Isolated De Novo Antiendothelial Cell Antibodies and Kidney Transplant Rejection. [artículo]
Por: Sánchez Zapardiel, Elena [Inmunología]
| Mancebo Sierra, Esther [Inmunología] | Serrano Hernández, Antonio [Inmunología] | Castro Panete, María José [Inmunología] | Utrero Rico, Alberto [Instituto de investigación imas12] | Andrés Belmonte, Amado [Nefrología] | Morales Cerdán, José María [Nefrología] | Paz Artal, Estela [Inmunología].
Colaborador(es): Servicio de Inmunología | Servicio de Nefrología | Instituto de Investigación imas12.
Tipo de material: 
ArtículoEditor: American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016Descripción: 68(6):933-43.Recursos en línea: Solicitar documento Resumen: Background: Studies analyzing the role of antiendothelial cell antibodies (AECAs) in large series of kidney transplant recipients are scarce, and HLA, MHC (major histocompatibility complex) class I-related chain A (MICA), and angiotensin II type 1 receptor have not been formally excluded as targets.
Study design: Retrospective study of a cohort of kidney transplant recipients.
Setting & participants: 324 kidney transplant recipients who were negative for anti-HLA, anti-MICA, and anti-angiotensin II type 1 receptor antibodies were tested for AECAs in pre- and posttransplantation serum samples.
Predictors: AECA-positive (preformed [pre+/post+] vs de novo [pre-/post+]) versus AECA-negative (pre-/post-) before or after transplantation.
Outcomes: Patient mortality, transplant loss, and acute rejection events.
Results: 66 (20%) patients were AECA positive (39 [12%] preformed, 27 [8%] de novo) and 258 (80%) were AECA negative. During a follow-up of 10 years, 7 (18%) AECA pre+/post+ patients had rejections compared with 14 (52%) AECA pre-/post+ and 57 (22%) AECA pre-/post- recipients (OR, 3.80; P=0.001). AECA pre-/post+ status emerged as an independent risk factor for transplant rejection compared to the AECA pre-/post- group (OR, 5.17; P<0.001). However, AECA pre+/post+ and AECA pre-/post+ patients did not show higher risk for either patient death (ORs of 1.49 [P=0.7] and 1.06 [P=0.9], respectively) or transplant loss (ORs of 1.22 and 0.86, respectively; P for both = 0.8) compared to the AECA pre-/post- population.
Limitations: Retrospective study. Posttransplantation sera were collected before or after rejection, entailing a nearly cross-sectional relationship between the exposure and outcome. Lack of identification of precise antigens for AECAs.
Conclusions: De novo AECAs may be associated with rejection. These antibodies might serve as biomarkers of endothelium damage in kidney transplant recipients.
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Artículo
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PC17946 (Navegar estantería) | Disponible |
Formato Vancouver:
Sánchez Zapardiel E, Mancebo E, Díaz Ordoñez M, de Jorge Huerta L, Ruiz Martínez L, Serrano A et al. Isolated De Novo Antiendothelial Cell Antibodies and Kidney Transplant Rejection. Am J Kidney Dis. 2016 Dec;68(6):933-43.
PMID: 27599627
Contiene 34 referencias
Background: Studies analyzing the role of antiendothelial cell antibodies (AECAs) in large series of kidney transplant recipients are scarce, and HLA, MHC (major histocompatibility complex) class I-related chain A (MICA), and angiotensin II type 1 receptor have not been formally excluded as targets.
Study design: Retrospective study of a cohort of kidney transplant recipients.
Setting & participants: 324 kidney transplant recipients who were negative for anti-HLA, anti-MICA, and anti-angiotensin II type 1 receptor antibodies were tested for AECAs in pre- and posttransplantation serum samples.
Predictors: AECA-positive (preformed [pre+/post+] vs de novo [pre-/post+]) versus AECA-negative (pre-/post-) before or after transplantation.
Outcomes: Patient mortality, transplant loss, and acute rejection events.
Results: 66 (20%) patients were AECA positive (39 [12%] preformed, 27 [8%] de novo) and 258 (80%) were AECA negative. During a follow-up of 10 years, 7 (18%) AECA pre+/post+ patients had rejections compared with 14 (52%) AECA pre-/post+ and 57 (22%) AECA pre-/post- recipients (OR, 3.80; P=0.001). AECA pre-/post+ status emerged as an independent risk factor for transplant rejection compared to the AECA pre-/post- group (OR, 5.17; P<0.001). However, AECA pre+/post+ and AECA pre-/post+ patients did not show higher risk for either patient death (ORs of 1.49 [P=0.7] and 1.06 [P=0.9], respectively) or transplant loss (ORs of 1.22 and 0.86, respectively; P for both = 0.8) compared to the AECA pre-/post- population.
Limitations: Retrospective study. Posttransplantation sera were collected before or after rejection, entailing a nearly cross-sectional relationship between the exposure and outcome. Lack of identification of precise antigens for AECAs.
Conclusions: De novo AECAs may be associated with rejection. These antibodies might serve as biomarkers of endothelium damage in kidney transplant recipients.
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