Evaluation of the level of alloantibodies and selected cytokines in kidney recipients

Abstract

Introduction and Objective. Anti-HLA antibodies, especially anti-DSA, are believed to be potentially involved in acute and chronic rejection. New techniques, e.g. flow fluorimetry, can be an excellent supplement to the lymphocytotoxic tests currently used in pre-transplantation practice, and become a tool for monitoring post-transplant immunisation. The aim of the study was to assess the level of cytokines and alloimmunisation in kidney recipients, with the histopathological evaluation of the transplanted kidney biopsy. Materials and method. The study included 62 graft recipients six months after transplant. The level of anti-HLA antibodies was assessed using the x-Map Luminex technique, and the level of cytokines (IFN-γ, IL-4, IL-10, IL-17) was determined using the ELISA test. Results. Histopathological analysis showed that more than 45.2% of patients had changes in the biopsy material. Analysis of the level of alloimmunisation showed that in over 75.8%, the presence was detected of anti-HLA IgM class I antibodies, while anti-HLA IgM class II antibodies were found less often -17.8%. The level of anti-HLA IgG antibodies, depending on the type of the assessed class, respectively, was: class I -43.5% and class II -50%. More than half of the subjects also had anti-MICA antibodies. The level of analysed cytokines was low. Conclusions. The results indicate significant alloimmunisation of kidney recipients, although they do not answer the question whether these are antibodies that appeared de novo after transplantation, and whether anti-DSA antibodies were present among them. For this purpose, the diagnostics should be expanded to include anti-HLA monitoring in the pre-and post-transplant period, using screening tests and tests to identify their specificity. The protocol biopsy and examination of level cytokine can also be a helpful tool in post-transplant diagnosis.