Circulating Immune Complexes after Renal Transplantation

Abstract

A B S T R A C T To assess the role ofcirculating immune complexes in the pathogenesis of acute rejection, sera were measured for such complexes by the 125I-Clq binding assay in 45 normal subjects, 24 allografted patients undergoing acute rejection, and in 11 allografted patients in a quiescent phase. Increased Clqbinding activity (Clq-BA) was detected in 14 patients with acute rejection, 9 of whom had renal biopsies showing fibrin deposition in the vasculature together with cellular infiltrates in the tubulo-interstitial structures; renal histology was not available in the other 5 patients. The other 10 patients with acute rejection, whose biopsies showed only cellular infiltrates, and the 11 patients in a quiescent phase posttransplantation did not have increased levels of serum Clq-BA.Of the group with increased serum Clq-BA, serial studies in eight patients showed a correlation between increased serum Clq-BA and the occurrence of rejection; with reversal by therapy, serum Clq-BA returned to within normal levels. Complexes from six patients were analyzed by sucrose density gradient ultracentrifugation to have sedimentation coefficients ranging from 15S to 18.4S. After acid dissociation and analysis by double-diffusion techniques, Clq-reactive complexes were shown to contain IgG. Immunofluorescent studies done in five renal biopsies from this group revealed granular deposits of immunoThis work has been previously published in abstract form: 1976. Kidney Int. 10: 608. (Abstr.)

Circulating Immune Complexes during Various Forms of Renal Allograft Rejection Episodes

“…A positive relationship between AR and CICs was re ported by Ooi et al [3], Smith et al [4] and Vincent et al [5], whereas our studies [2] and those of others [6][7][8] failed to demonstrate such a relationship. Ooi et al [3] and Smith et al [4] noted that CICs were present in association with a specific type of Immorally mediated rejections character ized by fibrin deposition in the glomeruli.…”

“…Ooi et al [3] and Smith et al [4] noted that CICs were present in association with a specific type of Immorally mediated rejections character ized by fibrin deposition in the glomeruli. These investiga tions did not find CICs in patients with cell-mediated rejec tion.…”

“…Posttrans plant circulating immune complexes (CICs) have been de tected in renal allograft recipients, but the nephritogenic capacity of these CICs is most likely minimal [2,[6][7][8]. Re cent studies [2][3][4][5][6][7][8] in acute allograft rejection (AR); however, a possible immunopathological role for CICs in other types of allograft rejection and/or enhancement -accelerated acute (AAR) and chronic rejection (CR) has not been fully evaluated. We therefore addressed this question by determining CIC levels in 4 pediatric allograft recipients with AAR, 21 pedi atric allograft recipients with CR and additionally evalu ating 16 pediatric allograft recipients with stable long-term allograft function.…”

Circulating Immune Complexes after Cadaver Kidney Transplantation

“…Beside the discussion of the pathogenetic and diagnostic as well as prognostic value of CICs in autoimmune diseases [7][8][9][10][11][12][13][14], malignant tumors [15][16][17][18][19][20][21][22] and infections [23][24][25][26] their role in connection with kidney allotransplantation has recently attracted wider interest. While Palosuoet al [I] and Haskovà et al [2] succeeded in showing CICs after kidney transplantation but did not describe their associa tion with rejection crises, Ooi et al [3] and Simpson et al [27] described the occurrence of increased serum levels of CICs in connection with acute rejection crises. Our studies carried out on 27 patients and including 17 rejection crises showed no verification of these findings whatsoever.…”

“…While in GN patients the positive reactions showed a steady decrease after transplantation, in PN patients we found a decrease only after an immediate postoperative increase. In their recent publication, Ooi et al [3] reported on a significant association between increased values of serum Clq-binding activities (Clq-BA) as determined by a 125I-Clq binding assay and the occurrence of humoral rejection episodes. In contrast to this report, Wegtnüller et al [4] could not observe an association between the presence of CICs and rejection episodes.…”