Renal Endothelial Cytotoxicity Assay to Diagnose and Monitor Renal Transplant Recipients for Anti-Endothelial Antibodies.

Autor:	Lammerts RGM; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.; Transplantation Immunology, Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands., van den Born J; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands., Huberts-Kregel M; Transplantation Immunology, Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands., Gomes-Neto AW; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands., Daha MR; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands., Hepkema BG; Transplantation Immunology, Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands., Sanders JS; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands., Pol RA; Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands., Diepstra A; Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands., Berger SP; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Jazyk:	angličtina
Zdroj:	Frontiers in immunology [Front Immunol] 2022 Jun 06; Vol. 13, pp. 845187. Date of Electronic Publication: 2022 Jun 06 (Print Publication: 2022).
DOI:	10.3389/fimmu.2022.845187
Abstrakt:	Tissue-specific nonhuman leukocyte antigen (HLA) antigens can play crucial roles in allograft immunity and have been shown to trigger humoral responses leading to rejection of HLA-matched kidney allografts. Interest in the role of endothelial-specific antigens has grown over the past years, and several case reports have been described in which antibodies reacting with endothelial cells (ECs) are associated with rejection. Such antibodies escape the detection in conventional crossmatch tests as they do not react with lymphocytes. However, due to the heterogeneity of endothelial cells from different vascular beds, it remains difficult to draw organ-specific conclusions from studies describing endothelial crossmatch assays. We present a case of a 69-year-old male patient whose kidney allograft was rejected as hyperacute, despite the absence of pretransplant HLA-specific antibodies. To place findings from previous studies in a kidney-related context, we performed crossmatch assays with primary renal endothelial cells. The patient's serum was reactive with primary renal ECs, demonstrated by antibody binding and complement-dependent cytotoxicity. Antibodies from this patient did not react with lymphocytes nor were HLA donor-specific antibodies (DSAs) found. Two years later, the patient successfully received a second kidney transplant after treatment with rituximab and plasmapheresis before and after transplantation. We demonstrated that the removal of antibodies against non-HLA EC-specific molecules can be monitored using a primary renal EC crossmatch test, possibly contributing to a successful transplantation outcome. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Lammerts, Born, Huberts-Kregel, Gomes-Neto, Daha, Hepkema, Sanders, Pol, Diepstra and Berger.)
Databáze:	MEDLINE
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