Increased Late Graft Loss in Kidney Recipients With Serum Sickness Disease Following Anti-Thymocyte Globulin Induction: Relation With an Anti-Neu5Gc Response

Autor: Salama, A., Couvrat-Desvergnes, G., Lorent, M., Evanno, G., Le Berre, L., Hruba, P., Pavel Vesely, Guerif, P., Nicot, A., Bach, J. M., Foucher, Y., Brouard, S., Castagnet, S., Viklicky, O., Giral, M., Harb, J., Jean-Paul, S.
Přispěvatelé: Société d'Accélération du Transfert de Technologies (SATT OUEST VALORISATION), Université de Nantes (UN), Biostatistique, Recherche Clinique et Mesures Subjectives en Santé, Institute for Clinical and Experimental Medicine (IKEM), Brno University of Technology [Brno] (BUT), Immuno-Endocrinologie Cellulaire et Moléculaire (IECM), Ecole Nationale Vétérinaire de Nantes-Université de Nantes (UN)-Institut National de la Recherche Agronomique (INRA), Etablissement Français du Sang, Transplant Center, American Society of Transplantation (AST). USA. American Society of Transplant Surgeons (ASTS).
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: American Journal of Transplantation
American Transplant Congress 2015
American Transplant Congress 2015, American Society of Transplantation (AST). USA. American Society of Transplant Surgeons (ASTS)., May 2015, Philadelphie, United States. pp.1
ResearcherID
Popis: International audience; Anti-thymocyte globulins (ATG) are rabbit IgGs against human T cells widely used as induction treatment of kidney recipients. ATG can induce immune-complex diseases including Serum Sickness Diseases (SSD). Rabbit and human IgGs differ in the expression of the sialic acid Neu5Gc, and humans exhibit preexisting and produce elicited anti-Neu5Gc antibodies. We assessed here the role of SSD on long-term allograft outcome in a cohort of 889 first kidney graft recipients with ATG induction, grafted between 1985 and 1998 (n=86 with overt SSD and n=803 without SSD), and analyzed the immunization status of a subgroup of this population against some xeno-antigens. We show that SSD is associated with the risk of graft failure (death-censored, HR=1.72, p=0.022). Total anti-ATG, anti-Gal and anti-Neu5Gc IgG levels were analyzed in a case-control subgroup constituted of 14 SSD+ versus 42 SSD- patients matched for 5 variables (recipients age, date of graft, PRA class I/II positivity, HLA mismatches). No significant differences were found in preexisting antibodies of any type. SSD+ patients exhibited elevated titers of anti-ATG (p=0.001) and anti-Neu5Gc (p=0.054) between pre-graft and late post-graft samples. Anti-Neu5Gc IgGs were increased in late post-graft sera of SSD+ patients when compared to SSD- patients (p=0.020). Anti-Gal antibodies were not informative. Finally, late graft survival was associated with high anti-Neu5Gc IgG levels in late post-graft samples, independently of SSD status (p=0.025). In conclusion, we demonstrated that ATG-induced SSD is an independent risk factor of graft failure, and suggested that anti-Neu5Gc antibodies could have a role in allograft outcome following SSD.
Databáze: OpenAIRE
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