| Autor: |
SUCIU-FOCA, NICOLE, REED, ELAINE, D'AGATI, VIVETTE D., HO, ERIC, COHEN, DAVID J., BENVENISTY, ALAN I., MCCABE, ROBERT, BRENSILVER, JEFFREY M., KING, DONALD W., HARDY, MARK A. |
| Zdroj: |
Transplantation; March 1991, Vol. 51 Issue: 3 p593-601, 9p |
| Abstrakt: |
Chronic rejection represents the major threat to long-term survival of organ allografts. It is presumed that this form of rejection is mediated by antibodies against mismatched HLA antigens of the graft. The presence and specificity of anti-HLA-antibodies in posttransplantation sera are, however, difficult to document. We have explored the possibility that anti-HLA antibodies form immune complexes with soluble HLA antigens released from the injured graft and/or that they are blocked by antiidiotypic, anti-anti-HLA-antibodies. Our data demonstrate that the long-term survival of renal allografts is significantly lower in patients who develop anti-HLA-antibodies following transplantation than in patients who do not form antibodies. Following depletion of soluble HLA antigens by magnetic immunoaffinity, we could identify anti-HLA-antibodies in 57 of the sera obtained from patients undergoing chronic rejection of kidney allografts, comared with 41 prior to antigen depletion. In patients tolerating the grafts for 4 years or more, the corresponding frequencies of antibody-positive sear was 2 and 5 prior and following depletion of HLA antigens. The presence of HLA-antibody immune complexes in patients' sear was positively associated with chronic humoral rejection (P < 0.0001). Patients who tolrated the graft in spite of having developed antibodies against one of its mismatched HLA antigens show specific antiidiotypic (anit-anit-HLA-antibodies). Such antiidiotypic antibodies were not found in sear from patients with chronic rejection (P = 0.005). This indicates that anitiidiotypic antibodies may delay the progression of chronic humoral rejection. |
| Databáze: |
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