Soluble HLA antigens, anti-HLA antibodies, and antiidiotypic antibodies in the circulation of renal transplant recipients.
Soluble HLA antigens, anti-HLA antibodies, and antiidiotypic antibodies in the circulation of renal transplant recipients.
复制标题
肾移植受者循环中的可溶性 HLA 抗原、抗 HLA 抗体和抗独特型抗体。
DOI：
10.1097/00007890-199103000-00011
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发表时间：
1991
期刊：
影响因子：
6.2
通讯作者：
Hardy,MA
中科院分区：
文献类型：
--
作者：
Suciu-Foca,N;Reed,E;D'Agati,VD;Ho,E;Cohen,DJ;Benvenisty,AI;McCabe,R;Brensilver,JM;King,DW;Hardy,MA
慢性排斥反应是器官移植长期存活的主要威胁。据推测，这种形式的排斥反应是由针对移植物的错配HLA抗原的抗体介导的。然而，移植后血清中抗HLA抗体的存在和特异性难以记录。我们已经探索了抗HLA抗体与从受损移植物释放的可溶性HLA抗原形成免疫复合物和/或它们被抗独特型、抗抗HLA抗体阻断的可能性。我们的数据表明，肾移植后产生抗HLA抗体的患者的长期存活率明显低于未形成抗体的患者。用磁性免疫亲和法去除可溶性HLA抗原后，我们可以在57%的肾移植慢性排斥患者血清中鉴定出抗HLA抗体，而去除抗原前为41%。在耐受移植物4年或更长时间的患者中，HLA抗原耗尽之前和之后抗体阳性烧伤的相应频率分别为2%和5%。慢性体液性排斥反应与患者瘢痕中HLA抗体免疫复合物的存在呈正相关（P< 0.0001）。尽管移植物中有一种不匹配的HLA抗原产生了抗体，但仍接受移植物的患者显示出特异性抗独特型（抗-抗-HLA抗体）。慢性排斥反应患者的血清中未发现这种抗独特型抗体（P= 0.005）。这表明抗独特型抗体可延缓慢性体液排斥反应的进展。
Chronic rejection represents the major threat to long-term survival of organ allografts. It is presumed that this form of rejection is mediated by antibodies against mismatched HLA antigens of the graft. The presence and specificity of anti-HLA-antibodies in posttransplantation sera are, however, difficult to document. We have explored the possibility that anti-HLA antibodies form immune complexes with soluble HLA antigens released from the injured graft and/or that they are blocked by antiidiotypic, anti-anti-HLA-antibodies. Our data demonstrate that the long-term survival of renal allografts is significantly lower in patients who develop anti-HLA-antibodies following transplantation than in patients who do not form antibodies. Following depletion of soluble HLA antigens by magnetic immunoaffinity, we could identify anti-HLA-antibodies in 57% of the sera obtained from patients undergoing chronic rejection of kidney allografts, comared with 41% prior to antigen depletion. In patients tolerating the grafts for 4 years or more, the corresponding frequencies of antibody-positive sear was 2% and 5% prior and following depletion of HLA antigens. The presence of HLA-antibody immune complexes in patients' sear was positively associated with chronic humoral rejection (P< 0.0001). Patients who tolrated the graft in spite of having developed antibodies against one of its mismatched HLA antigens show specific antiidiotypic (anit-anit-HLA-antibodies). Such antiidiotypic antibodies were not found in sear from patients with chronic rejection (P= 0.005). This indicates that anitiidiotypic antibodies may delay the progression of chronic humoral rejection.