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Investigation of Serum Angiotensin II Type 1 Receptor Antibodies at the Time of Renal Allograft Rejection.

Lee H, Kim JI, Moon IS, Chung BH, Yang CW, Kim Y, Han K, Oh EJ - Ann Lab Med (2015)

Bottom Line: Angiotensin II type 1 receptor (AT1R) is responsible for cardiovascular effects mediated by angiotensin II.Four of five anti-AT1R(+) patients had DSA and were also found to have AMR.However, DSA(+)/anti-AT1R(+) was more frequently found in AMR than in TCMR (P=0.036).

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Background: Angiotensin II type 1 receptor (AT1R) is responsible for cardiovascular effects mediated by angiotensin II. This study aimed to investigate the impact of antibodies directed against AT1R (anti-AT1R) in renal allograft rejection.

Methods: We evaluated 53 patients who had biopsy-proven rejection including antibody-mediated rejection (AMR) (N=22), T-cell-mediated rejection (TCMR) (N=29), and mixed AMR and TCMR (N=2). Donor specific HLA antibodies (DSA) and anti-AT1Rs were simultaneously determined.

Results: Anti-AT1Rs were detected in 9.4% (5/53) of rejection patients (one with acute AMR, two with chronic active AMR, one with acute TCMR, and one with mixed acute AMR & TCMR). HLA antibodies and DSA were detected in 75.5% (40/53) and 49.1% (26/53) of patients, respectively. There was no significant difference in transplant characteristics between anti-AT1R(+) and anti-AT1R(-) patients except for the association of HLA class-I DSA(+) and anti-AT1R(+). Four of five anti-AT1R(+) patients had DSA and were also found to have AMR. A single anti-AT1R(+)/DSA(-) patient developed acute TCMR. Detection rates of DSA, HLA antibodies, or anti-AT1R were not different between AMR and TCMR. However, DSA(+)/anti-AT1R(+) was more frequently found in AMR than in TCMR (P=0.036). Patients with anti-AT1R showed a greater tendency to develop high-grade rejection as Banff IIA/IIB or AMR.

Conclusions: The presence of anti-AT1R was significantly associated with HLA class-I DSA in renal allograft rejection patients. Both anti-AT1R and DSA positivity was associated with AMR in patients with renal allograft rejection.

No MeSH data available.


Related in: MedlinePlus

Median fluorescence intensity values of detected DSA class I and class II were not different between patients with AMR and TCMR. The top and bottom border of the box means 95% confidence interval. The bars below and above the box mean minimum and maximum values, respectively, and horizontal line in the box means median value.Abbreviations: DSA, donor specific HLA antibodies; AMR, antibody-mediated rejection; TCMR, T-cell-mediated rejection.
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Figure 2: Median fluorescence intensity values of detected DSA class I and class II were not different between patients with AMR and TCMR. The top and bottom border of the box means 95% confidence interval. The bars below and above the box mean minimum and maximum values, respectively, and horizontal line in the box means median value.Abbreviations: DSA, donor specific HLA antibodies; AMR, antibody-mediated rejection; TCMR, T-cell-mediated rejection.

Mentions: We analyzed HLA antibodies, DSA, and anti-AT1R results in association with histological rejection classification (AMR vs. TCMR) (Fig. 1). HLA antibodies and DSA data were also analyzed according to HLA class specificity. Two patients with AMR and TCMR mixed rejection were categorized as AMR. Of 24 patients with AMR, 20 patients showed C4d deposition, 11 patients had DSA, and four patients had both DSA and anti-AT1R. Of 13 patients who developed AMR and no DSA at the time of rejection, none had anti-AT1R. The detection rate of anti-AT1R, DSA, DSA class-I, DSA class-II, HLA antibodies, anti-HLA class I, or anti-HLA class II was not different between AMR and TCMR in patients with allograft rejection. However, C4d deposition and detection of both DSA and anti-AT1R were more frequent in AMR than in TCMR (P<0.001 for C4d deposition and P=0.036 for both DSA and anti-AT1R, respectively). MFI values of DSA class I or class II were not different between patients with AMR and TCMR (Fig. 2).


Investigation of Serum Angiotensin II Type 1 Receptor Antibodies at the Time of Renal Allograft Rejection.

Lee H, Kim JI, Moon IS, Chung BH, Yang CW, Kim Y, Han K, Oh EJ - Ann Lab Med (2015)

Median fluorescence intensity values of detected DSA class I and class II were not different between patients with AMR and TCMR. The top and bottom border of the box means 95% confidence interval. The bars below and above the box mean minimum and maximum values, respectively, and horizontal line in the box means median value.Abbreviations: DSA, donor specific HLA antibodies; AMR, antibody-mediated rejection; TCMR, T-cell-mediated rejection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4390699&req=5

Figure 2: Median fluorescence intensity values of detected DSA class I and class II were not different between patients with AMR and TCMR. The top and bottom border of the box means 95% confidence interval. The bars below and above the box mean minimum and maximum values, respectively, and horizontal line in the box means median value.Abbreviations: DSA, donor specific HLA antibodies; AMR, antibody-mediated rejection; TCMR, T-cell-mediated rejection.
Mentions: We analyzed HLA antibodies, DSA, and anti-AT1R results in association with histological rejection classification (AMR vs. TCMR) (Fig. 1). HLA antibodies and DSA data were also analyzed according to HLA class specificity. Two patients with AMR and TCMR mixed rejection were categorized as AMR. Of 24 patients with AMR, 20 patients showed C4d deposition, 11 patients had DSA, and four patients had both DSA and anti-AT1R. Of 13 patients who developed AMR and no DSA at the time of rejection, none had anti-AT1R. The detection rate of anti-AT1R, DSA, DSA class-I, DSA class-II, HLA antibodies, anti-HLA class I, or anti-HLA class II was not different between AMR and TCMR in patients with allograft rejection. However, C4d deposition and detection of both DSA and anti-AT1R were more frequent in AMR than in TCMR (P<0.001 for C4d deposition and P=0.036 for both DSA and anti-AT1R, respectively). MFI values of DSA class I or class II were not different between patients with AMR and TCMR (Fig. 2).

Bottom Line: Angiotensin II type 1 receptor (AT1R) is responsible for cardiovascular effects mediated by angiotensin II.Four of five anti-AT1R(+) patients had DSA and were also found to have AMR.However, DSA(+)/anti-AT1R(+) was more frequently found in AMR than in TCMR (P=0.036).

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Background: Angiotensin II type 1 receptor (AT1R) is responsible for cardiovascular effects mediated by angiotensin II. This study aimed to investigate the impact of antibodies directed against AT1R (anti-AT1R) in renal allograft rejection.

Methods: We evaluated 53 patients who had biopsy-proven rejection including antibody-mediated rejection (AMR) (N=22), T-cell-mediated rejection (TCMR) (N=29), and mixed AMR and TCMR (N=2). Donor specific HLA antibodies (DSA) and anti-AT1Rs were simultaneously determined.

Results: Anti-AT1Rs were detected in 9.4% (5/53) of rejection patients (one with acute AMR, two with chronic active AMR, one with acute TCMR, and one with mixed acute AMR & TCMR). HLA antibodies and DSA were detected in 75.5% (40/53) and 49.1% (26/53) of patients, respectively. There was no significant difference in transplant characteristics between anti-AT1R(+) and anti-AT1R(-) patients except for the association of HLA class-I DSA(+) and anti-AT1R(+). Four of five anti-AT1R(+) patients had DSA and were also found to have AMR. A single anti-AT1R(+)/DSA(-) patient developed acute TCMR. Detection rates of DSA, HLA antibodies, or anti-AT1R were not different between AMR and TCMR. However, DSA(+)/anti-AT1R(+) was more frequently found in AMR than in TCMR (P=0.036). Patients with anti-AT1R showed a greater tendency to develop high-grade rejection as Banff IIA/IIB or AMR.

Conclusions: The presence of anti-AT1R was significantly associated with HLA class-I DSA in renal allograft rejection patients. Both anti-AT1R and DSA positivity was associated with AMR in patients with renal allograft rejection.

No MeSH data available.


Related in: MedlinePlus