Donor-specific antibodies to human leukocyte antigens are associated with and precede antibodies to major histocompatibility complex class I-related chain A in antibody-mediated rejection and cardiac allograft vasculopathy after human cardiac transplantation

作者：Nath Dilip S; Angaswamy Nataraju; Basha Haseeb Ilias; Phelan Donna; Moazami Nader; Ewald Gregory A; Mohanakumar T^*

来源：Human Immunology, 2010, 71(12): 1191-1196.

DOI：10.1016/j.humimm.2010.09.012

• MICA
• HLA
• Cardiac transplantation
• Antibody mediated rejection
• Cardiac allograft vasculopathy

Humoral immune responses to mismatched donor human leukocyte antigen (HLA) and major histocompatibility complex (MHC) class I-related chain A (MICA) have been reported to contribute to immunopathogenes's of antibody-mediated rejection (AMR) in the early period and cardiac allograft vasculopathy (CAV) in the late period after cardiac transplantation (HTx) The goal of this study is to define the roles of donor-specific antibodies (DSA) and anti-MICA in AMR and CAV A total of 95 post-HTx recipients were enrolled 43 patients in the early period (<= 12 months post-HTx) and 52 patients in the late period (>12 months post-HTx) Development of DSA and anti-MICA were serially monitored using Luminex Development of DSA (AMR+ n = 6/8 75% AMR- n = 4/35 11% p = 0 009) and anti-MICA (AMR+ n = 5/8 63% AMR- n = 4/35 11% p = 0 002) was significantly associated with AMR AMR+DSA+ patients demonstrated increased anti-MICA levels compared with AMR+DSA- patients (p=0 01) Serial monitoring revealed DSA (2 7 +/- 1 4 months) preceded development of anti-MICA (6 5 2 1 months) in recipients diagnosed with AMR at 83 +/- 2 5 months post-HTx Development of DSA (CAV+ n = 8/12 67% CAV- n = 5/40 13% p = 0 004) and anti-MICA (CAV+ n = 9/12 75% CAV- n = 5/40 13% p = 0 001) was significantly associated with CAV CAV+DSA+ patients demonstrated Increased anti-MICA levels compared with CAV+DSA- patients (p = 0 01) Antibodies to HLA are associated with and precede development of anti-MICA in AMR and CAV

• 出版日期2010-12