Sorohan Bogdan Marian, Sinescu Ioanel, Tacu Dorina, Bucșa Cristina, Țincu Corina, Obrișcă Bogdan, Berechet Andreea, Constantinescu Ileana, Mărunțelu Ion, Ismail Gener, Baston Cătălin
Department of General Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, 022328 Bucharest, Romania.
J Clin Med. 2021 Nov 18;10(22):5390. doi: 10.3390/jcm10225390.
(1) Background: Angiotensin II type I receptor antibodies (AT1R-Ab) represent a topic of interest in kidney transplantation (KT). Data regarding the risk factors associated with de novo AT1R-Ab development are lacking. Our goal was to identify the incidence of de novo AT1R-Ab at 1 year after KT and to evaluate the risk factors associated with their formation. (2) Methods: We conducted a prospective cohort study on 56 adult patients, transplanted between 2018 and 2019. Recipient, donor, transplant, treatment, and complications data were assessed. A threshold of >10 U/mL was used for AT1R-Ab detection. (3) Results: De novo AT1R-Ab were observed in 12 out of 56 KT recipients (21.4%). The median value AT1R-Ab in the study cohort was 8.5 U/mL (inter quartile range: 6.8-10.4) and 15.6 U/mL (10.8-19.8) in the positive group. By multivariate logistic regression analysis, induction immunosuppression with anti-thymocyte globulin (OR = 7.20, 95% CI: 1.30-39.65, = 0.02), maintenance immunosuppression with immediate-release tacrolimus (OR = 6.20, 95% CI: 1.16-41.51, = 0.03), and mean tacrolimus trough level (OR = 2.36, 95% CI: 1.14-4.85, = 0.01) were independent risk factors for de novo AT1R-Ab at 1 year after KT. (4) Conclusions: De novo AT1R-Ab development at 1 year after KT is significantly influenced by the type of induction and maintenance immunosuppression.
（1）背景：血管紧张素II 1型受体抗体（AT1R-Ab）是肾移植（KT）领域的一个研究热点。目前缺乏与新发AT1R-Ab产生相关的危险因素的数据。我们的目标是确定肾移植术后1年新发AT1R-Ab的发生率，并评估与其形成相关的危险因素。（2）方法：我们对2018年至2019年间接受移植的56例成年患者进行了一项前瞻性队列研究。评估了受者、供者、移植、治疗及并发症的数据。AT1R-Ab检测的阈值设定为>10 U/mL。（3）结果：56例肾移植受者中有12例（21.4%）出现新发AT1R-Ab。研究队列中AT1R-Ab的中位数为8.5 U/mL（四分位间距：6.8 - 10.4），阳性组为15.6 U/mL（10.8 - 19.8）。通过多因素逻辑回归分析，使用抗胸腺细胞球蛋白进行诱导免疫抑制（OR = 7.20，95%置信区间：1.30 - 39.65，P = 0.02）、使用速释他克莫司进行维持免疫抑制（OR = 6.20，95%置信区间：1.16 - 41.51，P = 0.03）以及他克莫司平均谷浓度（OR = 2.36，95%置信区间：1.14 - 4.85，P = 0.01）是肾移植术后1年新发AT1R-Ab的独立危险因素。（4）结论：肾移植术后1年新发AT1R-Ab的发生受诱导和维持免疫抑制类型的显著影响。
