Jucaud Vadim
Terasaki Institute for Biomedical Innovation, Los Angeles, CA 91367, USA.
Antibodies (Basel). 2024 Jul 24;13(3):61. doi: 10.3390/antib13030061.
The development of de novo donor-specific HLA antibodies (dnDSAs) following solid organ transplantation is considered a major risk factor for poor long-term allograft outcomes. The prediction of dnDSA development is a boon to transplant recipients, yet the assessment of allo-HLA immunogenicity remains imprecise. Despite the recent technological advances, a comprehensive evaluation of allo-HLA immunogenicity, which includes both B and T cell allorecognition, is still warranted. Recent studies have proposed using mismatched HLA epitopes (antibody and T cell) as a prognostic biomarker for humoral alloimmunity. However, the identification of immunogenic HLA mismatches has not progressed despite significant improvements in the identification of permissible mismatches. Certainly, the prediction of dnDSA development may benefit permissible HLA mismatched organ transplantations, personalized immunosuppression, and clinical trial design. However, characteristics that go beyond the listing of mismatched HLA antibody epitopes and T cell epitopes, such as the generation of HLA T cell epitope repertoires, recipient's HLA class II phenotype, and immunosuppressive regiments, are required for the precise assessment of allo-HLA immunogenicity.
实体器官移植后新生供者特异性HLA抗体（dnDSA）的产生被认为是长期移植器官预后不良的主要危险因素。dnDSA产生的预测对移植受者有益，但同种异体HLA免疫原性的评估仍不准确。尽管最近技术有所进步，但仍有必要对同种异体HLA免疫原性进行全面评估，其中包括B细胞和T细胞的同种异体识别。最近的研究提出使用不匹配的HLA表位（抗体和T细胞）作为体液同种异体免疫的预后生物标志物。然而，尽管在可允许的错配识别方面有了显著改进，但免疫原性HLA错配的识别却没有进展。当然，dnDSA产生的预测可能有益于可允许的HLA错配器官移植、个性化免疫抑制和临床试验设计。然而，要精确评估同种异体HLA免疫原性，需要一些超越不匹配HLA抗体表位和T细胞表位列表的特征，例如HLA T细胞表位库的产生、受者的HLA II类表型和免疫抑制方案。
