Alloantibody and autoantibody monitoring predicts islet transplantation outcome in human type 1 diabetes.
Alloantibody and autoantibody monitoring predicts islet transplantation outcome in human type 1 diabetes.
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同种抗体和自身抗体监测预测人类1型糖尿病的胰岛移植结果。
DOI：
10.2337/db12-1258
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发表时间：
2013-05
期刊：
影响因子：
7.7
通讯作者：
Terasaki PI
中科院分区：
文献类型：
--
作者：
Piemonti L;Everly MJ;Maffi P;Scavini M;Poli F;Nano R;Cardillo M;Melzi R;Mercalli A;Sordi V;Lampasona V;Espadas de Arias A;Scalamogna M;Bosi E;Bonifacio E;Secchi A;Terasaki PI
胰岛移植的长期临床结果受到自身免疫排斥反应和复发的影响。准确的监测可以及早发现和治疗这些潜在的免疫事件。对59例连续接受胰岛移植患者的胰岛移植结果进行了分析，并对移植前和移植后新的自身抗体(GAD抗体、胰岛素瘤相关蛋白2抗原、锌转运体8型抗原)和供者特异性同种异体抗体(DSA)进行了定量。39例(66%)胰岛移植后DSA或自身抗体升高(从头表达或滴度增加)。移植后抗体升高的受者与无抗体升高的受者相比，初始表现相似，但移植物存活率显著降低(胰岛自身抗体P<；0.001，DSA P<；0.001)。移植后DSA或自身抗体升高与人类白细胞抗原-DR不匹配(P=0.008)、抗胸腺细胞球蛋白诱导(P=0.0001)、移植前群体反应性同种异体抗体I类或II类15%(P=0.024)和雷帕霉素对抗体升高有保护作用(P=0.006)相关。胰岛移植后DSA或自身抗体的升高是重要的预后标志，它们的识别可能会改善胰岛细胞移植的结果。
Long-term clinical outcome of islet transplantation is hampered by the rejection and recurrence of autoimmunity. Accurate monitoring may allow for early detection and treatment of these potentially compromising immune events. Islet transplant outcome was analyzed in 59 consecutive pancreatic islet recipients in whom baseline and de novo posttransplant autoantibodies (GAD antibody, insulinoma-associated protein 2 antigen, zinc transporter type 8 antigen) and donor-specific alloantibodies (DSA) were quantified. Thirty-nine recipients (66%) showed DSA or autoantibody increases (de novo expression or titer increase) after islet transplantation. Recipients who had a posttransplant antibody increase showed similar initial performance but significantly lower graft survival than patients without an increase (islet autoantibodies P < 0.001, DSA P < 0.001). Posttransplant DSA or autoantibody increases were associated with HLA-DR mismatches (P = 0.008), induction with antithymocyte globulin (P = 0.0001), and pretransplant panel reactive alloantibody >15% in either class I or class II (P = 0.024) as independent risk factors and with rapamycin as protective (P = 0.006) against antibody increases. DSA or autoantibody increases after islet transplantation are important prognostic markers, and their identification could potentially lead to improved islet cell transplant outcomes.
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影响因子：
8.2
作者：
BONIFACIO, E;GENOVESE, S;BOSI, E
通讯作者：
BOSI, E
影响因子：
3.7
作者：
Melero, J;Tarrago, D;Sanchez, B
通讯作者：
Sanchez, B
影响因子：
6.2
作者：
Cardani, Roberta;Pileggi, Antonello;Alejandro, Rodolfo
通讯作者：
Alejandro, Rodolfo
影响因子：
8.8
作者：
Eng, H. S.;Bennett, G.;Russ, G. R.
通讯作者：
Russ, G. R.
影响因子：
6.2
作者：
Hoshino, Junichi;Kaneku, Hugo;Terasaki, Paul I.
通讯作者：
Terasaki, Paul I.