De novo development of circulating anti-endothelial cell antibodies rather than pre-existing antibodies is associated with post-transplant allograft rejection

Sun, Qiannan; Zhang, Cheng; Cheng, Donghui; Chen, Jinsong; Ji, Song; Wen, Jie; Cai, Zheng; Liu, Fei

doi:10.1038/ki.2010.437

Cited by 60 publications

(35 citation statements)

References 38 publications

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“…Non-HLA antibodies, although potentially determinants of outcomes, are outside the scope of this review and will be discussed only briefly. [11][12][13][14] …”

mentioning

confidence: 99%

Utility of HLA Antibody Testing in Kidney Transplantation

Konvalinka¹,

Tinckam

2015

Journal of the American Society of Nephrology

161

135

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HLA antigens are polymorphic proteins expressed on donor kidney allograft endothelium and are critical targets for recipient immune recognition. HLA antibodies are risk factors for acute and chronic rejection and allograft loss. Solid-phase immunoassays for HLA antibody detection represent a major advance in sensitivity and specificity over cell-based methods and are widely used in organ allocation and pretransplant risk assessment. Post-transplant, development of de novo donorspecific HLA antibodies and/or increase in donor-specific antibodies from pretransplant levels are associated with adverse outcomes. Although single antigen bead assays have allowed sensitive detection of recipient HLA antibodies and their specificities, a number of interpretive considerations must be appreciated to understand test results in clinical and research contexts. This review, which is especially relevant for clinicians caring for transplant patients, discusses the technical aspects of single antigen bead assays, emphasizes their quantitative limitations, and explores the utility of HLA antibody testing in identifying and managing important pre-and post-transplant clinical outcomes.

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“…Non-HLA antibodies, although potentially determinants of outcomes, are outside the scope of this review and will be discussed only briefly. [11][12][13][14] …”

mentioning

confidence: 99%

Utility of HLA Antibody Testing in Kidney Transplantation

Konvalinka¹,

Tinckam

2015

Journal of the American Society of Nephrology

161

135

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“…Also, AMR can be caused by non-HLA antibodies. These may include hemagglutinin A or B antibody, anti-MICA, anti-minor histocompatibility antigens (MiHA), antiendothelial antibodies and anti-angiotensin-2 receptor [2] [17] [18]. As our knowledge in transplant immunology advances, there will likely be more alloreactive and autoreactive antibodies to be discovered in the future.…”

Section: Antibody-mediated Rejectionmentioning

confidence: 99%

Clinical Management of Kidney Allograft Dysfunction

Zhang¹

2014

OJOTS

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Allograft dysfunction is a common problem after kidney transplant. Allograft rejection is an important entity, and timely diagnosis and appropriate treatment are essential for caring transplant recipients. Hyperacute rejection is mediated by the preformed donor specific antibody, while accelerated acute rejection represents an anamnestic response by memory B and T cells. They occur early after transplant. Acute cellular rejection is relatively common and usually responds to pulse corticosteroids or antithymocyte globulin (ATG). The complexity of antibody-mediated rejection (AMR) as well as its detrimental effect has been increasingly recognized. The treatment of acute AMR requires a combination of several modalities, such as plasmapheresis or immunoadsorption, IVIG, corticosteroids, rituximab and ATG. After treatment of rejection episode, the maintenance immunosuppressive drugs should be adjusted to prevent further acute rejection and/or evolution into chronic active rejection. Chronic rejection is not reversible and it has been recognized as the most important cause of chronic graft dysfunction and failure.

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“…A single center study demonstrated an association between de novo posttransplant anti-endothelial cell antibodies and recurrent transplant rejection resulting in allograft dysfunction [19]. The specific antigenic target remains to be determined.…”

Section: Antibodies To Non-hla Antigens and Transplant Outcomementioning

confidence: 99%

Immunologic monitoring in transplantation revisited

Cravedi¹,

Heeger

2012

Current Opinion in Organ Transplantation

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Purpose of review Tailoring immunosuppressive drugs to the individual needs is crucial to improve long-term outcomes of organ transplant patients. The purpose of this review is to summarize data on promising biomarkers able to detect the risk of acute or chronic rejection and to discuss the potential issues for their implementation in the clinic. Recent findings Multiple publications indicate that circulating antibodies targeting HLA and non-HLA antigens, as well as donor-specific memory T cells are associated with accelerated graft failure. Other studies published within the year show that specific genomic and proteomic signatures obtained from urine, blood and graft tissue correlate with acute rejection in kidney and heart transplant patients. Summary Developing reliable biomarkers is crucial for individualizing therapy aimed at extending allograft survival and improving patient health. Emerging data indicate that monitoring assays, likely used in panels, have potential to be diagnostic and possibly predictive of long-term outcome. In addition to ongoing discovery efforts, progress in the field will require multicenter validation, assay standardization and commercialization so as to efficiently deliver reliable testing strategies to the practicing clinician.

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De novo development of circulating anti-endothelial cell antibodies rather than pre-existing antibodies is associated with post-transplant allograft rejection

Cited by 60 publications

References 38 publications

Utility of HLA Antibody Testing in Kidney Transplantation

Utility of HLA Antibody Testing in Kidney Transplantation

Clinical Management of Kidney Allograft Dysfunction

Immunologic monitoring in transplantation revisited

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