Department of Clinical Immunology 7631, Rigshospitalet, University Hospital of Copenhagen, Ole Maaløes Vej 26, DK-2200 Copenhagen, Denmark.
Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark.
Clin Immunol. 2021 May;226:108711. doi: 10.1016/j.clim.2021.108711. Epub 2021 Mar 2.
The importance of the human leukocyte antigen (HLA) system in kidney transplantation is well-known, but it remains unexplored if patient HLA antigens constitute independent risk factors in complications after transplantation. We hypothesized that specific HLA class II phenotypes associated with immune-mediated disease (HLA-IMD) predispose to immunological activity and/or complications after kidney transplantation. Based on the literature we defined HLA-DR2-DQ6; -DR3-DQ2 and -DR4-DQ8 as HLA-IMD phenotypes. We investigated associations between HLA-IMD phenotypes in patients, biomarkers of systemic chronic inflammation at the time of transplantation, and the outcome after kidney transplantation in a retrospective cohort study of 611 kidney transplanted patients. The HLA-IMD phenotypes were associated with higher levels of biomarkers of systemic inflammation. The HLA-DR4-DQ8 phenotype was associated with mortality after transplantation in Cox analyses with adjustments for confounders. Data support the hypothesis that specific HLA class II phenotypes affects immunological pathways that determine the midterm clinical outcome of kidney transplantation.
人类白细胞抗原（HLA）系统在肾移植中的重要性是众所周知的，但患者 HLA 抗原是否构成移植后并发症的独立危险因素仍未得到探索。我们假设与免疫介导疾病相关的特定 HLA Ⅱ类表型（HLA-IMD）易导致肾移植后免疫活性和/或并发症。根据文献，我们将 HLA-DR2-DQ6；-DR3-DQ2 和 -DR4-DQ8 定义为 HLA-IMD 表型。我们在 611 例肾移植患者的回顾性队列研究中，调查了患者 HLA-IMD 表型与移植时全身慢性炎症的生物标志物之间的关系，以及肾移植后的结果。HLA-IMD 表型与全身炎症标志物水平升高相关。在调整混杂因素的 Cox 分析中，HLA-DR4-DQ8 表型与移植后死亡率相关。数据支持这样一种假设，即特定的 HLA Ⅱ类表型影响决定肾移植中期临床结果的免疫途径。
