The impact of non-HLA antibodies directed against endothelin-1 type A receptors (ETAR) on early renal transplant outcomes
The impact of non-HLA antibodies directed against endothelin-1 type A receptors (ETAR) on early renal transplant outcomes
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DOI：
10.1016/j.trim.2013.10.007
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发表时间：
2014-01-01
影响因子：
1.5
通讯作者：
Klinger, Marian
中科院分区：
文献类型：
--
作者：
Banasik, Miroslaw;Boratynska, Maria;Klinger, Marian
背景：靶向血管受体的非HLA抗体（Abs）被认为对肾移植损伤有影响。抗内皮素-1 A型受体（抗ETAR）抗体与心脏移植患者的细胞和抗体介导的排斥反应以及血管病变的早期发作相关，但其在肾移植中的作用尚不清楚。我们的研究的目的是评估的发病率和重要性的抗ETAR抗体及其对肾transplant. Methods的影响在第一年observation.Methods：我们评估了存在的抗ETAR抗体在116个连续的肾移植受者在移植前和移植后的筛选（前，在第1，第3，第6，第12个月移植后）。此外，我们评估了抗HLA抗体的存在。通过ELISA测定抗ETAR抗体。结果：55例（47.4%）受者在移植前检测到抗TAR抗体。在移植后第一年，抗ETAR（+）组的肾移植功能显著差于抗ETAR（-）组。移植后1个月，抗ETAR（+）患者（pts）的血清肌酐为1.86 +/- 0.8 mg/dl。抗ETAR（-）患者为1.51 ± 0.5（p = 0.009）。移植后12个月，仍观察到组间差异为1.70 +/- 0.7 vs. 1.40 +/- 0.4（p = 0.04）。活检证实的急性排斥反应在ETAR（+）患者中为8/55（14.5%），在ETAR（-）患者中为9/61（14.8%），但轻度至重度内膜动脉炎（v1-v3）的病例在存在抗ETAR抗体的患者中更常见，4/55（72%）与抗ETAR（-）患者中的1/61（1.6%）相比。抗ETAR抗体水平变化在不同的测量间隔在一年follow-up.Conclusions：抗ETAR抗体的存在与移植后的第一个12个月内肾移植功能较差。应考虑在肾移植受者免疫状态的诊断中包括抗ETAR抗体，以提供体液同种免疫的全面评估。(C)2013作者Elsevier B. V.出版，保留所有权利。
Background: Non-HLA antibodies (Abs) targeting vascular receptors are considered to have an influence on renal transplant injury. Anti-endothelin-1 type A receptor (anti-ETAR) antibodies were associated with cellular and antibody-mediated rejection and early onset of vasculopathy in heart transplant patients but their role in renal transplantation remains unclear. The aim of our study was to assess the incidence and importance of anti-ETAR antibodies and their impact on renal transplant during the first year observation.Methods: We evaluated the presence of anti-ETAR antibodies in 116 consecutive renal transplant recipients in pre- and post-transplant screening (before and in 1st, 3rd, 6th, 12th month after transplantation). Additionally, we assessed the presence of anti-HLA antibodies. Anti-ETAR antibodies were assayed by ELISA. The diagnosis of acute rejection was based on the Banff criteria.Results: Anti-TAR antibodies were observed in 55 (47.4%) of the analyzed recipients before transplantation. The function of renal transplant was significantly worse in the anti-ETAR(+) group compared to the anti-ETAR(-) group during the first post-transplant year. One month after transplantation the serum creatinine in anti-ETAR (+) patients (pts) was 1.86 +/- 0.8 mg/dl. and 1.51 +/- 0.5 in anti-ETAR(-) pts (p = 0.009). Twelve months after transplantation the difference between the groups was still observed 1.70 +/- 0.7 vs. 1.40 +/- 0.4 (p = 0.04). Biopsy proven acute rejection was recognized in 8/55 (14.5%) in ETAR(+) and 9/61 (14.8%) in ETAR(-) patients but cases with mild to severe intimal arteritis (v1-v3) were more often observed in patients with the presence of anti-ETAR Abs 4/55 (72%) comparing with 1/61 (1.6%) in anti-ETAR(-) patients. The anti-ETAR antibody levels varied at different measurement intervals during the one-year follow-up.Conclusions: The presence of anti-ETAR antibodies is associated with a worse renal transplant function during the first 12 months after transplantation. Including anti-ETAR antibodies in the diagnostics of renal transplant recipient immune status should be considered to provide comprehensive assessment of humoral alloimmunity. (C) 2013 The Authors. Published by Elsevier B.V. All rights reserved.