Reed E, Ho E, Cohen D J, Ramey W, Marboe C, D'Agati V, Rose E A, Hardy M, Suciu-Foca N
College of Physicians and Surgeons of Columbia University, Department of Pathology, New York, NY 10032.
Immunol Res. 1993;12(1):1-11. doi: 10.1007/BF02918364.
Chronic rejection is the major threat to both heart and renal allograft survival. We have explored the possibility that some patients with anti-donor HLA antibodies (Ab1) develop specific anti-idiotypic antibodies (Ab2) which suppress the production of Ab1, and subsequently, the progression of chronic rejection. Analysis of Ab2 in sera obtained from Ab1 producers showed that 22% of heart and 18% of kidney recipients produced Ab2. The 4- and 5-year actuarial graft survivals in Ab2 producers were 100% and 83%, respectively, compared to 57% in patients who formed Ab1 but not Ab2 (p < 0.004). Patients carrying the DR2 alleles, DRB1*1501, *1502 or *1601 were at a lower risk of producing anti-donor HLA antibodies.
慢性排斥反应是心脏和肾脏同种异体移植存活的主要威胁。我们探讨了一些具有抗供体HLA抗体（Ab1）的患者产生特异性抗独特型抗体（Ab2）的可能性，这些抗独特型抗体可抑制Ab1的产生，进而抑制慢性排斥反应的进展。对Ab1产生者血清中的Ab2进行分析发现，22%的心脏移植受者和18%的肾脏移植受者产生了Ab2。产生Ab2者4年和5年的移植精算存活率分别为100%和83%，而产生Ab1但未产生Ab2的患者为57%（p<0.004）。携带DR2等位基因、DRB1*1501、1502或1601的患者产生抗供体HLA抗体的风险较低。
