Levels of angiotensin II type-1 receptor antibodies and endothelin-1 type-A receptor antibodies correlate with antibody-mediated rejection and poor graft function in kidney-transplantation patients |
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| Affiliation: | 2. Department of Blood Transfusion, Tianjin First Central Hospital, School of Medicine, NanKai University, 24 Fukang Road, Tianjin, Nankai, China;1. Department of Clinical Immunology, Medical University of Warsaw, Nowogrodzka 59, 02-006 Warsaw, Poland;2. Department of Immunology, Transplantology and Internal Medicine, Medical University of Warsaw, Nowogrodzka 59, 02-006 Warsaw, Poland;3. Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Nowogrodzka 59, 02-006 Warsaw, Poland;1. Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu;2. Keimyung University Kidney Institute, Daegu, Republic of Korea;1. Pharmacy Department, Grenoble Alpes University Hospital, Grenoble, France;2. Pharmacy Department, Grenoble Alpes University Hospital, Univ. Grenoble Alpes, LBFA, INSERM U1055, St Martin d''Heres, France;3. Respiratory Medicine University Hospital Service, Grenoble Alpes University Hospital, Grenoble, France;4. Respiratory Medicine Service, Hôpitaux du Leman, Thonon Les Bains, France;5. Pharmacy Department, Grenoble Alpes University Hospital, CNRS, TIMC UMR 5525, Grenoble, France;1. Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya City, Saitama, Japan;2. Transplant Center, Dokkyo Medical University Saitama Medical Center, Koshigaya City, Saitama, Japan;3. Department of Pathology, Dokkyo Medical University Saitama Medical Center, Koshigaya City, Saitama, Japan;4. Division of Transplant Surgery, Tokyo Metropolitan Health and Hospitals Corporation Ohkubo Hospital, Shinjuku Ward, Tokyo, Japan;5. Department of Nephrology, Dokkyo Medical University Saitama Medical Center, Koshigaya City, Saitama, Japan;1. Transfusion Medicine & Blood Centre, Jaypee Hospital, Noida, Delhi NCR, India;2. Nephrology & Renal Transplant, Jaypee Hospital, Noida, Delhi NCR, India;3. Urology & Renal Transplant, Jaypee Hospital, Noida, Delhi NCR, India |
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| Abstract: | ObjectiveAngiotensin II type-1 receptor antibodies (AT1R-Ab) and endothelin-1 type-A receptor antibodies (ETAR-Ab) are non-human leukocyte antigen (HLA) antibodies that can elicit adverse effects on kidney transplantation (KT) outcomes. We investigated the correlation between levels of AT1R-Ab and ETAR-Ab and postoperative outcomes in KT recipients.MethodsPre-KT and post-KT serum from 79 patients was collected. Post-KT serum was collected within 1 year after KT or simultaneously as the biopsy. Levels of AT1R-Ab and ETAR-Ab were measured using enzyme-linked immunosorbent assay kits. AT1R-Ab >17.0 U/mL and ETAR-Ab >10.0 U/mL was considered to denote positivity according to manufacturer recommendations. We measured donor-specific antibodies against human leukocyte antigens (HLA-DSA) levels using LABScreen™ single-antigen kits.ResultsSeventy-nine (54 men, 25 women) formed the study cohort. Seven (8.7%) patients were positive for AT1R-Ab, 25 (31.6%) patients were positive for both AT1R-Ab and ETAR-Ab, and 47 (59.5%) were negative for both antibodies at all time points. No patients died during the study period. Patients with both AT1R-Ab and ETAR-Ab were associated with a higher prevalence of antibody-mediated rejection (AMR) and lower estimated glomerular filtration rate, but not allograft loss or delayed graft function. AT1R-Ab were associated with T-cell-mediated rejection, but the association was not significant. HLA-DSA were associated significantly with a higher creatinine level in serum at 12 months and 24 months in patients with AT1R-Ab and/or ETAR-Ab.ConclusionsAT1R-Ab, ETAR-Ab, and HLA-DSA were associated with a higher prevalence of AMR and decline in graft function. Measurement of levels of AT1R-Ab and ETAR-Ab in KT patients may be useful for stratification of immunological risk and identification of patients at a high risk of adverse graft outcome. |
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