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肺移植中与抗体介导性排斥反应相关的供体特异性抗体的特征

Characteristics of Donor-Specific Antibodies Associated With Antibody-Mediated Rejection in Lung Transplantation.

作者信息

Roux Antoine, Bendib Le Lan Ines, Holifanjaniaina Sonia, Thomas Kimberly A, Picard Clément, Grenet Dominique, De Miranda Sandra, Douvry Benoit, Beaumont-Azuar Laurence, Sage Edouard, Devaquet Jérôme, Cuquemelle Elise, Le Guen Morgan, Suberbielle Caroline, Gautreau Chantal, Stern Marc, Rossetti Maura, Hamid Abdul Monem, Parquin Francois

机构信息

Pneumology, Adult CF Center, Lung Transplantation Department, Foch Hospital, Suresnes, France.

Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA, United States.

出版信息

Front Med (Lausanne). 2017 Oct 11;4:155. doi: 10.3389/fmed.2017.00155. eCollection 2017.

DOI:10.3389/fmed.2017.00155
PMID:29075627
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5641623/
Abstract

Although donor-specific anti-human leukocyte antigen (HLA) antibodies (DSAs) are frequently found in recipients after lung transplantation (LT), the characteristics of DSA which influence antibody-mediated rejection (AMR) in LT are not fully defined. We retrospectively analyzed 206 consecutive LT patients of our center (2010-2013). DSAs were detected by using luminex single antigen beads assay and mean fluorescence intensity was assessed. Within the study population, 105 patients had positive DSA. Patients with and without AMR (AMR,  = 22, and AMR,  = 83, respectively) were compared. AMR patients had significantly greater frequencies of anti-HLA DQ DSA (DQ DSA) than AMR patients (95 vs 58%, respectively,  < 0.0001). Compared to AMR patients, AMR patients had higher DQ DSA sum MFI [7,332 (2,067-10,213) vs 681 (0-1,887),  < 0.0001]. DQ DSA when associated with AMR, had more frequent graft loss and chronic lung allograft dysfunction (CLAD). These data suggest (i) that DSA characteristics clearly differ between AMR and AMR patients and (ii) the deleterious impact of DQ DSA on clinical outcome.

摘要

尽管在肺移植（LT）受者中经常发现供者特异性抗人白细胞抗原（HLA）抗体（DSA），但影响LT中抗体介导排斥反应（AMR）的DSA特征尚未完全明确。我们回顾性分析了本中心2010年至2013年连续的206例LT患者。采用Luminex单抗原微珠分析法检测DSA，并评估平均荧光强度。在研究人群中，105例患者DSA呈阳性。对发生和未发生AMR的患者（分别为22例和83例）进行了比较。发生AMR的患者抗HLA DQ DSA（DQ DSA）的频率显著高于未发生AMR的患者（分别为95%和58%，P<0.0001）。与未发生AMR的患者相比，发生AMR的患者DQ DSA总和的平均荧光强度更高[7332（2067-10213）对681（0-1887），P<0.0001]。当DQ DSA与AMR相关时，移植肺丢失和慢性移植肺功能障碍（CLAD）的发生率更高。这些数据表明：（i）发生AMR和未发生AMR的患者之间DSA特征明显不同；（ii）DQ DSA对临床结局有有害影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70c5/5641623/1f57ea1490c6/fmed-04-00155-g005.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70c5/5641623/acb95242de26/fmed-04-00155-g002.jpg
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