研究肾移植后慢性免疫损伤进展与非 HLA 肾自身抗原抗体之间的关系。
Study of association between antibodies to non-HLA kidney self-antigens and progression to chronic immune injury after kidney transplantation.
机构信息
Department of Medicine, Mayo Clinic, Phoenix, AZ, United States.
Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States.
出版信息
Hum Immunol. 2023 Oct;84(10):509-514. doi: 10.1016/j.humimm.2023.07.006. Epub 2023 Jul 26.
BACKGROUND
Immune response to several kidney self-antigens (KSAg) such as Collagen IV (Col-IV), Perlecan (PL), and Fibronectin (FN) have been associated with antibody-mediated damage and poor allograft survival. Thus, the aim of this study was to determine if humoral immune responses to KSAg correlates with progression of chronic immune injury (CII) changes at 1 year or 2 years.
METHODS
Kidney transplant recipients who underwent 1- or 2-year biopsies, with chronic interstitial inflammation (ci > 1) and/or glomerular membrane double contouring (cg > 0) were analyzed with matched controls. Sera were analyzed retrospectively for antibodies against KSAg using ELISA. The presence of antibodies to KSAg were compared at 0, 4, 12, and 24 months using logistic regression.
RESULTS
We identified a cohort of 214 kidney transplant recipients. Of these, we identified 33 cases and matched 66 controls. Logistical regression showed an odds ratio of 1 with the confidence interval crossing 1 for the presence of response to KSAg at all the time points.
CONCLUSIONS
Humoral immune responses to either KSAg alone or in combination with donor-specific anti-HLA antibodies are not associated with progression to CII at 1 and 2 years after kidney transplantation.
背景
针对几种肾脏自身抗原（KSAg）的免疫反应，如胶原 IV（Col-IV）、Perlecan（PL）和纤维连接蛋白（FN），与抗体介导的损伤和移植物存活率差有关。因此，本研究旨在确定针对 KSAg 的体液免疫反应是否与 1 年或 2 年后慢性免疫损伤（CII）变化的进展相关。
方法
对接受 1 年或 2 年活检、伴有慢性间质炎症（ci>1）和/或肾小球膜双重轮廓（cg>0）的肾移植受者进行分析，并与匹配的对照进行比较。使用 ELISA 法回顾性分析血清中针对 KSAg 的抗体。使用逻辑回归比较 0、4、12 和 24 个月时 KSAg 抗体的存在情况。
结果
我们确定了 214 例肾移植受者的队列。在这些患者中，我们确定了 33 例病例和 66 例匹配对照。逻辑回归显示，在所有时间点，针对 KSAg 的反应存在的优势比为 1，置信区间跨越 1。
结论
针对 KSAg 单独或与供体特异性抗 HLA 抗体联合的体液免疫反应与肾移植后 1 年和 2 年 CII 的进展无关。
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