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Immucor Lifecodes 检测到的新生 DSA 的强度和 C3d 固定抗体与肾移植后亚临床 ABMR 无关。

Intensity of de novo DSA detected by Immucor Lifecodes assay and C3d fixing antibodies are not predictive of subclinical ABMR after Kidney Transplantation.

机构信息

Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France.

EFS Normandie, Rouen, France.

出版信息

PLoS One. 2021 Apr 22;16(4):e0249934. doi: 10.1371/journal.pone.0249934. eCollection 2021.

DOI:10.1371/journal.pone.0249934
PMID:33886604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8062066/
Abstract

De novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and allograft loss. We tested Immucor* (IM) Luminex Single-antigen beads (LSAB) assay and C3d-fixing antibodies in the setting of dnDSA and subclinical (s) ABMR. This retrospective multicentric study included 123 patients biopsied because of the presence of subclinical de novo DSA detected by One Lamda* Labscreen (MFI > 1000). In 112 patients, sera of the day of the biopsy were available and tested in a central lab with IM Lifecodes LSAB and C3d fixing antibodies assays. In 16 patients (14.3%), no DSA was detected using Immucor test. In 96 patients, at least one DSA was determined with IM. Systematic biopsies showed active sABMR in 30 patients (31.2%), chronic active sABMR in 17 patients (17.7%) and no lesions of sABMR in 49 KT recipients (51%). Intensitity criteria (BCM, BCR and AD-BCR) of DSA were not statistically different between these 3 histological groups. The proportion of patients with C3d-fixing DSA was not statistically different between the 3 groups and did not offer any prognostic value regarding graft survival. Performing biopsy for dnDSA could not be guided by the intensity criteria of IM LSAB assay. C3d-fixing DSA do not offer added value.

摘要

新生供者特异性抗体 (dnDSA) 与抗体介导的排斥反应 (ABMR) 和移植物丢失有关。我们在 dnDSA 和亚临床 (s) ABMR 背景下测试了 Immucor* (IM) Luminex 单抗原珠 (LSAB) 检测和 C3d 结合抗体。这项回顾性多中心研究纳入了 123 例因 One Lamda* Labscreen 检测到亚临床新生 DSA (MFI > 1000) 而进行活检的患者。在 112 例患者中，活检当天的血清可用于在中央实验室使用 IM Lifecodes LSAB 和 C3d 结合抗体检测进行检测。在 16 例患者 (14.3%) 中，Immucor 检测未检测到 DSA。在 96 例患者中，至少有一例 DSA 被 IM 确定。系统性活检显示 30 例患者 (31.2%) 存在活跃的 sABMR，17 例患者 (17.7%) 存在慢性活跃的 sABMR，49 例 KT 受者 (51%) 无 sABMR 病变。DSA 的强度标准 (BCM、BCR 和 AD-BCR) 在这 3 组组织学患者中无统计学差异。这 3 组患者中 C3d 结合 DSA 的比例无统计学差异，且在移植物存活率方面无预后价值。根据 IM LSAB 检测的强度标准，不能对 dnDSA 进行活检。C3d 结合 DSA 没有额外的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d2/8062066/7dcacf73c9c7/pone.0249934.g007.jpg
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本文引用的文献

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Transplantation. 2020 Aug;104(8):1726-1737. doi: 10.1097/TP.0000000000003055.
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Optimizing HLA-antibody Determination.优化人类白细胞抗原抗体检测
Transplantation. 2019 Jul;103(7):e208. doi: 10.1097/TP.0000000000002719.
3
Specificity, strength, and evolution of pretransplant donor-specific HLA antibodies determine outcome after kidney transplantation.
移植前供体特异性 HLA 抗体的特异性、强度和演变决定了肾移植后的结果。
Am J Transplant. 2019 Nov;19(11):3100-3113. doi: 10.1111/ajt.15414. Epub 2019 Jun 19.
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Antibody-Mediated Rejection of Solid-Organ Allografts.抗体介导的实体器官同种异体移植排斥反应
N Engl J Med. 2018 Sep 20;379(12):1150-1160. doi: 10.1056/NEJMra1802677.
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Histological picture of antibody-mediated rejection without donor-specific anti-HLA antibodies: Clinical presentation and implications for outcome.抗体介导排斥反应而无供体特异性抗 HLA 抗体的组织学图像：临床表现和对结局的影响。
Am J Transplant. 2019 Mar;19(3):763-780. doi: 10.1111/ajt.15074. Epub 2018 Sep 28.
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Comparison of Two Luminex Single-antigen Bead Flow Cytometry Assays for Detection of Donor-specific Antibodies After Renal Transplantation.两种 Luminex 单抗原微球流式细胞术检测肾移植后供体特异性抗体的比较。
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