The importance of anti-HLA-specific antibody strength in monitoring kidney transplant patients
The importance of anti-HLA-specific antibody strength in monitoring kidney transplant patients
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DOI：
10.1111/j.1600-6143.2006.01721.x
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发表时间：
2007-04-01
影响因子：
8.8
通讯作者：
Ozawa, M.
中科院分区：
文献类型：
--
作者：
Mizutani, K.;Terasaki, P.;Ozawa, M.
大约 25% 接受肾移植的患者会产生 HLA 特异性抗体，此前并未发现该抗体的强度与移植失败相关。本研究研究了这些从头抗体的强度。强 HLA 特异性同种抗体的连续稀释（高达 1:25,600）并用 HLA 抗原包被的珠子进行测试表明，对不同 HLA 抗原的反应滴度与 Luminex 机器获得的最大荧光值和等效可溶性荧光染料 (MESF) 值的分子直接相关。因此，可以利用最大荧光和 MESF 来测量抗体的强度。 39 名随后出现移植失败的患者血清中的抗体强度明显高于 26 名继续具有良好移植功能的患者血清中的抗体强度（p = 0.0084）。九名患者的抗体强度明显增加，随后血清肌酐水平也增加。如果对供体特异性进行分析，就会发现供体特异性 MESF 与失败之间存在很强的关联 (p = 0.00000027)。我们的结果表明，在评估移植后患者血清时监测抗体的强度非常重要。
Approximately 25% of patients who undergo kidney transplantation develop HLA-specific antibodies, the strength of which has not been previously correlated with graft failure. The strength of these de novo antibodies is investigated in this study. Serial dilution of strong HLA-specific allo-antibodies (up to 1:25,600) and testing with HLA-antigen-coated beads showed that the titer of the reaction to different HLA antigens is directly correlated to maximum fluorescence values and the molecules of equivalent soluble fluorochrome (MESF) values obtained by Luminex machines. Thus, the strength of antibodies can be measured utilizing maximum fluorescence and MESF. The strength of antibodies in the sera from 39 patients who subsequently had graft failure were markedly higher than those in the sera of 26 patients who continued to have good graft function (p = 0.0084). A clear increase in the strength of antibodies was identified in nine patients with a subsequent increase in serum creatinine levels. If analyzed for donor specificity, a strong association was noted for donor-specific MESF and failure (p = 0.00000027). Our results suggest that it is important to monitor the strength of antibodies when evaluating patient sera posttransplant.