The present investigation was designed to show the effect of molecular HLA class II DR and DQ allelic differences between donor and recipient on humoral antibody rejection identified by C4d peritubular capillary staining. The hypothesis is that expression of the DRβ1*1501, DQβ1*0602 allele in the donor kidney increases the likelihood of humoral antibody rejection. We found that 67 %(n=18) of DR15 and/or DQ6 haplotype donor kidneys induce humoral antibody renal allograft rejection; 35% (n=40) of DR15 and/orDQ6 haplotype donor kidneys failed to induce humoral antibody renal allograft rejection. 41% of C4d+ recipients had donors with DR15; 15% of C4d− recipients had donors with HLA‐DR15. We compared donor haplotype alleles of 4 C4d+ with 6 C4d− recipients by high resolution molecular typing; 3 of 4 C4d+ recipients had a donor with the DRβ1*1501/DQβ1*0602 allele. This allele was absent in all C4d− donors. 35% of C4d+ recipients had 2 DR mismatches when compared to 33% of C4d− recipients. Our results, suggest that the DRβ1*1501, DQβ1*0602 allele in the donor kidney increases the risk of humoral antibody episodes of acute rejection, and signals the need for C4d staining. Future analysis of additional donor and recipient haplotypes will establish whether or not this is a useful predictor of humoral rejection episodes.
The present investigation was designed to show the incidence of molecular Human Leukocytic Antigen (HLA) class I and class II allelic specificities in plasma cell neoplasia patients, identified by immunohistochemistry, flow cytometry, and high resolution molecular typing. Plasma cell myeloma is the second most common hematological malignancy (13%), comprising 1% of all cancers. Each year, 21000 new cases are diagnosed with a two‐fold prevalence in African Americans in contrast to Caucasians. Our hypothesis is that plasma cell neoplasia have a significant disease association with selected HLA class I and class II alleles. We found that in African American patients diagnosed with plasma cell myeloma (n=10), 50 % expressed HLA‐A*7401 (p= 0.002) and 60% were HLA‐C*0401 positive ( p= 0.004). In patients suspected to have plasma cell neoplasia ( controls n=50), 6% were HLA‐A*7401 positive and 14% expressed HLA‐C*0401. Our results suggest that persons expressing these alleles are more likely to develop plasma cell neoplasia than are those not expressing these alleles. African American patients diagnosed with plasma cell myeloma have significant associations with HLA‐A*7401 and HLA‐C*0401 alleles. Future studies will be directed to identification of HLA class II alleles associated with plasma cell neoplasia.
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