Böhmig Georg A, Bartel Gregor, Regele Heinz, Wahrmann Markus
Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Hum Immunol. 2009 Aug;70(8):640-4. doi: 10.1016/j.humimm.2009.04.014. Epub 2009 Apr 15.
Antibody-mediated immunity is generally accepted to be a major cause of kidney allograft injury and loss. Post-transplantation monitoring for circulating alloantibodies was proposed to represent a useful noninvasive diagnostic approach to assess individual immunologic risks and to guide the implementation of specific therapeutic measures. This was supported by the recent establishment of highly sensitive and specific solid phase immunoassays for detailed characterisation of reactivity patterns. Nevertheless, imperfect associations of serologic results with biopsy-based criteria of antibody-mediated rejection, as well as the disputed long-term significance of circulating alloantibody detected in recipients with normal graft function, necessitate a careful interpretation of monitoring results.
抗体介导的免疫反应通常被认为是同种异体肾移植损伤和丧失的主要原因。有人提出，移植后监测循环中的同种异体抗体是一种有用的非侵入性诊断方法，可用于评估个体免疫风险并指导具体治疗措施的实施。最近建立的高灵敏度和特异性固相免疫测定法可详细表征反应模式，这为上述观点提供了支持。然而，血清学结果与基于活检的抗体介导排斥反应标准之间的关联并不完美，而且在移植肾功能正常的受者中检测到的循环同种异体抗体的长期意义也存在争议，因此需要仔细解读监测结果。
