We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Preformed circulating HLA-specific memory B cells predict high risk of humoral rejection in kidney transplantation.
- Authors
Lúcia, Marc; Luque, Sergi; Crespo, Elena; Melilli, Edoardo; Cruzado, Josep M; Martorell, Jaume; Jarque, Marta; Gil-Vernet, Salvador; Manonelles, Anna; Grinyó, Josep M; Bestard, Oriol; Lúcia, Marc; Grinyó, Josep M
- Abstract
The accurate evaluation of donor-specific antibodies (DSAs) has allowed a precise identification of sensitized patients at risk of antibody-mediated rejection (ABMR). However, the scale of the humoral response is not always fully addressed, as it excludes the complete memory B-cell (mBC) pool such as that caused by antigen-specific mBC. Using a novel B-cell ELISpot assay approach, we assessed circulating mBC frequencies against class I and II HLA antigens in highly sensitized and nonsensitized patients in the waiting list for kidney transplantation. Also, kidney transplant patients undergoing ABMR were evaluated for the presence of donor-specific mBCs both at the time of rejection and before transplantation. For this purpose, 278 target HLA-sp antigens from 70 patients were studied and compared to circulating HLA-sp antibodies. Both class I and II HLA-sp mBC frequencies were identified in highly sensitized individuals but not in nonsensitized and healthy individuals, many years after first sensitization. Also, high donor-specific mBC responses were clearly found both during ABMR and before transplantation, regardless of circulating DSA. The higher the donor-specific mBC response, the more aggressive the allograft rejection. Thus, assessing donor-specific mBC frequencies may be relevant to better refine patient alloimmune-risk stratification, and provides new insight into the mechanisms of the adaptive humoral alloimmune response taking place in kidney transplantation.
- Subjects
GRAFT rejection; IMMUNOGLOBULINS; HLA-B27 antigen; PREDICTIVE tests; HOMOGRAFTS; TIME; KIDNEY transplantation; CASE-control method; HISTOCOMPATIBILITY testing; HISTOCOMPATIBILITY; ANTIBODY formation; TREATMENT effectiveness; RISK assessment; IMMUNITY
- Publication
Kidney International, 2015, Vol 88, Issue 4, p874
- ISSN
0085-2538
- Publication type
journal article
- DOI
10.1038/ki.2015.205