Hesemann Laura E, Subramanian Vijay, Mohanakumar Thalachallour, Dharnidharka Vikas R
Division of Pediatric Nephrology, Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA.
Department of Surgery, Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA.
Pediatr Transplant. 2015 Aug;19(5):499-503. doi: 10.1111/petr.12531. Epub 2015 Jun 9.
Chronic rejection is the leading cause of graft loss following pediatric kidney transplantation. Our group and others have demonstrated an association between the development of Abs to self-antigens and chronic rejection following adult lung and heart transplantation. The goal of this study was to determine whether Abs to kidney-associated self-antigens develop following pediatric renal transplantation. We investigated post-transplant development of Abs to kidney-associated self-antigens angiotensin II receptor type I, Fn, and collagen IV in a pediatric cohort. Using ELISA, we measured Abs to kidney-associated self-antigens in serum. Our cohort included 29 subjects with samples collected pretransplant and for 12 months post-transplant. No samples had Abs to kidney-associated self-antigen pretransplant. In contrast, 50% (10/20) of subjects developed Abs to one or more kidney-associated self-antigen post-transplantation. The median time to antibody appearance and duration of persistence were 103 and 61 days, respectively. Development of Abs did not correlate with graft function. Half of subjects developed Abs to kidney-associated self-antigens angiotensin II receptor type I, Fn, or collagen IV in the first year after kidney transplantation--a higher rate of early antibody development than expected. In this small study, Abs did not correlate with worse clinical outcomes.
慢性排斥反应是小儿肾移植后移植物丢失的主要原因。我们团队及其他研究团队已证明，在成人肺移植和心脏移植后，自身抗体的产生与慢性排斥反应之间存在关联。本研究的目的是确定小儿肾移植后是否会产生针对肾脏相关自身抗原的抗体。我们在一个小儿队列中调查了肾移植后针对肾脏相关自身抗原（血管紧张素II 1型受体、纤连蛋白和IV型胶原）抗体的产生情况。我们使用酶联免疫吸附测定法（ELISA）检测血清中针对肾脏相关自身抗原的抗体。我们的队列包括29名受试者，收集了他们移植前及移植后12个月的样本。移植前没有样本含有针对肾脏相关自身抗原的抗体。相比之下，50%（10/20）的受试者在移植后产生了针对一种或多种肾脏相关自身抗原的抗体。抗体出现的中位时间和持续时间分别为103天和61天。抗体的产生与移植物功能无关。一半的受试者在肾移植后的第一年产生了针对肾脏相关自身抗原血管紧张素II 1型受体、纤连蛋白或IV型胶原的抗体——抗体早期产生率高于预期。在这项小型研究中，抗体与较差的临床结局无关。
