JOURNAL OF HEART AND LUNG TRANSPLANTATION | 卷:29 |
Increased erythrocyte C4D is associated with known alloantibody and autoantibody markers of antibody-mediated rejection in human lung transplant recipients | |
Article | |
Golocheikine, Angali1  Basha, Haseeb Ilias1  Saini, Deepti1  Phelan, Donna4  Aloush, Aviva3  Trulock, Elbert P.3  Hachem, Ramsey R.3  Ahearn, Joseph M.5  Mohanakumar, Thalachallour1,2  | |
[1] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA | |
[2] Washington Univ, Sch Med, Dept Pathol & Immunol, St Louis, MO 63110 USA | |
[3] Washington Univ, Sch Med, Dept Med, St Louis, MO 63110 USA | |
[4] Barnes Jewish Hosp, HLA Lab, St Louis, MO 63110 USA | |
[5] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA | |
关键词: self-antigens; lung transplantation; AMR; complement degradation products; erythrocytes; | |
DOI : 10.1016/j.healun.2009.10.003 | |
来源: Elsevier | |
【 摘 要 】
BACKGROUND: Immune responses to mismatched donor human leukocyte antigens (HLA) are important in the pathogenesis of chronic rejection. This study evaluated whether erythrocyte-bound C4d (E-C4d) is associated with known alloimmune and autoimmune markers of antibody-mediated rejection after human lung transplantation (LTx). METHODS: Flow cytometry was used to analyze 22 LTx recipients and 15 healthy individuals for E-C4d. Development of antibodies to donor-mismatched HLA (donor-specific antibody [DSA]) and antibodies to HLA were determined using the solid-phase method by Luminex. Development of antibodies to self-antigens, K-alpha-1-tubulin (KAIT) and collagen V (Col-V), were measured by enzyme-linked immunosorbent assay. C3d deposition in lung biopsy specimens was determined by immunohistochemical staining. RESULTS: Percent E-C4d (%E-C4d) levels were 19.9% in LTx patients vs 3.7% in healthy individuals (p = 0.02). DSA + patients had higher E-C4d levels than DSA patients (34.1% vs 16.7%, p = 0.02). In 5 patients with preformed anti-HLA, E-C4d levels were not significantly different vs 13 patients without detectable anti-HLA (p = 0.1). E-C4d levels were higher in patients who developed antibodies to KA1T (p = 0.02) and Col-V (p = 0.03). Recipients with C3d-positive tissue deposition had higher E-C4d levels than patients with C3d-negative biopsy results (p = 0.01). CONCLUSIONS: Increased %E-C4d levels are found in patients with positive DSA, high antibody titers to KA1T and Col-V, and have C3d+ lung biopsy findings. Therefore, %E-C4d can serve as a potential marker for antibody-mediated rejection after LTx. J Heart Lung Transplant 2010;29:410-416 (C) 2010 International Society for Heart and Lung Transplantation. All rights reserved.
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