B-cell activating factor BAFF reflects patients' immunological risk profile after kidney transplantation
| Autor: | B. Banas, Daniel Zecher, Tobias Bergler, Louisa Kühne, Bettina Jung, J Hofbauer, Antonia Schuster |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Graft Rejection Male Risk 0301 basic medicine Immunology Drug Resistance Context (language use) 030230 surgery Isoantibodies 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine B-Cell Activating Factor Humans Immunology and Allergy Medicine B-cell activating factor Kidney transplantation Aged B-Lymphocytes Transplantation Creatinine biology business.industry Graft Survival Antibody-Dependent Cell Cytotoxicity Cell Differentiation Confounding Factors Epidemiologic Middle Aged medicine.disease Kidney Transplantation stomatognathic diseases 030104 developmental biology chemistry Virus Diseases Concomitant Antibody Formation biology.protein Female Immunization Steroids Antibody Transcriptome business Follow-Up Studies |
| Zdroj: | Transplant Immunology. 45:35-41 |
| ISSN: | 0966-3274 |
| Popis: | The B-cell activating factor BAFF plays an important role in the development and maturation of B-lymphocytes, which can contribute to the generation of donor-specific antibodies and thus may influence graft function and graft survival. Inconsistent data on the role of BAFF levels after renal transplantation for the formation of donor-specific antibodies and the contribution for allograft rejection exist. The aim of the current study was to determine to what extent the degree of pre-immunization is reflected by each patient's BAFF levels before transplantation and in the follow-up. Furthermore, the impact of BAFF on allograft rejection frequency as well as severity and resulting allograft function over time was analyzed. Additionally, the impact of viral infections on BAFF levels after transplantation - as a potential confounder - was examined. For this purpose, a group of pre-sensitized patients (PRA>0%, (52±24% on average), n=40) was compared with non-sensitized patients (PRA=0%, n=62) and in a subsequent analysis stratification in accordance to the detected BAFF level was performed. Pre-sensitized patients had significantly higher BAFF levels before transplantation and suffered significantly more often from early steroid-resistant, mainly antibody-mediated rejections. A result which was confirmed also in highly sensitized patients with PRA levels >50%. Additionally, in the follow-up patients with either rising BAFF levels over time or BAFF levels above the median also had significantly more often antibody mediated rejections. Additionally, patients with BAFF levels above detected median even displayed impaired creatinine values as well as an induced eGFR slope up to month 48 after transplantation. The occurrence of viral infections (CMV, BKV) was only an additional influencing factor in the absence of concomitant allograft rejections. Therefore, the B-cell proliferation factor BAFF appears not only to reflect the immunological risk profile of patients in the context of kidney transplantation, it may possibly be further developed as a predictor of patients with an increased risk profile for subsequent allograft rejection and impaired allograft function. |
| Databáze: | OpenAIRE |
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