http://www.cnr.it/ontology/cnr/individuo/prodotto/ID192368
HLA-DPA1 and -DPB1 Antibodies in Kidney Transplantation (Abstract/Poster in rivista)
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- HLA-DPA1 and -DPB1 Antibodies in Kidney Transplantation (Abstract/Poster in rivista) (literal)
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- 2012-01-01T00:00:00+01:00 (literal)
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Piazza A.1,2, Ozzella G.1,2, Poggi E.1,2, Manfreda A.R.2, Palombi C.2, Adorno D.1,2,3 (2012)
HLA-DPA1 and -DPB1 Antibodies in Kidney Transplantation
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- 1National Council of Researches, IFT Unit of Rome S. Camillo Hospital, Rome, Italy,
2Regional Transplant Center of Lazio., Rome, Italy,
3Tor Vergata University, Rome, Italy (literal)
- Titolo
- HLA-DPA1 and -DPB1 Antibodies in Kidney Transplantation (literal)
- Abstract
- Introduction: All preformed HLA antibodies have a deleterious impact on kidney graft outcome. Moreover, HLA sensitization
often shows in broad antibody patterns since antibodies bind to epitope/s of HLA molecules and these target epitopes can be
shared between several molecules intra- and inter-HLA loci.Current HLA class II matching strategies for kidney transplantation
only consider the DR antigens; DQ matching is sometimes considered for organ sharing program. But both ? and ? chains of
DP molecules are polymorphic and can elicit a humoral immune response. DP molecules have generally low expression but
are upregulated upon inflammation that may occur during transplantation. Detection of anti-DP antibodies have been difficult
using complement-dependent citotoxicity but newer assays for antibody analysis, such as Luminex-Single Antigen beads (One
Lambda, CA), greatly enhanced detection of anti-DP antibodies and allowed to distinguish between anti-DPB1 and -DPA1.
Methods: We investigated the incidence of anti-DP alloantibodies in 248 renal transplant candidates showing production of
HLA class II antibodies. Antibody characterization was performed using Luminex Single Antigen beads that contain 26
microbeads coated with DPA1/DPB1 heterodimers (4 DPA1 alleles and 19 DPB1 alleles variously combined each other).Using
an online database (www.ebi.ac.uk/imgt/hla), we also analyzed the amino acid sequences of DPA1/DPB1 molecules
corresponding to the detected antibodies to identify the putative epitopes for antibody formation. All the anti-DP positive
patients had been typed for DPB1/DPA1 alleles by SSP methods.
Results: Ninety-two (37%) of the HLA class II positive patients showed production of anti-DP antibodies; 71% of these
patients had anti-DPB1, 2% had anti-DPA1 and the remaining 27% of patients had both anti-DPA1 and-DPB1.As for
sensitizing events, 66 (72%) of the anti-DP positive patients had had a previous transplant, 21 (23%) had had pregnancies
and 5 (5%) received transfusions only. Noteworthy, anti-DP antibodies were exclusively present in sera from 8 of the 66
(12%) patients sensitized by a previous transplant; 2 of these re-transplant patients developed anti-DPA1 only.Analyzing
epitopes whose recognition determined antibody formation, we evidenced that 42 (64%) of the re-transplant patients
developed a broad antibody pattern (anti-DPB1*01, *03, *05, *06, *09, *10, *11, *13, *14, *17, *19, *20) due to the recognition
of 84-87DEAV epitope of the previous graft.
Conclusion: This study confirms that both ? and ? chain epitopes of HLA-DP molecules are immunogenic. The most
important stimulus for anti-DP antibody production was a previous transplant, but also pregnancies and transfusions may
determine the development of anti-DP ?/? chain specific antibodies. The anti-DPB1 humoral response often resulted in broad
antibody patterns because of the sharing of the same epitope by many DPB1 molecules.Consequently, in renal
transplantation, HLA matching strategy should consider all the HLA class II molecules especially for re-transplant patients.
All abstracts are available in a quotable version on the Transplantation Journal Website www.transplantjournal.com from beginning of September 2012. (literal)
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