Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Laboratory Medicine, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
Ann Clin Lab Sci. 2020 Mar;50(2):247-252.
The association of anti-MHC class I-related chain A (MICA) and kidney allograft rejection has been reported. However, the associations of antibodies specific to donor MICA (dsMICA) and dsMICA levels with allograft outcome have not been elucidated. From November 2009 to June 2017, 125 sera samples from renal transplantation recipients with no HLA antibodies were screened for MICA antibodies. Patients with positive MICA antibody screening results and available residual donor DNA for MICA geno-typing underwent dsMICA analysis. Among these 125 sera samples, 19 were positive for MICA antibodies. dsMICA was positive in 5 out of the 12 analyzed sera samples. Neither MICA antibodies nor dsMICA were associated with acute rejection. However, interstitial fibrosis and tubular atrophy (IFTA) was significantly associated with MICA antibody positivity (OR=3.84, =0.009). In addition, the MFI value of dsMICA was significantly higher in patients with IFTA II or III than in patients without IFTA II or III (=0.009). The association of MICA antibodies and dsMICA with high grade IFTA (grade II or III) was suggested. The MICA antibody and dsMICA might be useful indicators of chronic renal damage.
已有研究报道抗主要组织相容性复合体Ⅰ类相关链 A（MICA）与肾移植排斥反应相关。然而，针对供体 MICA 的特异性抗体（dsMICA）与移植物结局的关系尚未阐明。本研究回顾性分析了 2009 年 11 月至 2017 年 6 月期间 125 例无 HLA 抗体的肾移植受者的 125 份血清样本，筛选 MICA 抗体。对 MICA 抗体筛查阳性且有剩余供体 DNA 进行 MICA 基因分型的患者进行 dsMICA 分析。在这 125 份血清样本中，有 19 份为 MICA 抗体阳性。在 12 份分析的血清样本中，有 5 份 dsMICA 阳性。MICA 抗体和 dsMICA 均与急性排斥反应无关。然而，间质纤维化和肾小管萎缩（IFTA）与 MICA 抗体阳性显著相关（OR=3.84，=0.009）。此外，IFTA II 或 III 患者的 dsMICA 的 MFI 值明显高于无 IFTA II 或 III 的患者（=0.009）。提示 MICA 抗体和 dsMICA 与高级别 IFTA（II 级或 III 级）相关。MICA 抗体和 dsMICA 可能是慢性肾损伤的有用指标。
