Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Ann N Y Acad Sci. 2013 Apr;1283:30-42. doi: 10.1111/nyas.12034. Epub 2013 Feb 5.
The detection and characterization of anti-HLA antibodies and the clinical impact of their appearance following renal transplantation are areas of immense interest. In particular, de novo development of donor-specific antibodies (DSA) has been associated with acute and chronic antibody-mediated graft rejection (AMR). Recently, methods for antibody detection have evolved remarkably from conventional cell-based assays to advanced solid phase systems. These systems have revolutionized the art of defining clinically relevant antibodies that are directed toward a renal graft. While anti-HLA DSAs have been widely associated with poor graft survival, the role of non-HLA antibodies, particularly those directed against endothelial cells, is beginning to be realized. Appreciation of the mechanisms underlying T cell recognition of alloantigens has generated great interest in the use of synthetic peptides to prevent graft rejection. Hopefully, continued progress in unraveling the molecular mechanisms of graft rejection and posttransplant monitoring of antibodies using highly sensitive testing systems will prove beneficial to immunological risk assessment and early prediction of renal allograft failure.
抗 HLA 抗体的检测和鉴定及其在肾移植后出现的临床影响是人们非常关注的领域。特别是，供体特异性抗体（DSA）的新出现与急性和慢性抗体介导的移植物排斥反应（AMR）有关。最近，抗体检测方法已经从传统的基于细胞的检测方法发展到了先进的固相系统。这些系统彻底改变了定义针对肾脏移植物的临床相关抗体的方法。虽然抗 HLA DSA 已被广泛认为与移植物存活率差有关，但非 HLA 抗体的作用，特别是针对内皮细胞的抗体的作用，开始被认识到。对 T 细胞识别同种抗原的机制的认识，激发了人们使用合成肽来预防移植物排斥的极大兴趣。希望在阐明移植物排斥的分子机制以及使用高度敏感的检测系统对抗体进行移植后监测方面的持续进展，将有助于免疫风险评估和早期预测肾移植失败。
