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The serum level of de novo donor specific antibody can predict acute rejection in lung transplantation.

新供体特异性抗体的血清水平可以预测肺移植中的急性排斥反应。

基本信息

批准号：
19591626
负责人：
SANO Yoshifumi
金额：
$ 1.25万
依托单位：
Okayama University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2007
资助国家：
日本
起止时间：
2007 至 2009
项目状态：
已结题

项目摘要

There is no useful biomarkers for diagnosis of acute rejection have been clinically used after lung transplantation (LTx). In this study, daily transition of de novo donor-specific alloantibodies (DSA) was analyzed for our living-donor lobar LT ecipients to determine whether DSA levels are influenced by acute rejection. Ten non-sensitized patients who had received living donor lobar LTx by donation from two individuals were analyzed. Five of them developed unilateral acute rejection during the first 14 days after transplantation (AR+ group), and the others had no rejection episode during the period (AR- group). The immunoreactivity against T-cells from each side of donors was daily monitored by detecting donor-specific IgM using flow cytometry crossmatch technique. The difference between donor-specific IgM levels of serum from each side of donors was more remarkable in the AR+ group than in the AR- group (p<0.05). In the AR+ group, the IgM levels against the rejected donors started to be significantly higher than that ageinst he non-rejected donors from two days before the clinical onset of acute rejection (p<0.05). A greater immunoreactivity only for the rejected donor preceded the clinical onset of acute rejection. Sequential de novo donor-specic IgM monitoring can contribute the early diagnosis of acute rejection.

目前临床上尚无诊断肺移植术后急性排斥反应的有效生物标志物。在这项研究中，分析了我们的活体供者肺叶LT受体的新生供体特异性同种抗体（DSA）的每日变化，以确定DSA水平是否受到急性排斥反应的影响。分析了10例非致敏患者，他们接受了来自两个人的活体供体肺叶LTx。其中5例（AR+组）在移植后14天内发生了单侧急性排斥反应，其余5例（AR-组）在移植后14天内未发生排斥反应。通过使用流式细胞术交叉配型技术检测供体特异性IgM，每天监测来自供体每侧的T细胞的免疫反应性。供者血清特异性IgM水平在AR+组较AR-组差异显著（p<0.05）。在AR+组中，排斥组的IgM水平从急性排斥临床发生前2天开始显著高于非排斥组（p<0.05）。一个更大的免疫反应性，只有拒绝捐助者之前的临床急性排斥反应的发作。序贯从头检测供者特异性IgM有助于急性排斥反应的早期诊断。