Non-HLA antibodies in solid organ transplantation

Abstract

Confirmed clinical relevance of non-HLA humoral responses in solid organ transplantation emphasizes the need for revision of classical diagnostic approaches based solely on detection of HLA-donor-specific antibodies (DSA). A better understanding of intersections of HLA- and non-HLA-related mechanisms and identification of common effector mechanisms would represent an important step towards targeted therapies.

Optimizing transplantation of sensitized heart candidates using 4 antibody detection assays to prioritize the assignment of unacceptable antigens

“…33,34 The impact of non-HLA specific antibodies, especially antibodies to angiotensin type 1 receptor, must also be considered. [32][33][34][35][36] We also reported an increased negative impact of antibodies to angiotensin type 1 receptor along with de novo donor HLA specific antibody on heart allograft outcome. 37 There is increasing evidence that antibodies to HLA and non-HLA work in concert toward an increased negative impact on graft dysfunction.…”

Non-HLA Antibodies: Angiotensin II Type 1 Receptor (Anti-AT1R) and Endothelin-1 Type A Receptor (Anti-ETAR) Are Associated With Renal Allograft Injury and Graft Loss

“…The AT1 receptor is one of the most successful cardiovascular targets of new drug therapies. Plasmapheresis or immunoadsorption are known and used in the reduction of antibodies titers [1].…”

“…Several antigenic targets, including 2 G-proteinecoupled receptors (angiotensin type 1 receptor and endothelin type A receptor), are of considerable clinical significance [1]. Angiotensin type 1 receptor mediates many physiological and pathophysiological actions of the angiotensin II [3].…”

Desensitization for solid organ and hematopoietic stem cell transplantation

“…In the last 10 years, there has been a growing recognition of the importance in transplantation of antibodies to antigens other than HLA and ABO (reviewed in 131,132). However, little information is available on the effect of desensitization on these antibodies.…”