Gilbert M, Paul S, Perrat G, Giannoli C, Pouteil Noble C, Morelon E, Rigal D, Dubois V
Histocompatibility Laboratory, Etablissement Français du Sang Rhône-Alpes, Lyon, France.
Transplant Proc. 2011 Nov;43(9):3412-4. doi: 10.1016/j.transproceed.2011.09.023.
The aim of our study was to determine whether the presence of specific human leukocyte antigen (HLA)-C and -DP antibodies before transplantation influenced graft outcomes in immunized recipients. Two groups of pretransplant immunized recipients were studied: patients with only classical HLA-A, -B, -DR, -DQ antibodies (n = 176) and those with classical plus HLA-C and/or -DP antibodies (n = 27). Acute antibody-mediated rejection was preferentially associated with the presence of pretransplant anti-HLA-C and -DP antibodies (5/6 cases). In four cases, acute rejection episodes were followed by graft loss within 15 months after transplantation. There was a significant increase in the number of acute rejection episodes especially antibody-mediated acute rejections (P = .036) and in the number of graft losses for immunologic reasons (P < .001) among the group with pretransplant anti-C and -DP antibodies. Pretransplant anti-DP antibodies seemed to be involved more frequently in poor graft outcomes as shown in several recent published cases. We need to investigate their specific role among a larger cohort, taking into account an epitope analysis.
我们研究的目的是确定移植前特定人类白细胞抗原（HLA）-C和-DP抗体的存在是否会影响免疫受者的移植结果。我们研究了两组移植前免疫的受者：仅具有经典HLA-A、-B、-DR、-DQ抗体的患者（n = 176）和具有经典抗体加HLA-C和/或-DP抗体的患者（n = 27）。急性抗体介导的排斥反应优先与移植前抗HLA-C和-DP抗体的存在相关（5/6例）。在4例中，急性排斥反应发作后在移植后15个月内出现移植物丢失。在移植前有抗C和-DP抗体的组中，急性排斥反应发作的数量显著增加，尤其是抗体介导的急性排斥反应（P = .036），以及因免疫原因导致的移植物丢失数量显著增加（P < .001）。如最近几例已发表的病例所示，移植前抗DP抗体似乎更频繁地与不良移植结果有关。我们需要在更大的队列中研究它们的具体作用，并考虑进行表位分析。
