-A-B-C DisAssoc Typing LowRes,B Yes Yes
2DIS HLA-DR-DQ DisAssoc Typing LowRes,B Yes Yes

Method Name

Polymerase Chain Reaction (PCR)/Next-Generation Sequencing (NGS)

Reporting Name

HLA CI-CII DisAssoc Typing LowRes,B

Specimen Type

Whole Blood ACD

Specimen Minimum Volume

3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood ACD Ambient (preferred)
  Refrigerated 

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Human leukocyte antigens (HLA) class I and II genes (A, B, C, DRB1, DRB3/4/5, DQB1, DQA1, DPB1, DPA1) are a part of the major histocompatibility gene complex that encodes for proteins involved in immune recognition and are regulators of the immune response.

 

This assay is designed to provide low-to-medium resolution typing. Low-to-medium resolution defines the typing at first field (antigen or allele group level). This is in contrast to high-resolution typing, which defines typing at second field or higher (allele level).

Reference Values

Not applicable

Interpretation

Interpretation depends on the rationale for ordering the test.

Cautions

No significant cautionary statements

Clinical Reference

1. Terasaki PI, Bernoco D, Park MS, Ozturk G, Iwaki Y. Microdroplet testing for HLA-A, -B, -C, and -D antigens. The Phillip Levine Award Lecture. Am J Clin Pathol. 1978;69(2):103-120

2. Colinas RJ, Bellisario R, Pass KA. Multiplexed genotyping of beta-globin variants from PCR-amplified newborn blood spot DNA by hybridization with allele-specific oligodeoxynucleotides coupled to an array of fluorescent microspheres. Clin Chem. 2000;46(7):996-998

3. Kennedy AE, Ozbek U, Dorak MT. What has GWAS done for HLA and disease associations? Int J Immunogenet. 2017;44(5):195-211. doi:10.1111/iji.12332

4. Caillat-Zucman S. New insights into the understanding of MHC associations with immune-mediated disorders. HLA. 2017;89(1):3-13. doi: 10.1111/tan.12947

5. Howell WM. HLA and disease: guilt by association. Int J Immunogenet. 2014;41(1):1-12. doi:10.1111/iji.12088

6. Profaizer T, Pole A, Monds C, Delgado JC, Lazar-Molnar E. Clinical utility of next generation sequencing based HLA typing for disease association and pharmacogenetic testing. Hum Immunol. 2020;81(7):354-360

Method Description

Next-generation sequencing is used to type for Class I alleles (A, B, and C) and Class II alleles (DRB1, DRB3/4/5, DQB1, DQA1, DPB1, and DPA1) from genomic DNA. This method uses strictly controlled polymerase chain reaction (PCR) conditions for DNA amplification. The PCR amplicons are processed and sequenced via the Illumina MiSeq instrument. The output files are analyzed in provided software, which compares the data against the IMGT/HLA database to assign the molecular typing.(Package inserts: Holotype HLA Kit. Omixon; v3.0.1, 08/16/2019; NGSgo HLA Kit. GenDx; v2, 02/2021)

 

For resolution of an allelic ambiguity or in select cases, the following additional methodologies may be utilized:

-Sequence-based typing (SBT) by Sanger sequencing(Package insert: SeCore Sequencing and GSSP Kits. One Lambda, Inc; Rev 3, 02/06/2021)

-SBT by sequence-specific primers (SSP)(Package insert: Olerup SSP HLA typing kits including Taq Polymerase. CareDx; Rev 04, 12/2020)

-Reverse sequence-specific oligonucleotides (SSO)(Package insert: LABType SSO Typing Test. One Lambda, Inc.; Rev 04, 11/11/2019)

Day(s) Performed

Monday, Thursday

Report Available

7 to 17 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

81370

81376 x3

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DIS HLA CI-CII DisAssoc Typing LowRes,B 98005-2

 

Result ID Test Result Name Result LOINC Value
1DA02 ABC DisAssoc Comment 96625-9
2DA02 DRDQ DisAssoc Comment 96625-9
2DA03 DRB1 - 1 Equivalent 57298-2
1DA03 A - 1 Equivalent 13298-5
1DA04 A - 2 Equivalent 13298-5
2DA04 DRB1 - 2 Equivalent 57298-2
2DA05 DRB1 - 1 Molecular 96664-8
1DA05 A - 1 Molecular 78014-8
1DA06 A - 2 Molecular 78014-8
2DA06 DRB1 - 2 Molecular 96664-8
2DA07 DRB345 - 1 Equivalent 96673-9
1DA07 B - 1 Equivalent 13299-3
1DA08 B - 2 Equivalent 13299-3
2DA08 DRB345 - 2 Equivalent 96673-9
2DA09 DRB345 - 1 Molecular 96672-1
1DA09 B - 1 Molecular 78015-5
1DA10 B - 2 Molecular 78015-5
2DA10 DRB345 - 2 Molecular 96672-1
2DA11 DQB1 - 1 Equivalent 53938-7
1DA11 Bw - 1 Equivalent 96633-3
1DA12 Bw - 2 Equivalent 96633-3
2DA12 DQB1 - 2 Equivalent 53938-7
2DA13 DQB1 - 1 Molecular 78017-1
1DA13 C - 1 Equivalent 13302-5
1DA14 C - 2 Equivalent 13302-5
2DA14 DQB1 - 2 Molecular 78017-1
2DA15 DQA1 - 1 Molecular 96654-9
1DA15 C - 1 Molecular 96636-6
1DA16 C - 2 Molecular 96636-6
2DA16 DQA1 - 2 Molecular 96654-9
2DA17 DPB1 - 1 Molecular 96648-1
LRTM1 Test Method 85069-3
2DA18 DPB1 - 2 Molecular 96648-1
2DA19 DPA1 - 1 Molecular 96643-2
2DA20 DPA1 - 2 Molecular 96643-2
LRTM2 Test Method 85069-3

NY State Approved

Yes