Deptartment of Internal Medicine 3, University Erlangen-Nürnberg, Erlangen, Germany.
Int J Immunogenet. 2013 Feb;40(1):17-20. doi: 10.1111/iji.12032. Epub 2012 Dec 22.
In this multicentre study, sera from 803 retransplant candidates, including 775 kidney transplant recipients, were analysed with regard to the presence and specificity of anti-HLA alloantibodies of the IgA isotype using a modified microsphere-based platform. Of the kidney recipients, nearly one-third (n = 237, 31%) had IgA alloantibodies. Mostly, these antibodies were found in sera that also harboured IgG alloantibodies that could be found in a total of 572 (74%) of patients. Interestingly, IgA anti-HLA antibodies were preferentially targeting HLA class I antigens in contrast to those of the IgG isotype, which targeted mostly both HLA class I and II antigens. Donor specificity of the IgA alloantibodies could be established for over half of the 237 patients with IgA alloantibodies (n = 124, 52%). A further 58 patients had specificities against HLA-C or HLA-DP, for which no information regarding donor typing was available. In summary, these data showed in a large cohort of retransplant candidates that IgA alloantibodies occur in about one-third of patients, about half of these antibodies being donor specific.
在这项多中心研究中,使用改良的基于微球的平台分析了 803 名再移植候选者(包括 775 名肾移植受者)的血清中 IgA 同种异体抗体的存在和特异性。在这些肾移植受者中,近三分之一(n=237,31%)存在 IgA 同种异体抗体。这些抗体主要存在于同时存在 IgG 同种异体抗体的血清中,这些抗体总共存在于 572 名(74%)患者中。有趣的是,与 IgG 同种型相比,IgA 抗 HLA 抗体优先靶向 HLA Ⅰ类抗原,而 IgG 同种型主要靶向 HLA Ⅰ类和Ⅱ类抗原。对于 237 名存在 IgA 同种异体抗体的患者(n=124,52%)中的一半以上,可以确定 IgA 同种异体抗体的供体特异性。另有 58 名患者具有针对 HLA-C 或 HLA-DP 的特异性,对于这些患者,没有关于供体类型的信息。总之,这些数据表明,在大量再移植候选者中,约有三分之一的患者存在 IgA 同种异体抗体,其中约一半抗体具有供体特异性。