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Cannon E, Stevenson K, Little AM, McKenzie D, Hastie C, Calvert A, Poles A, Battle R, McConnell S, Phelan PJ, Turner D. Kidney transplant outcomes in patients with antibodies to human neutrophil antigen 3a. Transpl Immunol 2023; 81:101905. [PMID: 37541630 DOI: 10.1016/j.trim.2023.101905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/14/2023] [Accepted: 07/22/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Antibody mediated rejection (ABMR) of kidney transplants has been shown to occur in the absence of a known donor specific antibody to human leucocyte antigen (HLA). Antibodies to the human neutrophil antigen (HNA) system have been detected in kidney transplant recipients and linked to ABMR in the absence of an HLA donor specific antibody (DSA), but there remains limited literature regarding this. METHODS Case series analysis was carried out examining three cases of HNA-3a antibody positive flow cytometry cross match (FC-XM) from two transplant centres in Scotland. RESULTS All patients included were female and had been sensitised as a result of pregnancy. One live donor recipient with HNA-3a antibodies identified prior to transplant received ATG induction and has had a good outcome. The remaining two patients received deceased donor transplants. HNA-3a antibodies were indicated following a retrospective flow cytometry crossmatch. Both patients received Basiliximab induction and both have experienced ABMR requiring supplementary immunosuppression. CONCLUSIONS The predicted rate of HNA-3a antibodies amongst patients awaiting kidney transplant in the UK is <1%. However, with increasing evidence to support a role for HNA-3a antibodies in the development of ABMR there may be value in screening at risk groups to allow for augmented immunosuppression to be considered at the time of kidney transplant.
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Affiliation(s)
- Emma Cannon
- The Department of Renal Medicine, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.
| | - Karen Stevenson
- Renal Transplant Unit, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK.
| | - Ann-Margaret Little
- Histocompatibility and Immunogenetics Laboratory, Gartnavel General Hospital, Level 1, Laboratory Medicine Building, 21, Shelley Road, Glasgow G12 0ZD, UK.
| | - David McKenzie
- Histocompatibility and Immunogenetics Laboratory, Gartnavel General Hospital, Level 1, Laboratory Medicine Building, 21, Shelley Road, Glasgow G12 0ZD, UK.
| | - Catherine Hastie
- Histocompatibility and Immunogenetics Laboratory, Gartnavel General Hospital, Level 1, Laboratory Medicine Building, 21, Shelley Road, Glasgow G12 0ZD, UK.
| | - Anthony Calvert
- Histocompatibility and Immunogenetics Laboratory, NHSBT, 500 North Bristol Park, Northway, Filton, Bristol BS34 7QH, UK.
| | - Anthony Poles
- Histocompatibility and Immunogenetics Laboratory, NHSBT, 500 North Bristol Park, Northway, Filton, Bristol BS34 7QH, UK.
| | - Richard Battle
- Histocompatibility and Immunogenetics Laboratory, Scottish National Blood Transfusion Service, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
| | - Sylvia McConnell
- Histocompatibility and Immunogenetics Laboratory, Scottish National Blood Transfusion Service, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
| | - Paul J Phelan
- The Department of Renal Medicine, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.
| | - David Turner
- Histocompatibility and Immunogenetics Laboratory, Scottish National Blood Transfusion Service, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
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Amdani S, Henderson H, Everitt MD, Beasley G, Shih R, Exil V, Alejos J, Wallis G, Azeka E, Nandi D, Profita E, Spinner J, Magnetta D, Martinez H, Fenton M, Conway J, Urschel S. Clinical approach to antibody-mediated rejection from the pediatric heart transplant society. Pediatr Transplant 2022; 26:e14398. [PMID: 36377325 DOI: 10.1111/petr.14398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/03/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022]
Abstract
This document is designed to outline the definition, pathogenesis, diagnostic modalities and therapeutic measures to treat antibody-mediated rejection in children postheart transplant METHODS: Literature review was conducted by a Pediatric Heart Transplant Society (PHTS) working group to identify existing pediatric and adult studies on antibody-mediated rejection (AMR). In addition, the centers participating in PHTS were asked to submit their approach to diagnosis and management of pediatric AMR. This document synthesizes information gathered from both these sources to highlight a practical approach to diagnosing and managing a child with AMR postheart transplant. This document may not represent the practice at all centers in the PHTS and serves as a starting point to understand an approach to this clinical scenario.
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Affiliation(s)
- Shahnawaz Amdani
- Pediatric Heart Failure and Transplant Cardiologist, Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA
| | - Heather Henderson
- Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Melanie D Everitt
- Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA
| | - Gary Beasley
- Division of Pediatric Cardiology; and The Heart Institute at Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Renata Shih
- Division of Pediatric Cardiology, University of Florida, Gainesville, Florida, USA
| | - Vernat Exil
- Carver School of Medicine, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA
| | - Juan Alejos
- Division of Pediatric Cardiology, Mattel Children's Hospital, Los Angeles, California, USA
| | - Gonzalo Wallis
- Division of Pediatric Cardiology, Levine Children's Hospital, Charlotte, North Carolina, USA
| | - Estela Azeka
- Unidade de Cardiologia, Heart Institute (InCor) University of São Paulo Medical School, Cerqueira César, Sao Paulo, Brazil
| | - Deipanjan Nandi
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Elizabeth Profita
- Stanford University, Lucile Packard Children's Hospital Stanford, Palo Alto, California, USA
| | - Joseph Spinner
- Division of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA
| | - Defne Magnetta
- unidade de cardiologia, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Hugo Martinez
- Division of Pediatric Cardiology; and The Heart Institute at Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Matthew Fenton
- Division of Pediatric Cardiology, Great Ormond Street Hospital, London, UK
| | - Jennifer Conway
- Division of Pediatric Cardiology, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Simon Urschel
- Division of Pediatric Cardiology, Stollery Children's Hospital, Edmonton, Alberta, Canada
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Nair N. Vascular rejection in cardiac allograft vasculopathy: Impact on graft survival. Front Cardiovasc Med 2022; 9:919036. [PMID: 35990962 PMCID: PMC9386065 DOI: 10.3389/fcvm.2022.919036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/14/2022] [Indexed: 11/24/2022] Open
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4
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Non-HLA Antibodies in Kidney Transplantation: Immunity and Genetic Insights. Biomedicines 2022; 10:biomedicines10071506. [PMID: 35884811 PMCID: PMC9312985 DOI: 10.3390/biomedicines10071506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/27/2022] Open
Abstract
The polymorphic human leukocyte antigen (HLA) system has been considered the main target for alloimmunity, but the non-HLA antibodies and autoimmunity have gained importance in kidney transplantation (KT). Apart from the endothelial injury, secondary self-antigen exposure and the presence of polymorphic alloantigens, respectively, auto- and allo- non-HLA antibodies shared common steps in their development, such as: antigen recognition via indirect pathway by recipient antigen presenting cells, autoreactive T cell activation, autoreactive B cell activation, T helper 17 cell differentiation, loss of self-tolerance and epitope spreading phenomena. Both alloimmunity and autoimmunity play a synergic role in the formation of non-HLA antibodies, and the emergence of transcriptomics and genome-wide evaluation techniques has led to important progress in understanding the mechanistic features. Among them, non-HLA mismatches between donors and recipients provide valuable information regarding the role of genetics in non-HLA antibody immunity and development.
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5
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Senev A, Ray B, Lerut E, Hariharan J, Heylen C, Kuypers D, Sprangers B, Emonds MP, Naesens M. The Pre-Transplant Non-HLA Antibody Burden Associates With the Development of Histology of Antibody-Mediated Rejection After Kidney Transplantation. Front Immunol 2022; 13:809059. [PMID: 35250981 PMCID: PMC8888449 DOI: 10.3389/fimmu.2022.809059] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/25/2022] [Indexed: 01/03/2023] Open
Abstract
Background Many kidney allografts fail due to the occurrence of antibody-mediated rejection (ABMR), related to donor-specific anti-HLA antibodies (HLA-DSA). However, the histology of ABMR can also be observed in patients without HLA-DSA. While some non-HLA antibodies have been related to the histology of ABMR, it is not well known to what extent they contribute to kidney allograft injury. Here we aimed to investigate the role of 82 different non-HLA antibodies in the occurrence of histology of ABMR after kidney transplantation. Methods We included all patients who underwent kidney transplantation between 2004-2013 in a single center and had biobanked serum. Pre- and post-transplant sera (n=2870) were retrospectively tested for the presence of 82 different non-HLA antibodies using a prototype bead assay on Luminex (Immucor, Inc). A ratio was calculated between the measured MFI value and the cut-off MFI defined by the vendor for each non-HLA target. Results 874 patients had available pretransplant sera and were included in this analysis. Of them, 133 (15.2%) received a repeat kidney allograft, and 100 (11.4%) had pretransplant HLA-DSA. In total, 204 (23.3%) patients developed histology of ABMR after kidney transplantation. In 79 patients (38.7%) the histology of ABMR was explained by pretransplant or de novo HLA-DSA. The multivariable Cox analysis revealed that only the broadly non-HLA sensitized (number of positive non-HLA antibodies) patients and those with the highest total strength of the non-HLA antibodies (total ratios of the positive non-HLA antibodies) were independently associated with increased rates of histology of ABMR after transplantation. Additionally, independent associations were found for antibodies against TUBB (HR=2.40; 95% CI 1.37 – 4.21, p=0.002), Collagen III (HR=1.67; 95% CI 1.08 – 2.58, p=0.02), VCL (HR=2.04; 95% CI 1.12 – 3.71, p=0.02) and STAT6 (HR=1.47; 95% CI 1.01 – 2.15, p=0.04). The overall posttransplant non-HLA autoreactivity was not associated with increased rates of ABMRh. Conclusions This study shows that patients highly and broadly sensitized against non-HLA targets are associated with an increased risk of ABMR histology after kidney transplantations in the absence of HLA-DSA. Also, some pretransplant non‐HLA autoantibodies are individually associated with increased rates of ABMR histology. However, whether these associations are clinically relevant and represent causality, warrants further studies.
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Affiliation(s)
- Aleksandar Senev
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Histocompatibility and Immunogenetics Laboratory, Belgian Red Cross-Flanders, Mechelen, Belgium
| | - Bryan Ray
- Immucor Inc., Norcross, GA, United States
| | - Evelyne Lerut
- Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Dirk Kuypers
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Ben Sprangers
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Marie-Paule Emonds
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Histocompatibility and Immunogenetics Laboratory, Belgian Red Cross-Flanders, Mechelen, Belgium
| | - Maarten Naesens
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
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Miura K, Shirai Y, Kaneko N, Yabuuchi T, Ishizuka K, Horita S, Furusawa M, Unagami K, Okumi M, Ishida H, Tanabe K, Koike J, Honda K, Yamaguchi Y, Hattori M. Chronic Active Antibody-Mediated Rejection with Linear IgG Deposition on Glomerular Capillaries in a Kidney Transplant Recipient. Nephron Clin Pract 2020; 144 Suppl 1:97-101. [PMID: 33238286 DOI: 10.1159/000511322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/02/2020] [Indexed: 11/19/2022] Open
Abstract
Glomerular IgG deposition is rarely observed in antibody-mediated rejection. Here, we report chronic active antibody-mediated rejection with linear IgG deposition on glomerular capillary walls in a pediatric kidney transplant recipient. A 6-year-old boy with bilateral renal hypoplasia underwent preemptive deceased-donor kidney transplantation. Five years after the transplantation, an allograft biopsy revealed chronic active antibody-mediated rejection with diffuse linear IgG deposition on glomerular capillaries. Anti-glomerular basement membrane antibody, donor-specific anti-human leukocyte antigen (HLA) antibodies, and anti-angiotensin II type 1 receptor antibody were negative. A multiplex antibody assay identified anti-major histocompatibility complex class I chain-related molecule A antibody. Additionally, a single-antigen bead assay identified autoantibodies to 12 non-HLA antigens, including vimentin and glutathione S-transferase theta-1. To investigate whether IgG autoantibodies in the patient's serum bind to antigens on glomerular capillaries, we incubated the patient's serum with 0-h biopsy specimens of tissue donated to the patient and a control subject, both obtained immediately after nephrectomy from respective donors. IgG signals were observed in neither patient nor control samples. Nevertheless, linear IgG deposition may be explained by the binding of autoantibodies to non-HLA antigens that are usually hidden and only exposed via severe endothelial cell injury. Further studies are needed to confirm the significance of non-HLA antibodies in glomerular IgG deposition.
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Affiliation(s)
- Kenichiro Miura
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoko Shirai
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Naoto Kaneko
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomoo Yabuuchi
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kiyonobu Ishizuka
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Shigeru Horita
- Department of Pathology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Miyuki Furusawa
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kohei Unagami
- Department of Organ Transplant Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Hideki Ishida
- Department of Organ Transplant Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazunari Tanabe
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
| | - Junki Koike
- Department of Diagnostic Pathology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kazuho Honda
- Department of Anatomy, Showa University School of Medicine, Tokyo, Japan
| | | | - Motoshi Hattori
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan,
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7
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Batth IS, Li S. Discovery of Cell-Surface Vimentin (CSV) as a Sarcoma Target and Development of CSV-Targeted IL12 Immune Therapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1257:169-178. [PMID: 32483739 DOI: 10.1007/978-3-030-43032-0_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This chapter discusses a novel target of osteosarcoma (OS), cell-surface vimentin (CSV), and a novel generation of interleukin-12 (IL12), CSV-targeted IL12, for treating OS tumor metastasis. Vimentin is a known intracellular structural protein for mesenchymal cells but is also documented in tumor cells. Our recent study definitively revealed that vimentin can be translocated to the surface of very aggressive tumor cells, such as metastatic cells. This CSV property allows investigators to capture circulating tumor cells (CTCs) across any type of tumor, including OS. CTCs are known as the seeds of metastasis; therefore, targeting these cells using CSV is a logical approach for use in a metastatic OS setting. Interestingly, we found that the peptide VNTANST can bind to CSV when fused to the p40 subunit encoding the DNA of IL12. Systemic delivery of this CSV-targeted IL12 immune therapy inhibited OS metastasis and relapse in a mouse tumor model as detailed in this chapter. This CSV-targeted delivery of IL12 also reduced toxicity of IL12. In summary, this chapter details a novel approach for safe IL12 immune therapy via targeting CSV.
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Affiliation(s)
- Izhar S Batth
- The University of Texas MD Anderson Cancer Center, Department of Pediatrics - Research, Houston, TX, USA
| | - Shulin Li
- The University of Texas MD Anderson Cancer Center, Department of Pediatrics - Research, Houston, TX, USA.
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8
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A Review on the Function and Regulation of ARHGDIB/RhoGDI2 Expression Including the Hypothetical Role of ARHGDIB/RhoGDI2 Autoantibodies in Kidney Transplantation. Transplant Direct 2020; 6:e548. [PMID: 32548242 PMCID: PMC7213606 DOI: 10.1097/txd.0000000000000993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/18/2022] Open
Abstract
Challenging and still unsolved problems in kidney transplantation are risk stratification and the treatment of humoral rejection. Antibody-mediated rejection is an important cause of early and chronic rejection. The impact of donor-specific HLA antibodies on antibody-mediated rejection–causing graft damage is well known, but the clinical relevance of non-HLA antibodies remains unclear. Recently, in 2 independent studies, a new correlation was found between the presence of non-HLA anti-Rho guanosine diphosphate dissociation inhibitor 2 (ARHGDIB) antibodies and increased graft failure. RhoGDI2, another name for ARHGDIB, is a negative regulator of the Rho guanosine triphosphate (RhoGTP)ases RhoA, Rac1m, and Cdc42, whose main function is regulating the actin network in a variety of cells. RhoGDI2 is mainly expressed intracellularly, and some expression is observed on the cell surface. Currently, there is no mechanism known to explain this correlation. Additionally, the reason why the antibodies are produced is unknown. In this review, we will address these questions, provide an overview of other diseases in which these antibodies are prevalent, and describe the physiological role of RhoGDI2 itself. If the mechanism and impact of RhoGDI2 antibodies in kidney graft failure are known, improved risk stratification can be provided to decrease the rate of donor kidney graft failure.
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9
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Kinloch AJ, Cascino MD, Dai J, Bermea RS, Ko K, Vesselits M, Dragone LL, Mor Vaknin N, Legendre M, Markovitz DM, Okoreeh MK, Townsend MJ, Clark MR. Anti-vimentin antibodies: a unique antibody class associated with therapy-resistant lupus nephritis. Lupus 2020; 29:569-577. [PMID: 32216516 DOI: 10.1177/0961203320913606] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Tubulointerstitial inflammation (TII) in lupus nephritis is associated with a worse prognosis. Vimentin, a filamental antigen, is commonly targeted by in situ activated B-cells in TII. The prognostic importance of high serum anti-vimentin antibodies (AVAs) in lupus nephritis and their relationship with common lupus autoantibody specificities is unknown. Herein we investigated associations between AVA isotypes, other autoantibodies, and response to mycophenolate mofetil (MMF) in the presence or absence of rituximab. Methods The Translational Research Initiative in the Department of Medicine (TRIDOM) cross-sectional cohort of 99 lupus patients was assayed for IgG-, IgA- and IgM- AVAs, lupus-associated and rheumatoid arthritis-associated antibodies, and hierarchically clustered. Serum from baseline, 26 and 52 weeks from 132 Lupus Nephritis Assessment with Rituximab (LUNAR) trial enrolled lupus nephritis patients was also analysed and correlated with renal function up to week 78. Results In TRIDOM, AVAs, especially IgM AVAs, clustered with IgG anti-dsDNA and away from anti-Sm and -RNP and rheumatoid arthritis-associated antibodies. In LUNAR at baseline, AVAs correlated weakly with anti-dsDNA and more strongly with anticardiolipin titers. Regardless of treatment, IgG-, but not IgM- or IgA-, AVAs were higher at week 52 than at baseline. In contrast, anti-dsDNA titers declined, regardless of therapeutic regime. High IgG AVA titers at entry predicted less response to therapy. Conclusion AVAs, especially IgG AVAs, are unique in distribution and response to therapy compared with other commonly measured autoantibody specificities. Furthermore, high-titer IgG AVAs identify lupus nephritis patients resistant to conventional therapies. These data suggest that AVAs represent an independent class of prognostic autoantibodies.
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Affiliation(s)
- Andrew J Kinloch
- Gwen Knapp Center for Lupus and Immunology Research, University of Chicago, Section of Rheumatology and Department of Medicine, Chicago, USA
| | - Matthew D Cascino
- Product Development I20, Genentech Research & Early Development, South San Francisco, USA
| | - Jian Dai
- Early Clinical Development Informatics, Genentech Research & Early Development, South San Francisco, USA
| | - Rene S Bermea
- University of Chicago, Section of Rheumatology and Department of Medicine, Chicago, USA
| | - Kichul Ko
- University of Chicago, Section of Rheumatology and Department of Medicine, Chicago, USA
| | - Margaret Vesselits
- Gwen Knapp Center for Lupus and Immunology Research, University of Chicago, Section of Rheumatology and Department of Medicine, Chicago, USA
| | - Leonard L Dragone
- Early Development, Infectious Disease, The Janssen Pharmaceutical Companies of Johnson & Johnson, South San Francisco, California
| | - Nirit Mor Vaknin
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | - Maureen Legendre
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | - David M Markovitz
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
| | - Michael K Okoreeh
- Gwen Knapp Center for Lupus and Immunology Research, University of Chicago, Section of Rheumatology and Department of Medicine, Chicago, USA
| | - Michael J Townsend
- Biomarker Discovery OMNI, Genentech Research & Early Development, South San Francisco, USA
| | - Marcus R Clark
- Gwen Knapp Center for Lupus and Immunology Research, University of Chicago, Section of Rheumatology and Department of Medicine, Chicago, USA.,University of Chicago, Section of Rheumatology and Department of Medicine, Chicago, USA
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10
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Alexander MP, Bentall A, Aleff PCA, Gandhi MJ, Scott JP, Roden AC. Ultrastructural changes in pulmonary allografts with antibody-mediated rejection. J Heart Lung Transplant 2019; 39:165-175. [PMID: 31870771 DOI: 10.1016/j.healun.2019.11.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 10/02/2019] [Accepted: 11/27/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Antibody-mediated rejection (AMR) is an important cause of lung allograft loss in some patients. Challenges with current diagnostic criteria limit timely detection. Ultrastructural studies of endothelia allow the early detection of AMR in kidney allografts. This study aimed to define the ultrastructural changes of the endothelium in lung allografts in the setting of AMR and determine its specificity for AMR. METHODS Ultrastuctural studies were performed on lung allograft biopsies of 12 patients using glutaraldehyde-fixed or paraffin-embedded material. AMR had been classified according to the International Society of Heart and Lung Transplant 2016 consensus report criteria. Endothelial changes (swelling [ES], vacuolization [EV], surface irregularity, detachment, neutrophil margination [NM]) and basement membrane changes were graded semi quantitatively using electron microscopy (EM). Grades were compared between AMR, acute cellular rejection, and non-transplant controls. RESULTS Significant differences were found between AMR and acute cellular reaction biopsies, particularly in ES (p = 0.006), EV (p = 0.023) and NM (p = 0.038). Using a combined score of all categories of assessment, the total EM score was significantly higher in AMR (p = 0.007) and provided excellent sensitivity and specificity with a receiver operator characteristic curve of 1.0. C4d did not correlate with EM changes associated with AMR. The use of paraffin-embedded material samples did not significantly affect the analysis compared with glutaraldehyde-fixed tissue, although ES was reduced in the former. CONCLUSIONS Endothelial structural analysis using EM can facilitate improved diagnostic accuracy of AMR and needs to be validated in larger cohorts, but it also allows retrospective studies to be performed.
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Affiliation(s)
| | | | | | | | - John P Scott
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
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11
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Nissen NI, Karsdal M, Willumsen N. Post-translational modifications of vimentin reflect different pathological processes associated with non-small cell lung cancer and chronic obstructive pulmonary disease. Oncotarget 2019; 10:6829-6841. [PMID: 31827725 PMCID: PMC6887574 DOI: 10.18632/oncotarget.27332] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/06/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Vimentin has shown to be highly implicated in cancer initiation and progression. Vimentin is often a target of post-translational modifications (PTMs) which can be disease specific, thus targeting these specific modifications can be of high biomarker potential. In this study we set out to evaluate the biological relevance and serum biomarker potential of citrullinated vimentin (VICM) and non-citrullinated vimentin (VIM) in non-small cell lung cancer (NSCLC) and chronic obstructive pulmonary disease (COPD). METHODS A competitive ELISA targeting VIM was developed and quantified in serum from patients with NSCLC and COPD. VIM was compared with levels of VICM in the same indications. RESULTS VIM was significantly increased in NSCLC (n = 100) compared to healthy controls (n = 67) in two independent cohorts (p = 0.0003 and p < 0.0001). Furthermore, VIM was highly increased in late stages of NSCLC (p = 0.001), however VIM was not increased in COPD patients (n = 10). Contrarily, serum levels of VICM was not increased in late stages of NSCLC, but highly elevated in patients with COPD (p < 0.0001). CONCLUSIONS These findings suggest a biomarker potential of VIM in NSCLC. Our findings also indicate that PTMs of vimentin are highly relevant and that targeting these modifications can have differential biomarker potential.
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Affiliation(s)
- Neel Ingemann Nissen
- Biotech Research & Innovation Centre (BRIC), University of Copenhagen, DK-2200 Copenhagen, Denmark.,Nordic Bioscience, Biomarkers and Research, DK-2730 Herlev, Denmark
| | - Morten Karsdal
- Nordic Bioscience, Biomarkers and Research, DK-2730 Herlev, Denmark
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12
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Compelling scientific and clinical evidence that non-HLA specific antibodies impact graft outcome independently and in concert with donor HLA specific antibodies. Hum Immunol 2019; 80:555-560. [PMID: 31279533 DOI: 10.1016/j.humimm.2019.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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13
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Anti-vimentin antibodies in transplant and disease. Hum Immunol 2019; 80:602-607. [PMID: 30926354 DOI: 10.1016/j.humimm.2019.03.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/18/2019] [Accepted: 03/25/2019] [Indexed: 02/06/2023]
Abstract
Non-HLA antibodies are recognized as a potential source of antibody mediated rejection following transplantation. The epitopes which lead to production of these antibodies are a result of tissue disruption, specifically endothelium, secondary to inflammation and injury. Vimentin is a cytoskeletal protein involved in many aspects of cellular organization, signaling, and proliferation. Recently, antivimentin antibodies have been shown to be important not only for rheumatological autoimmune diseases, but also cardiac and renal transplant dysfunction. In cardiac transplant recipients, antivimentin antibodies are associated with coronary artery vasculopathy and chronic graft loss. In renal transplantation, antivimentin antibodies are detected prior to transplantation and are also correlated with chronic graft dysfunction. In renal transplant recipients, antivimentin antibodies seen prior to transplantation are thought to be secondary to chronic endothelial injury during hemodialysis and therefore more prevalent prior to renal transplant than cardiac transplantation. In this review, we will examine the generation and pathogenesis of antivimentin antibodies. Given that these antibodies appear to be associated with both post-cardiac and -renal transplant dysfunction, developing standard detection paradigms may be important for risk stratification prior to transplantation. Finally, understanding the pathogenesis of antivimentin antibodies may lead to the development potential therapies in order to improve long-term survival.
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Yu MB, Guerra J, Firek A, Langridge WHR. Extracellular vimentin modulates human dendritic cell activation. Mol Immunol 2018; 104:37-46. [PMID: 30399492 DOI: 10.1016/j.molimm.2018.09.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/04/2018] [Accepted: 09/25/2018] [Indexed: 12/13/2022]
Abstract
Vimentin is an intermediate filament protein traditionally considered to be an intracellular protein with a structural role. However, recent evidence suggests that vimentin can also be found outside the cell in disease conditions such as cancer, traumatic tissue injury, and inflammation. Extracellular vimentin was previously found to stimulate innate immunity by increasing monocyte and macrophage ability to kill bacteria. However, vimentin has also been previously found to decrease neutrophil infiltration into inflamed tissue. How extracellular vimentin affects the initiation of adaptive immune responses is unknown. Initiation of adaptive immunity involves priming of naïve T cells by antigen-presenting cells, the most effective of which are dendritic cells (DCs). In this study, we demonstrate how extracellular vimentin modulates lipopolysaccharide (LPS) - induced activation of human DCs. Using cytometric bead arrays, we show that extracellular vimentin decreases LPS-activated DC secretion of pro-inflammatory cytokines IL-6 and IL-12 while increasing secretion of the anti-inflammatory cytokine IL-10. Using flow cytometry, we show that extracellular vimentin does not significantly affect LPS-induced DC surface expression of MHC I (HLA-ABC) or MHC II (HLA-DR) presentation molecules, costimulatory factors (CD80, CD86), or the DC maturation marker (CD83). Further, LPS-stimulated DCs co-cultured with allogeneic naïve CD4 + T cells (Th0) induced less secretion of the pro-inflammatory Th1 effector cytokine IFN-γ in the presence of vimentin than in the presence of LPS alone. This result suggests that vimentin reduces Th1 differentiation. Taken together, our data suggest that extracellular vimentin may inhibit pro-inflammatory adaptive immune responses, by blocking DC secretion of pro-inflammatory cytokines. Thus, extracellular vimentin may play an important role in cancer or trauma-complications by inducing suppression of the adaptive immune response. In a positive sense, the presence of extracellular vimentin may prevent tissue-damage from contributing to the development of autoimmunity. Consequently, extracellular vimentin may become a novel drug target for treatment of a variety of pro- and anti-inflammatory disease conditions.
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Affiliation(s)
- Mary Beth Yu
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda, University School of Medicine, Loma Linda, CA, 92354, USA; Division of Biochemistry, Department of Basic Sciences, Loma Linda, University School of Medicine, Loma Linda, CA, 92354, USA
| | - Joshua Guerra
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda, University School of Medicine, Loma Linda, CA, 92354, USA; University of Texas at San Antonio, San Antonio, TX, USA
| | - Anthony Firek
- Section of Endocrinology, Riverside University Health System Medical Center, Moreno Valley, CA, USA
| | - William H R Langridge
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda, University School of Medicine, Loma Linda, CA, 92354, USA; Division of Biochemistry, Department of Basic Sciences, Loma Linda, University School of Medicine, Loma Linda, CA, 92354, USA.
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Successful Treatment of Anti–angiotensin II Type 1 Receptor Antibody–Associated Rejection in Kidney Transplantation: A Case Report. Transplant Proc 2018; 50:877-880. [DOI: 10.1016/j.transproceed.2017.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/29/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022]
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16
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Downregulation of vimentin expression increased drug resistance in ovarian cancer cells. Oncotarget 2018; 7:45876-45888. [PMID: 27322682 PMCID: PMC5216767 DOI: 10.18632/oncotarget.9970] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 05/30/2016] [Indexed: 01/02/2023] Open
Abstract
Cisplatin and other platinum-based drugs have been widely used in the treatment of ovarian cancer, but most patients acquire the drug resistance that greatly compromises the efficacy of drugs. Understanding the mechanism of drug resistance is important for finding new therapeutic approaches. In the present study, we found that the expression of vimentin was downregulated in drug-resistant ovarian cancer cell lines A2780-DR and HO-8910 as compared to their respective control cells. Overexpression of vimentin in A2780-DR cells markedly increased their sensitivity to cisplatin, whereas knockdown of vimentin in A2780, HO-8910-PM and HO-8910 cells increased the resistance to cisplatin, demonstrating that vimentin silencing enhanced cisplatin resistance in ovarian cancer cells. Quantitative proteomic analysis identified 95 differentially expressed proteins between the vimentin silenced A2780 cells (A2780-VIM-KN) and the control cells, in which downregulation of endocytic proteins and the upregulation of exocytotic proteins CHMP2B and PDZK1 were proposed to contribute the decreased cisplatin accumulation in vimentin knockdown cells. Silencing of vimentin induced upregulation of cancer stem cell markers and both A2780-DR and A2780-VIM-KN cells were more facile to form spheroids than control cells under serum-free culture condition. Our results also revealed that vimentin knockdown increased the 14-3-3 mediated retention of Cdc25C in the cytoplasm, leading to inactivation of Cdk1 and the prolonged G2 phase arrest that allowed the longer period of time for cells to repair cisplatin-damaged DNA. Taken together, we demonstrated that vimentin silencing enhanced cells' resistance to cisplatin via prolonged G2 arrest and increased exocytosis, suggesting that vimentin is a potential target for treatment of drug resistant ovarian cancer.
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Gunasekaran M, Maw TT, Santos RD, Shenoy S, Wellen J, Mohanakumar T. Immunoglobulin isotype switching of antibodies to vimentin is associated with development of transplant glomerulopathy following human renal transplantation. Transpl Immunol 2017; 45:42-47. [DOI: 10.1016/j.trim.2017.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/08/2017] [Accepted: 09/09/2017] [Indexed: 11/30/2022]
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18
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Garg N, Samaniego MD, Clark D, Djamali A. Defining the phenotype of antibody-mediated rejection in kidney transplantation: Advances in diagnosis of antibody injury. Transplant Rev (Orlando) 2017; 31:257-267. [PMID: 28882367 DOI: 10.1016/j.trre.2017.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/08/2017] [Accepted: 08/10/2017] [Indexed: 11/29/2022]
Abstract
The diagnostic criteria for antibody-mediated rejection (ABMR) are constantly evolving in light of the evidence. Inclusion of C4d-negative ABMR has been one of the major advances in the Banff Classification in recent years. Currently Banff 2015 classification requires evidence of donor specific antibodies (DSA), interaction between DSA and the endothelium, and acute tissue injury (in the form of microvasculature injury (MVI); acute thrombotic microangiopathy; or acute tubular injury in the absence of other apparent cause). In this article we review not only the ABMR phenotypes acknowledged in the most recent Banff classification, but also the phenotypes related to novel pathogenic antibodies (non-HLA DSA, antibody isoforms and subclasses, complement-binding functionality) and molecular diagnostic tools (gene transcripts, metabolites, small proteins, cytokines, and donor-derived cell-free DNA). These novel tools are also being considered for the prognosis and monitoring of treatment response. We propose that improved classification of ABMR based on underlying pathogenic mechanisms and outcomes will be an important step in identifying patient-centered therapies to extend graft survival.
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Affiliation(s)
- Neetika Garg
- Department of Medicine, Nephrology Division, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, United States.
| | - Milagros D Samaniego
- Department of Medicine, Nephrology Division, University of Michigan, Ann Arbor, MI 48109, United States
| | - Dana Clark
- Department of Medicine, Nephrology Division, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, United States
| | - Arjang Djamali
- Department of Medicine, Nephrology Division, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, United States
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19
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Lopez-Soler RI, Borgia JA, Kanangat S, Fhied CL, Conti DJ, Constantino D, Ata A, Chan R, Wang Z. Anti-vimentin Antibodies Present at the Time of Transplantation May Predict Early Development of Interstitial Fibrosis/Tubular Atrophy. Transplant Proc 2017; 48:2023-33. [PMID: 27569939 DOI: 10.1016/j.transproceed.2016.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Anti-vimentin (a cytoskeletal protein) autoantibodies in renal transplant recipients have been correlated with interstitial fibrosis/tubular atrophy (IFTA). In this study, we examine the association between pretransplantation anti-vimentin antibodies and the subsequent development of IFTA. METHODS Sera obtained before renal transplantation from 97 transplant recipients were analyzed for the presence of anti-vimentin antibodies via Luminex assays to determine the concentration of anti-vimentin antibodies. Results were correlated with findings of IFTA on biopsy as well as graft function and patient and graft survival. RESULTS In our patient population, 56 of 97 patients were diagnosed by biopsy with IFTA 2.9 (±2.1) years after renal transplantation. Patients with IFTA on biopsy had higher mean concentration of anti-vimentin antibodies when compared to patients without IFTA (32.2 μg/mL [3.97-269.12 μg/mL] vs 14.57 μg/mL [4.71-87.81 μg/mL]). The risk of developing IFTA with a concentration of anti-vimentin antibody >15 μg/mL before transplantation was 1.96 (95% CI = 1.38-2.79, P = .011). Patients with elevated anti-vimentin antibody concentrations (>15 μg/mL) at the time of transplantation also had a higher risk of developing IFTA (81.4% vs 41.2%; P < .05). In addition, graft function was worse at 1, 3, and 5 years posttransplantation in patients with elevated concentrations of pretransplantation anti-vimentin antibody. Although there were more graft losses in the IFTA groups (49.12% vs 25.64%, P = .021) and the IFTA patients loss their grafts earlier (4.3 years vs 3.6 years), there was no statistical difference in graft loss rates. CONCLUSIONS Pretransplantation anti-vimentin antibody concentrations >15 μg/mL may be a risk factor for IFTA.
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Affiliation(s)
- R I Lopez-Soler
- Division of Surgery, Section of Transplantation, Albany Medical Center, Albany, New York.
| | - J A Borgia
- Department of Biochemistry, Rush University Medical Center, Chicago, Illinois; Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - S Kanangat
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - C L Fhied
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - D J Conti
- Division of Surgery, Section of Transplantation, Albany Medical Center, Albany, New York
| | - D Constantino
- Transplant Immunology Laboratory, Albany Medical College, Albany, New York
| | - A Ata
- Division of Surgery, Section of Transplantation, Albany Medical Center, Albany, New York
| | - R Chan
- Division of Surgery, Section of Transplantation, Albany Medical Center, Albany, New York
| | - Z Wang
- Center For Cardiovascular Sciences, Albany Medical College, Albany, New York
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20
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Endothelial Cells in Antibody-Mediated Rejection of Kidney Transplantation: Pathogenesis Mechanisms and Therapeutic Implications. J Immunol Res 2017; 2017:8746303. [PMID: 28255564 PMCID: PMC5309424 DOI: 10.1155/2017/8746303] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 12/22/2016] [Indexed: 12/11/2022] Open
Abstract
Antibody-mediated rejection (AMR) has been identified as a main obstacle for stable immune tolerance and long survival of kidney allografts. In spite of new insights into the underlying mechanisms of AMR, accurate diagnosis and efficient treatment are still challenges in clinical practice. Endothelium is the first barrier between recipients' immune systems and grafts in vascularized organ transplants. Considering that endothelial cells express a number of antigens that can be attacked by various allo- and autoantibodies, endothelial cells act as main targets for the recipients' humoral immune responses. Importantly, emerging evidence has shown that endothelial cells in transplants could also initiate protective mechanisms in response to immune injuries. A better understanding of the role of endothelial cells during the pathogenesis of AMR might provide novel therapeutic targets. In the present review, we summarize the antigens expressed by endothelial cells and also discuss the activation and accommodation of endothelial cells as well as their clinical implications. Collectively, the progress discussed in this review indicates endothelial cells as promising targets to improve current diagnosis and therapeutic regimens for AMR.
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21
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Mehra NK, Baranwal AK. Clinical and immunological relevance of antibodies in solid organ transplantation. Int J Immunogenet 2016; 43:351-368. [DOI: 10.1111/iji.12294] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 09/10/2016] [Accepted: 10/16/2016] [Indexed: 12/22/2022]
Affiliation(s)
- N. K. Mehra
- National Chair and Former Dean (Research); All India Institute of Medical Sciences; New Delhi India
| | - A. K. Baranwal
- Department of Transplant Immunology and Immunogenetics; All India Institute of Medical Sciences; New Delhi India
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22
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Cardinal H, Dieudé M, Hébert MJ. The Emerging Importance of Non-HLA Autoantibodies in Kidney Transplant Complications. J Am Soc Nephrol 2016; 28:400-406. [PMID: 27798244 DOI: 10.1681/asn.2016070756] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Antibodies that are specific to organ donor HLA have been involved in the majority of cases of antibody-mediated rejection in solid organ transplant recipients. However, recent data show that production of non-HLA autoantibodies can occur before transplant in the form of natural autoantibodies. In contrast to HLAs, which are constitutively expressed on the cell surface of the allograft endothelium, autoantigens are usually cryptic. Tissue damage associated with ischemia-reperfusion, vascular injury, and/or rejection creates permissive conditions for the expression of cryptic autoantigens, allowing these autoantibodies to bind antigenic targets and further enhance vascular inflammation and renal dysfunction. Antiperlecan/LG3 antibodies and antiangiotensin II type 1 receptor antibodies have been found before transplant in patients with de novo transplants and portend negative long-term outcome in patients with renal transplants. Here, we review mounting evidence suggesting an important role for autoantibodies to cryptic antigens as novel accelerators of kidney dysfunction and acute or chronic allograft rejection.
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Affiliation(s)
- Héloise Cardinal
- Research Centre, Infection, Inflammation, Immunity and Tissue Injury Axis, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.,Canadian National Transplant Research Program, Edmonton, Alberta, Canada; and
| | - Mélanie Dieudé
- Research Centre, Infection, Inflammation, Immunity and Tissue Injury Axis, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.,Canadian National Transplant Research Program, Edmonton, Alberta, Canada; and
| | - Marie-Josée Hébert
- Research Centre, Infection, Inflammation, Immunity and Tissue Injury Axis, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; .,Canadian National Transplant Research Program, Edmonton, Alberta, Canada; and.,Université de Montréal, Montreal, Quebec, Canada
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23
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Clinical value of non-HLA antibodies in kidney transplantation: Still an enigma? Transplant Rev (Orlando) 2016; 30:195-202. [DOI: 10.1016/j.trre.2016.06.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/22/2016] [Accepted: 06/01/2016] [Indexed: 12/14/2022]
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Sánchez-Zapardiel E, Mancebo E, Díaz-Ordoñez M, de Jorge-Huerta L, Ruiz-Martínez L, Serrano A, Castro-Panete MJ, Utrero-Rico A, de Andrés A, Morales JM, Domínguez-Rodríguez S, Paz-Artal E. Isolated De Novo Antiendothelial Cell Antibodies and Kidney Transplant Rejection. Am J Kidney Dis 2016; 68:933-943. [PMID: 27599627 DOI: 10.1053/j.ajkd.2016.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 07/06/2016] [Indexed: 11/11/2022]
Abstract
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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Affiliation(s)
| | - Esther Mancebo
- Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute I+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | - Antonio Serrano
- Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute I+12, Hospital Universitario 12 de Octubre, Madrid, Spain; Section of Immunology, Universidad San Pablo CEU, Madrid, Spain
| | - María J Castro-Panete
- Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute I+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alberto Utrero-Rico
- Research Institute I+12, Hospital Universitario 12 de Octubre, Madrid, Spain; School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Amado de Andrés
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José M Morales
- Research Institute I+12, Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Estela Paz-Artal
- Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute I+12, Hospital Universitario 12 de Octubre, Madrid, Spain; School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Section of Immunology, Universidad San Pablo CEU, Madrid, Spain
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Pathogenic Network Analysis Predicts Candidate Genes for Cervical Cancer. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2016; 2016:3186051. [PMID: 27034707 PMCID: PMC4789371 DOI: 10.1155/2016/3186051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/25/2016] [Accepted: 02/07/2016] [Indexed: 12/15/2022]
Abstract
Purpose. The objective of our study was to predicate candidate genes in cervical cancer (CC) using a network-based strategy and to understand the pathogenic process of CC. Methods. A pathogenic network of CC was extracted based on known pathogenic genes (seed genes) and differentially expressed genes (DEGs) between CC and normal controls. Subsequently, cluster analysis was performed to identify the subnetworks in the pathogenic network using ClusterONE. Each gene in the pathogenic network was assigned a weight value, and then candidate genes were obtained based on the weight distribution. Eventually, pathway enrichment analysis for candidate genes was performed. Results. In this work, a total of 330 DEGs were identified between CC and normal controls. From the pathogenic network, 2 intensely connected clusters were extracted, and a total of 52 candidate genes were detected under the weight values greater than 0.10. Among these candidate genes, VIM had the highest weight value. Moreover, candidate genes MMP1, CDC45, and CAT were, respectively, enriched in pathway in cancer, cell cycle, and methane metabolism. Conclusion. Candidate pathogenic genes including MMP1, CDC45, CAT, and VIM might be involved in the pathogenesis of CC. We believe that our results can provide theoretical guidelines for future clinical application.
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Dieudé M, Bell C, Turgeon J, Beillevaire D, Pomerleau L, Yang B, Hamelin K, Qi S, Pallet N, Béland C, Dhahri W, Cailhier JF, Rousseau M, Duchez AC, Lévesque T, Lau A, Rondeau C, Gingras D, Muruve D, Rivard A, Cardinal H, Perreault C, Desjardins M, Boilard É, Thibault P, Hébert MJ. The 20
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proteasome core, active within apoptotic exosome-like vesicles, induces autoantibody production and accelerates rejection. Sci Transl Med 2015; 7:318ra200. [DOI: 10.1126/scitranslmed.aac9816] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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27
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In JW, Park H, Rho EY, Shin S, Park KU, Park MH, Song EY. Anti-angiotensin type 1 receptor antibodies associated with antibody-mediated rejection in patients without preformed HLA-donor-specific antibody. Transplant Proc 2015; 46:3371-4. [PMID: 25498054 DOI: 10.1016/j.transproceed.2014.09.096] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 09/05/2014] [Accepted: 09/17/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Angiotensin II is a peptide hormone involved in the renin-angiotensin system (RAS). Anti-angiotensin receptor 1 (AT1R) antibodies are implicated in stimulating RAS and are suspected to have some adverse impacts on renal transplantation outcome. METHODS From November 2009 to February 2012, 37 remaining sera from renal transplantation recipients with biopsy-proven antibody-mediated rejection (AMR) (n = 6), acute cellular rejection (ACR) (n = 23), and AMR + ACR (n = 8) without preformed human leukocyte antigeon (HLA) antibodies were tested with anti-AT1R antibody assay. Forty-two control patients without rejection also were analyzed. RESULTS The frequency of elevated anti-AT1R antibodies was higher in patients with AMR (n = 14) compared to controls (28.6% vs 4.9%, P = .03, OR = 8.0). It was also higher in patients with AMR + ACR (n=8) (37.5% vs 4.9%, P = .03, OR = 12.0). There was no difference in frequencies of elevated anti-AT1R antibody in patients with ACR. CONCLUSION Anti-AT1R antibodies were suspected to be associated with occurrence of AMR without preformed HLA antibodies in renal transplantation. Further studies in a larger number of patients are needed.
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Affiliation(s)
- J W In
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - H Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - E Y Rho
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - S Shin
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - K U Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - M H Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - E Y Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea; Medical Research Center, Seoul National University College of Medicine, Seoul, South Korea.
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28
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Agashe VV, Burlingham WJ. Autoimmune Reactivity in Graft Injury: Player or Bystander? CURRENT TRANSPLANTATION REPORTS 2015; 2:211-221. [PMID: 29057202 DOI: 10.1007/s40472-015-0068-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Organ transplantation is the only viable treatment for several end-stage organ failures. However chronic rejection prevents long-term graft survival. Traditionally this rejection was attributed to the development of alloimmunity in transplant patients. However recent evidence suggests that autoimmunity plays a larger role in chronic rejection of certain organ transplants, than alloimmunity. In this review we will focus on the history of autoimmunity in solid-organ transplantation and at look the Collagen Type V, K-α-tubulin, Vimentin, Cardiac myosin and Heat Shock Proteins as classical examples of auto-antigens in organ transplantation. We will also look at some of the recent reports looking at the mechanisms of autoimmunity and try to provide answers to some of the age-old questions in autoimmunity.
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Affiliation(s)
- Vrushali V Agashe
- Comparative Biomedical Sciences Graduate Program.,Department of Surgery-Transplant division, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI 53795, USA
| | - William J Burlingham
- Department of Surgery-Transplant division, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI 53795, USA
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29
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Barz D, Friedrich S, Schuller A, Rummler S. Antibodies against AT1-receptor in transplantation (diagnostics, treatment, clinical relevance). ATHEROSCLEROSIS SUPP 2015; 18:112-8. [DOI: 10.1016/j.atherosclerosissup.2015.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Colvin MM, Cook JL, Chang P, Francis G, Hsu DT, Kiernan MS, Kobashigawa JA, Lindenfeld J, Masri SC, Miller D, O'Connell J, Rodriguez ER, Rosengard B, Self S, White-Williams C, Zeevi A. Antibody-mediated rejection in cardiac transplantation: emerging knowledge in diagnosis and management: a scientific statement from the American Heart Association. Circulation 2015; 131:1608-39. [PMID: 25838326 DOI: 10.1161/cir.0000000000000093] [Citation(s) in RCA: 205] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Shimizu T, Ishida H, Toki D, Nozaki T, Omoto K, Tanabe K, Honda K, Koike J. Clinical and pathological analyses of transplant glomerulopathy cases. Nephrology (Carlton) 2015; 19 Suppl 3:21-6. [PMID: 24842817 DOI: 10.1111/nep.12243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2014] [Indexed: 11/29/2022]
Abstract
AIM Transplant glomerulopathy (TG) is included as one of the criteria of chronic active antibody-mediated rejection (c-AMR) in Banff 09 classification. In this report, we discuss the clinical and pathological analyses of cases of TG after renal transplantation. PATIENTS TG was diagnosed in 86 renal allograft biopsy specimens (BS) obtained from 50 renal transplant patients followed up at our institute between January 2006 and October 2012. We retrospectively reviewed the data of these 86 BS and 50 patients. RESULTS Among the 50 patients, 42 (84%) had a history of acute rejection (AR); of these, 30 (60%) had acute antibody-mediated rejection (a-AMR). Among the 86 BS of TG, the TG was mild in 35 cases (cg1 in Banff classification), moderate in 28 cases (cg2) and severe in 23 cases (cg3). Peritubular capillaritis was present in 74 BS (86%), transplant glomerulitis in 65 (76%), interstitial fibrosis and tubular atrophy (IF/TA) in 71 (83%), thickening of the peritubular capillary (PTC) basement membrane in 72 (84%), and interstitial inflammation in 40 (47%). C4d deposition in the PTC was present in 49 BS (57%); 39 of these 49 BS showed diffuse C4d deposits in the PTC (C4d3), while the remaining 10 BS showed focal deposits (C4d2). Diffuse C4d deposition in the glomerular capillaries (GC) was seen in 70 BS (81%), while focal C4d deposition in the GC was seen in 9 (11%). In the assay using plastic beads coated with HLA antigen performed in 67 serum samples obtained in the peri-biopsy period, circulating ant-HLA alloantibody was detected in 55 (82%); in 33 of the 55 (49%) samples, donor-specific antibodies (DSA) were detected. Among our study, the findings in 22 BS (26%) fully met the criteria for c-AMR in Banff '09 classification, including TG, C4d deposition in the PTC and presence of DSA, while those in 27 BS were suspicious of c-AMR. Deterioration of the renal allograft function after the biopsies was seen in 31 patients (62%), of which 11 lost their graft. CONCLUSIONS We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis, thickening of the peritubular capillary basement membrane, and circulating anti-HLA antibodies. C4d deposition in the PTC is not always present in biopsy specimens of TG. We speculated that C4d deposition in the GC, rather than that in the PTC might be a more characteristic manifestation of TG. Many of the patients with TG had a history of AR. Anti-HLA antibody Class II, particularly when the antibody was DSA Class II, appeared to be associated with the development of TG. The prognosis of grafts exhibiting TG was not too good even under the currently used immunosuppressive protocol.
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Affiliation(s)
- Tomokazu Shimizu
- Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
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Development of antidonor antibody directed toward non-major histocompatibility complex antigens in tolerant animals. Transplantation 2014; 98:514-9. [PMID: 24933456 DOI: 10.1097/tp.0000000000000249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The clinical significance of antibodies directed against antigens other than major histocompatibility complex (MHC) antigens is poorly understood, and there are few large animal models in which such antibodies can be examined. We studied, both retrospectively and prospectively, the development of antibodies to non-MHC antigens in tolerant miniature swine. METHODS Our database was assessed for cases of antidonor antibody formation in tolerant animals over the last 20 years. Flow cytometry, absorption assays, and familial analyses for inheritance pattern of the gene(s) potentially responsible for the antibody reactivities were carried out, and an animal determined to be negative for this reactivity was immunized by a skin graft and subcutaneous injections of peripheral blood monocyte cells from an antigen-positive donor. RESULTS Sixteen of 469 tolerant animals tested were found to have developed antidonor antibodies. These antibodies were found to be specific for the same, presumably single, non-MHC antigen. Familial analyses indicated that the gene encoding this antigen was expressed in an autosomal-dominant manner in approximately 95% of the herd. In a prospective study, antidonor antibodies with the same specificity as those observed retrospectively were successfully induced in an antigen-negative animal after immunization with peripheral blood monocyte cells. CONCLUSION To our knowledge, this is the first report of the development of antibodies to a highly prevalent, non-MHC antigen present on peripheral blood mononuclear cells and developing in tolerant animals without signs of graft dysfunction. Considering the concern often raised by the appearance of antidonor antibodies in transplant recipients, these data could have important implications for clinical transplantation.
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Kinloch AJ, Chang A, Ko K, Dunand CJH, Henderson S, Maienschein-Cleine M, Kaverina N, Rovin B, Ferrer MS, Wolfgeher D, Liarski V, Haddon DJ, Utz PJ, Wilson PC, Clark MR. Vimentin is a dominant target of in situ humoral immunity in human lupus tubulointerstitial nephritis. Arthritis Rheumatol 2014; 66:3359-70. [PMID: 25306868 PMCID: PMC4264660 DOI: 10.1002/art.38888] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 09/18/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE In lupus nephritis (LN), severe tubulointerstitial inflammation (TII) predicts progression to renal failure. Severe TII is associated with tertiary lymphoid neogenesis and in situ antigen-driven clonal B cell selection. The autoantigen(s) driving in situ B cell selection in TII are not known. This study was undertaken to identify the dominant driving autoantigen(s). METHODS Single CD38+ or Ki-67+ B cells were laser captured from 7 biopsy specimens that were diagnostic for LN. Eighteen clonally expanded immunoglobulin heavy- and light-chain variable region pairs were cloned and expressed as monoclonal antibodies. Seven more antibodies were cloned from flow-sorted CD38+ cells from an eighth biopsy specimen. Antigen characterization was performed using a combination of confocal microscopy, enzyme-linked immunosorbent assay, screening protoarrays, immunoprecipitation, and mass spectrometry. Serum IgG titers to the dominant antigen in 48 LN and 35 non-nephritic lupus samples were determined using purified antigen-coated arrays. Autoantigen expression on normal and LN kidney was localized by immunohistochemistry and immunofluorescence. RESULTS Eleven of 25 antibodies reacted with cytoplasmic structures, 4 reacted with nuclei, and none reacted with double-stranded DNA. Vimentin was the only autoantigen identified by both mass spectrometry and protoarray. Ten of the 11 anticytoplasmic TII antibodies directly bound vimentin. Vimentin was highly expressed by tubulointerstitial inflammatory cells, and the TII antibodies tested preferentially bound inflamed tubulointerstitium. Finally, high titers of serum antivimentin antibodies were associated with severe TII (P = 0.0001). CONCLUSION Vimentin, an antigenic feature of inflammation, is a dominant autoantigen targeted in situ in LN TII. This adaptive autoimmune response likely feeds forward to worsen TII and renal damage.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcus R Clark
- Corresponding author: Marcus R Clark, M.D., Section of Rheumatology, Department of Medicine and Gwen Knapp Center for Lupus & Immunology Research, University of Chicago, JFK R310, 924 E. 57th Street, Chicago, Illinois 60637, Tel.773-702-0202, Fax.773-702-8702,
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Piotti G, Palmisano A, Maggiore U, Buzio C. Vascular endothelium as a target of immune response in renal transplant rejection. Front Immunol 2014; 5:505. [PMID: 25374567 PMCID: PMC4204520 DOI: 10.3389/fimmu.2014.00505] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 09/28/2014] [Indexed: 12/28/2022] Open
Abstract
This review of clinical and experimental studies aims at analyzing the interplay between graft endothelium and host immune system in renal transplantation, and how it affects the survival of the graft. Graft endothelium is indeed the first barrier between self and non-self that is encountered by host lymphocytes upon reperfusion of vascularized solid transplants. Endothelial cells (EC) express all the major sets of antigens (Ag) that elicit host immune response, and therefore represent a preferential target in organ rejection. Some of the Ag expressed by EC are target of the antibody-mediated response, such as the AB0 blood group system, the human leukocyte antigens (HLA), and MHC class I related chain A antigens (MICA) systems, and the endothelial cell-restricted Ag; for each of these systems, the mechanisms of interaction and damage of both preformed and de novo donor-specific antibodies are reviewed along with their impact on renal graft survival. Moreover, the rejection process can force injured EC to expose cryptic self-Ag, toward which an autoimmune response mounts, overlapping to the allo-immune response in the damaging of the graft. Not only are EC a passive target of the host immune response but also an active player in lymphocyte activation; therefore, their interaction with allogenic T-cells is analyzed on the basis of experimental in vitro and in vivo studies, according to the patterns of expression of the HLA class I and II and the co-stimulatory molecules specific for cytotoxic and helper T-cells. Finally, as the response that follows transplantation has proven to be not necessarily destructive, the factors that foster graft endothelium functioning in spite of rejection, and how they could be therapeutically harnessed to promote long-term graft acceptance, are described: accommodation that is resistance of EC to donor-specific antibodies, and endothelial cell ability to induce Foxp3+ regulatory T-cells, that are crucial mediators of tolerance.
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Affiliation(s)
- Giovanni Piotti
- Kidney and Pancreas Transplantation Unit, Department of Clinical Medicine, Nephrology and Health Sciences, University Hospital of Parma , Parma , Italy
| | - Alessandra Palmisano
- Kidney and Pancreas Transplantation Unit, Department of Clinical Medicine, Nephrology and Health Sciences, University Hospital of Parma , Parma , Italy
| | - Umberto Maggiore
- Kidney and Pancreas Transplantation Unit, Department of Clinical Medicine, Nephrology and Health Sciences, University Hospital of Parma , Parma , Italy
| | - Carlo Buzio
- Kidney and Pancreas Transplantation Unit, Department of Clinical Medicine, Nephrology and Health Sciences, University Hospital of Parma , Parma , Italy
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Otten HG, Joosten I, Allebes WA, van der Meer A, Hilbrands LB, Baas M, Spierings E, Hack CE, van Reekum F, van Zuilen AD, Verhaar MC, Bots ML, Seelen MAJ, Sanders JSF, Hepkema BG, Lambeck AJ, Bungener LB, Roozendaal C, Tilanus MGJ, Vanderlocht J, Voorter CE, Wieten L, van Duijnhoven E, Gelens M, Christiaans M, van Ittersum F, Nurmohamed A, Lardy NM, Swelsen WT, van Donselaar-van der Pant KAMI, van der Weerd NC, Ten Berge IJM, Bemelman FJ, Hoitsma AJ, de Fijter JW, Betjes MGH, Roelen DL, Claas FHJ. The PROCARE consortium: toward an improved allocation strategy for kidney allografts. Transpl Immunol 2014; 31:184-90. [PMID: 25258025 DOI: 10.1016/j.trim.2014.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Kidney transplantation is the best treatment option for patients with end-stage renal failure. At present, approximately 800 Dutch patients are registered on the active waiting list of Eurotransplant. The waiting time in the Netherlands for a kidney from a deceased donor is on average between 3 and 4 years. During this period, patients are fully dependent on dialysis, which replaces only partly the renal function, whereas the quality of life is limited. Mortality among patients on the waiting list is high. In order to increase the number of kidney donors, several initiatives have been undertaken by the Dutch Kidney Foundation including national calls for donor registration and providing information on organ donation and kidney transplantation. The aim of the national PROCARE consortium is to develop improved matching algorithms that will lead to a prolonged survival of transplanted donor kidneys and a reduced HLA immunization. The latter will positively affect the waiting time for a retransplantation. The present algorithm for allocation is among others based on matching for HLA antigens, which were originally defined by antibodies using serological typing techniques. However, several studies suggest that this algorithm needs adaptation and that other immune parameters which are currently not included may assist in improving graft survival rates. We will employ a multicenter-based evaluation on 5429 patients transplanted between 1995 and 2005 in the Netherlands. The association between key clinical endpoints and selected laboratory defined parameters will be examined, including Luminex-defined HLA antibody specificities, T and B cell epitopes recognized on the mismatched HLA antigens, non-HLA antibodies, and also polymorphisms in complement and Fc receptors functionally associated with effector functions of anti-graft antibodies. From these data, key parameters determining the success of kidney transplantation will be identified which will lead to the identification of additional parameters to be included in future matching algorithms aiming to extend survival of transplanted kidneys and to diminish HLA immunization. Computer simulation studies will reveal the number of patients having a direct benefit from improved matching, the effect on shortening of the waiting list, and the decrease in waiting time.
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Affiliation(s)
- H G Otten
- UMC Utrecht, Laboratory for Translational Immunology, The Netherlands
| | - I Joosten
- Radboudumc, Dept. of Laboratory Medicine, The Netherlands
| | - W A Allebes
- Radboudumc, Dept. of Laboratory Medicine, The Netherlands
| | - A van der Meer
- Radboudumc, Dept. of Laboratory Medicine, The Netherlands
| | | | - M Baas
- Radboudumc, Dept. of Nephrology, The Netherlands
| | - E Spierings
- UMC Utrecht, Laboratory for Translational Immunology, The Netherlands
| | - C E Hack
- UMC Utrecht, Laboratory for Translational Immunology, The Netherlands
| | - F van Reekum
- UMC Utrecht, Dept. of Nephrology and Hypertension, The Netherlands
| | - A D van Zuilen
- UMC Utrecht, Dept. of Nephrology and Hypertension, The Netherlands
| | - M C Verhaar
- UMC Utrecht, Dept. of Nephrology and Hypertension, The Netherlands
| | - M L Bots
- UMC Utrecht, Julius Center for Health Sciences and Primary Care, The Netherlands
| | | | | | - B G Hepkema
- UMCG, Dept. of Laboratory Medicine, The Netherlands
| | - A J Lambeck
- UMCG, Dept. of Laboratory Medicine, The Netherlands
| | - L B Bungener
- UMCG, Dept. of Laboratory Medicine, The Netherlands
| | - C Roozendaal
- UMCG, Dept. of Laboratory Medicine, The Netherlands
| | - M G J Tilanus
- Maastricht UMC, Transplantation Immunology, The Netherlands
| | - J Vanderlocht
- Maastricht UMC, Transplantation Immunology, The Netherlands
| | - C E Voorter
- Maastricht UMC, Transplantation Immunology, The Netherlands
| | - L Wieten
- Maastricht UMC, Transplantation Immunology, The Netherlands
| | | | - M Gelens
- Maastricht UMC, Dept. of Nephrology, The Netherlands
| | - M Christiaans
- Maastricht UMC, Dept. of Nephrology, The Netherlands
| | | | | | - N M Lardy
- Sanquin, Dept. of Immunogenetics, The Netherlands
| | - W T Swelsen
- Sanquin, Dept. of Immunogenetics, The Netherlands
| | | | | | - I J M Ten Berge
- AMC Renal Transplant Unit, Dept. of Nephrology, The Netherlands
| | - F J Bemelman
- AMC Renal Transplant Unit, Dept. of Nephrology, The Netherlands
| | | | | | - M G H Betjes
- Erasmus MC, Dept. of Nephrology, The Netherlands
| | - D L Roelen
- LUMC, Immunohematology and Blood Transfusion, The Netherlands
| | - F H J Claas
- LUMC, Immunohematology and Blood Transfusion, The Netherlands
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Abstract
BACKGROUND The role of non-HLA antibodies in rejection is not clear. We investigate whether antibodies to vimentin are made after renal transplantation and if production is associated with interstitial fibrosis and tubular atrophy (IFTA). METHODS In this retrospective study, sera from 70 recipients of renal allografts (40 controls, 30 IFTA) were studied. The biopsy diagnosis of interstitial fibrosis and tubular atrophy (IFTA) was based on random, cause-indicating biopsies. Sera were collected pretransplant and at 3 monthly intervals up to 5 years posttransplant or diagnosis of IFTA and assayed by ELISA for IgM and IgG anti-vimentin antibodies (AVA) and HLA antibodies. RESULTS Mean titers of IgM AVA were higher at every year after transplantation compared with pretransplant for both IFTA and controls groups (P<0.001). There was no difference in the mean level of IgM AVA achieved by IFTA and control groups. The mean pretransplant levels of IgG AVA in the IFTA and control group were 18.2±11.7 and 11.0±8.1, respectively (P=0.001). There was a significant increase between the pretransplant mean levels of IgG AVA and the levels at years 1 to 4 in the IFTA group (years 1-3, P<0.0001, year 4 P=0.003) but not in the controls. There was no significant difference between the numbers of IFTA or control patients achieving a positive value (mean+2SD of pretransplant antibody titers) of IgM AVA (50% versus 37.5%, respectively) or IgG AVA (26.6% versus 12.5%, respectively). There was no association between production of HLA and AVA antibodies. CONCLUSION Posttransplant production of IgM AVA is not associated with IFTA. The production of IgG AVA by a minority of IFTA patients suggests that in some individuals, IgG AVA may be involved in the pathology of IFTA.
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Increased negative impact of donor HLA-specific together with non-HLA-specific antibodies on graft outcome. Transplantation 2014; 97:595-601. [PMID: 24162250 DOI: 10.1097/01.tp.0000436927.08026.a8] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND De novo donor HLA-specific (dnDSA) and non-HLA antibodies including antiangiotensin type 1 receptor antibodies (AT1R-abs) have been associated with antibody-mediated rejection (AMR) and decreased graft survival as well as cellular-mediated rejection (CMR) and early onset of microvasculopathy in heart transplantation. The aim of our study was to determine the impact of anti-AT1R-ab and anti-donor HLA-specific antibody (DSA) on clinical outcomes. METHODS Pretransplant and posttransplant sera from 200 recipients transplanted between May 2007 and August 2011 were tested for DSA (Luminex-based single antigen bead assay) and AT1R-ab (enzyme-linked immunosorbent assay). Two cutoff levels (≥ 17 and ≥ 12 units) were used to define high and intermediate binding of AT1R-ab. Clinical parameters examined were 5-year AMR/CMR (≥ grade 2), coronary artery vasculopathy, and survival. RESULTS At 2 years after transplant, freedom from AMR and/or CMR was 95.4% for those with no DSA (n=175), 66.9% for those with dnDSA (n=19), and 25% for those with DSA at transplant (n=6) (P<0.0001). Neither ≥ 17 nor ≥ 12 units of pretransplant levels indicated a significant difference in freedom from AMR and/or CMR. When both dnDSA and AT1R-ab ≥ 17 or ≥ 12 units were considered, freedom from AMR and/or CMR decreased to 50% and 45% (P<0.0001), respectively. Coronary artery vasculopathy and survival were not significantly impacted. CONCLUSIONS These results show the increased negative impact of dnDSA and AT1R-ab on freedom from AMR and/or CMR and an increased hazard ratio when both parameters are considered. Both HLA- and non-HLA-specific antibodies seem to impact graft outcome in heart transplantation.
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38
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Donor non-specific MICA antibodies in renal transplant recipients. Immunobiology 2014; 219:109-12. [DOI: 10.1016/j.imbio.2013.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/29/2013] [Accepted: 08/16/2013] [Indexed: 11/18/2022]
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Ballet C, Giral M, Ashton-Chess J, Renaudin K, Brouard S, Soulillou JP. Chronic rejection of human kidney allografts. Expert Rev Clin Immunol 2014; 2:393-402. [DOI: 10.1586/1744666x.2.3.393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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40
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Taniguchi M, Rebellato LM, Cai J, Hopfield J, Briley KP, Haisch CE, Catrou PG, Bolin P, Parker K, Kendrick WT, Kendrick SA, Harland RC, Terasaki PI. Higher risk of kidney graft failure in the presence of anti-angiotensin II type-1 receptor antibodies. Am J Transplant 2013; 13:2577-89. [PMID: 23941128 DOI: 10.1111/ajt.12395] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 04/21/2013] [Accepted: 05/11/2013] [Indexed: 01/25/2023]
Abstract
Reports have associated non-HLA antibodies, specifically those against angiotensin II type-1 receptor (AT1R), with antibody-mediated kidney graft rejection. However, association of anti-AT1R with graft failure had not been demonstrated. We tested anti-AT1R and donor-specific HLA antibodies (DSA) in pre- and posttransplant sera from 351 consecutive kidney recipients: 134 with biopsy-proven rejection and/or lesions (abnormal biopsy group [ABG]) and 217 control group (CG) patients. The ABG's rate of anti-AT1R was significantly higher than the CG's (18% vs. 6%, p < 0.001). Moreover, 79% of ABG patients with anti-AT1R lost their grafts (vs. 0%, CG), anti-AT1R levels in 58% of those failed grafts increasing posttransplant. With anti-AT1R detectable before DSA, time to graft failure was 31 months-but 63 months with DSA detectable before anti-AT1R. Patients with both anti-AT1R and DSA had lower graft survival than those with DSA alone (log-rank p = 0.007). Multivariate analysis showed that de novo anti-AT1R was an independent predictor of graft failure in the ABG, alone (HR: 6.6), and in the entire population (HR: 5.4). In conclusion, this study found significant association of anti-AT1R with graft failure. Further study is needed to establish causality between anti-AT1R and graft failure and, thus, the importance of routine anti-AT1R monitoring and therapeutic targeting.
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Affiliation(s)
- M Taniguchi
- Terasaki Foundation Laboratory, Los Angeles, CA
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Angaswamy N, Tiriveedhi V, Sarma NJ, Subramanian V, Klein C, Wellen J, Shenoy S, Chapman WC, Mohanakumar T. Interplay between immune responses to HLA and non-HLA self-antigens in allograft rejection. Hum Immunol 2013; 74:1478-85. [PMID: 23876679 DOI: 10.1016/j.humimm.2013.07.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 07/09/2013] [Accepted: 07/09/2013] [Indexed: 01/02/2023]
Abstract
Recent studies strongly suggest an increasing role for immune responses against self-antigens (Ags) which are not encoded by the major histocompatibility complex in the immunopathogenesis of allograft rejection. Although, improved surgical techniques coupled with improved methods to detect and avoid sensitization against donor human leukocyte antigen (HLA) have improved the immediate and short term function of transplanted organs. However, acute and chronic rejection still remains a vexing problem for the long term function of the transplanted organ. Immediately following organ transplantation, several factors both immune and non immune mechanisms lead to the development of local inflammatory milieu which sets the stage for allograft rejection. Traditionally, development of antibodies (Abs) against mismatched donor HLA have been implicated in the development of Ab mediated rejection. However, recent studies from our laboratory and others have demonstrated that development of humoral and cellular immune responses against non-HLA self-Ags may contribute in the pathogenesis of allograft rejection. There are reports demonstrating that immune responses to self-Ags especially Abs to the self-Ags as well as cellular immune responses especially through IL17 has significant pro-fibrotic properties leading to chronic allograft failure. This review summarizes recent studies demonstrating the role for immune responses to self-Ags in allograft immunity leading to rejection as well as present recent evidence suggesting there is interplay between allo- and autoimmunity leading to allograft dysfunction.
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Affiliation(s)
- Nataraju Angaswamy
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
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42
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Carter V, Howell WM. Vimentin antibody production in transplant patients and immunomodulatory effects of vimentin in-vitro. Hum Immunol 2013; 74:1463-9. [PMID: 23777931 DOI: 10.1016/j.humimm.2013.06.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 04/09/2013] [Accepted: 06/07/2013] [Indexed: 11/16/2022]
Abstract
We investigated the presence of antibodies to vimentin in 150 patients awaiting transplant, (50 kidney, 50 liver and 50 thoracic) and in 51 previously transplanted kidney patients whose grafts had failed. Patients with primary end stage thoracic or kidney disease did not have increased levels of vimentin antibodies, but those with primary liver failure and those with kidney graft failure did. Those with kidney graft failure were more likely to form vimentin antibodies if the patient was HLA-DQ2 positive (p=<0.001). Further to this, we observed antibody mediated rejection in five HLA-DQ2 positive re-transplant patients where no other antibodies were identified. We investigated the effects of vimentin protein on cytokine production in phytohaemagglutinin stimulated and unstimulated peripheral blood mononuclear cells. When exposed to vimentin at low levels there was increased production of IL-10. When cultures were stimulated, there was a decrease in IL-10, IL-2 and IFN-gamma production and a large increase in IL-4 production (p=0.028) compared to the controls. These results suggest that under normal conditions exposure to vimentin can lead to regulation of the immune response. However, if the immune system is active, exposure to vimentin can enhance Th-2 immunity.
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Affiliation(s)
- Vaughan Carter
- National Health Service, Blood and Transplant, Newcastle, Newcastle Upon Tyne NE2 4NQ, United Kingdom.
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43
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Rose ML. Role of anti-vimentin antibodies in allograft rejection. Hum Immunol 2013; 74:1459-62. [PMID: 23777935 PMCID: PMC3820003 DOI: 10.1016/j.humimm.2013.06.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 05/10/2013] [Accepted: 06/07/2013] [Indexed: 11/27/2022]
Abstract
Production of anti-vimentin antibodies (AVA) after solid organ transplantation are common. Although classically thought to be expressed mainly within the cytosol, recent evidence demonstrates that extracellular or cell surface expression of vimentin is not unusual. This review examines the evidence to assess whether AVA contribute to allograft pathology. Clinical studies suggest that AVA are associated with cardiac allograft vasculopathy in heart transplant recipients. Studies in non-human primates confirm that production of AVA after renal and heart transplantation are not inhibited by Cyclosporine. Experimental studies have demonstrated that mice pre-immunised with vimentin undergo accelerated acute rejection and vascular intimal occlusion of cardiac allografts. Adoptive transfer of hyperimmune sera containing AVA into B-cell-knock-out mice caused accelerated rejection of allografted hearts, this is clear evidence that antibodies to vimentin accelerate rejection. AVA act in concert with the alloimmune response and AVA do not damage syngeneic or native heart allografts. Confocal microscopy of allografted organs in vimentin immunised mice shows extensive expression of vimentin on endothelial cells, apoptotic leukocytes and platelet/leukocyte conjugates, co-localising with C4d. One explanation for the ability of AVA to accelerate rejection would be fixation of complement within the graft and subsequent pro-inflammatory effects; there may also be interactions with platelets within the vasculature.
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Affiliation(s)
- Marlene L Rose
- National Heart and Lung Institute, Imperial College, Harefield Hospital, Harefield, Middlesex UB9 6JH, UK.
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Abadja F, Sarraj B, Ansari MJ. Significance of T helper 17 immunity in transplantation. Curr Opin Organ Transplant 2013; 17:8-14. [PMID: 22186097 DOI: 10.1097/mot.0b013e32834ef4e4] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW The aim of this review is to provide an overview of significance of T helper 17 (Th17) immunity in acute, chronic and antibody-mediated allograft rejection. The role of Th17 immunity in development of de-novo autoimmunity following transplantation is outlined. It will also consider the impact of Th17 immunity on transplantation tolerance. Potential therapies to target Th17 immunity are discussed. RECENT FINDINGS Interleukin17 (IL-17) is produced by a wide variety of immune and non-immune cells in response to injury. IL-17 production by tubular epithelial cells in response to complement activation in acute antibody-mediated rejection may perpetuate immune injury. Th17-dependent de-novo autoimmunity contributes to chronic allograft rejection. Targeting IL-17 not only inhibits Th17 immunity but also attenuates Th1 immunity by affecting the initial recruitment of immune cells to sites of inflammation and modulates innate and adaptive immune responses that ultimately lead to tissue destruction. SUMMARY Th17 immunity is now beginning to be appreciated as a set of responses mediated not only by CD4 Th17 cells but a variety of immune cells and a plethora of cytokines that collaborate to mediate immune disorders, including transplant rejection. Development and contribution of de-novo autoimmunity to chronic rejection is increasingly appreciated. The developmental plasticity of Tregs and Th17 cells is a major hurdle to Treg-based cellular therapies for transplantation. Several biologics targeting Th17 immunity are under evaluation for autoimmune disease. It remains to be determined whether these can be used in transplantation to improve outcomes.
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Affiliation(s)
- Farida Abadja
- Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Cardinal H, Dieudé M, Brassard N, Qi S, Patey N, Soulez M, Beillevaire D, Echeverry F, Daniel C, Durocher Y, Madore F, Hébert MJ. Antiperlecan antibodies are novel accelerators of immune-mediated vascular injury. Am J Transplant 2013; 13:861-874. [PMID: 23432943 DOI: 10.1111/ajt.12168] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 11/23/2012] [Accepted: 11/25/2012] [Indexed: 01/25/2023]
Abstract
Acute vascular rejection (AVR) is characterized by immune-mediated vascular injury and heightened endothelial cell (EC) apoptosis. We reported previously that apoptotic ECs release a bioactive C-terminal fragment of perlecan referred to as LG3. Here, we tested the possibility that LG3 behaves as a neoantigen, fuelling the production of anti-LG3 antibodies of potential importance in regulating allograft vascular injury. We performed a case-control study in which we compared anti-LG3 IgG titers in kidney transplant recipients with AVR (n=15) versus those with acute tubulo-interstitial rejection (ATIR) (n=15) or stable graft function (n=30). Patients who experienced AVR had elevated anti-LG3 titers pre and posttransplantation compared to subjects with ATIR or stable graft function (p<0.05 for both mediators). Elevated pretransplant anti-LG3 titers (OR: 4.62, 95% CI: 1.08-19.72) and pretransplant donor-specific antibodies (DSA) (OR 4.79, 95% CI: 1.03-22.19) were both independently associated with AVR. To address the functional role of anti-LG3 antibodies in AVR, we turned to passive transfer of anti-LG3 antibodies in an animal model of vascular rejection based on orthotopic aortic transplantation between fully MHC-mismatched mice. Neointima formation, C4d deposition and allograft inflammation were significantly increased in recipients of an ischemic aortic allograft passively transferred with anti-LG3 antibodies. Collectively, these data identify anti-LG3 antibodies as novel accelerators of immune-mediated vascular injury and obliterative remodeling.
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Affiliation(s)
- H Cardinal
- Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM)-Hôpital Notre-Dame and Université de Montréal, Montreal, QC, Canada
| | - M Dieudé
- Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM)-Hôpital Notre-Dame and Université de Montréal, Montreal, QC, Canada
| | - N Brassard
- Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM)-Hôpital Notre-Dame and Université de Montréal, Montreal, QC, Canada
| | - S Qi
- Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM)-Hôpital Notre-Dame and Université de Montréal, Montreal, QC, Canada
| | - N Patey
- Research Centre, Hôpital Ste-Justine, Montreal, Quebec, Canada
| | - M Soulez
- Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM)-Hôpital Notre-Dame and Université de Montréal, Montreal, QC, Canada
| | - D Beillevaire
- Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM)-Hôpital Notre-Dame and Université de Montréal, Montreal, QC, Canada
| | - F Echeverry
- INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - C Daniel
- INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Y Durocher
- Biotechnology Research Institute, Montreal, QC, Canada
| | - F Madore
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - M J Hébert
- Research Centre, Centre hospitalier de l'Université de Montréal (CRCHUM)-Hôpital Notre-Dame and Université de Montréal, Montreal, QC, Canada
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Abstract
INTRODUCTION Antibody is a major cause of allograft injury. However, it has not been routinely tested post-transplant. SOURCES OF DATA A literature search was performed using PubMed on the topics of 'antibody monitoring', 'autoantibody and allograft dysfunction' and 'prevention and treatment of antibody-mediated rejection (AMR)'. AREAS OF AGREEMENT Donor-specific antibody (DSA) monitoring not only helps to identify patients at risk of AMR, but also serves as a biomarker to personalize patient's maintenance immunosuppression. Development of autoantibody is a secondary response following primary tissue injury. Some autoantibodies are directly involved in allograft injury, while others only serve as biomarkers of tissue injury. AREAS OF CONTROVERSY It remains controversial whether DSA-positive patients without symptoms need to be treated. In addition, given the variation in study designs and patient's characteristics, there is discrepancy regarding which treatment regimens provide optimal clinical outcome in preventing/treating AMR. GROWING POINTS Efficacy of B-cell and/or antibody-targeted therapies in treating or preventing AMR would be better measured by the incorporation of antibody monitoring into current functional and pathological assays. AREAS TIMELY FOR DEVELOPING RESEARCH Research in B-cell targeted therapies to prevent and treat AMR is rapidly growing, which includes monoclonal antibodies against B-cell markers CD20, CD40, CD19, BlyS, etc. It requires extensive clinical research to determine the best approach to inhibit or delete antibody and how to balance the drug efficacy with safety.
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Affiliation(s)
- Junchao Cai
- Terasaki Foundation Laboratory, 11570 W Olympic Blvd, Los Angeles, CA 90064, USA.
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Lin X, Li W, Lai J, Okazaki M, Sugimoto S, Yamamoto S, Wang X, Gelman AE, Kreisel D, Krupnick AS. Five-year update on the mouse model of orthotopic lung transplantation: Scientific uses, tricks of the trade, and tips for success. J Thorac Dis 2012; 4:247-58. [PMID: 22754663 DOI: 10.3978/j.issn.2072-1439.2012.06.02] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 06/05/2012] [Indexed: 12/23/2022]
Abstract
It has been 5 years since our team reported the first successful model of orthotopic single lung transplantation in the mouse. There has been great demand for this technique due to the obvious experimental advantages the mouse offers over other large and small animal models of lung transplantation. These include the availability of mouse-specific reagents as well as knockout and transgenic technology. Our laboratory has utilized this mouse model to study both immunological and non-immunological mechanisms of lung transplant physiology while others have focused on models of chronic rejection. It is surprising that despite our initial publication in 2007 only few other laboratories have published data using this model. This is likely due to the technical complexity of the surgical technique and perioperative complications, which can limit recipient survival. As two of the authors (XL and WL) have a combined experience of over 2500 left and right single lung transplants, this review will summarize their experience and delineate tips and tricks necessary for successful transplantation. We will also describe technical advances made since the original description of the model.
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Puttarajappa C, Shapiro R, Tan HP. Antibody-mediated rejection in kidney transplantation: a review. J Transplant 2012; 2012:193724. [PMID: 22577514 PMCID: PMC3337620 DOI: 10.1155/2012/193724] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 01/09/2012] [Indexed: 01/12/2023] Open
Abstract
Antibody mediated rejection (AMR) poses a significant and continued challenge for long term graft survival in kidney transplantation. However, in the recent years, there has emerged an increased understanding of the varied manifestations of the antibody mediated processes in kidney transplantation. In this article, we briefly discuss the various histopathological and clinical manifestations of AMRs, along with describing the techniques and methods which have made it easier to define and diagnose these rejections. We also review the emerging issues of C4d negative AMR, its significance in long term allograft survival and provide a brief summary of the current management strategies for managing AMRs in kidney transplantation.
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Affiliation(s)
- Chethan Puttarajappa
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213-2582, USA
| | - Ron Shapiro
- Division of Transplantation, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213-2582, USA
| | - Henkie P. Tan
- Division of Transplantation, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213-2582, USA
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Satelli A, Li S. Vimentin in cancer and its potential as a molecular target for cancer therapy. Cell Mol Life Sci 2011; 68:3033-46. [PMID: 21637948 PMCID: PMC3162105 DOI: 10.1007/s00018-011-0735-1] [Citation(s) in RCA: 961] [Impact Index Per Article: 73.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 05/12/2011] [Accepted: 05/16/2011] [Indexed: 02/06/2023]
Abstract
Vimentin, a major constituent of the intermediate filament family of proteins, is ubiquitously expressed in normal mesenchymal cells and is known to maintain cellular integrity and provide resistance against stress. Vimentin is overexpressed in various epithelial cancers, including prostate cancer, gastrointestinal tumors, tumors of the central nervous system, breast cancer, malignant melanoma, and lung cancer. Vimentin's overexpression in cancer correlates well with accelerated tumor growth, invasion, and poor prognosis; however, the role of vimentin in cancer progression remains obscure. In recent years, vimentin has been recognized as a marker for epithelial-mesenchymal transition (EMT). Although EMT is associated with several tumorigenic events, vimentin's role in the underlying events mediating these processes remains unknown. By virtue of its overexpression in cancer and its association with tumor growth and metastasis, vimentin serves as an attractive potential target for cancer therapy; however, more research would be crucial to evaluate its specific role in cancer. Our recent discovery of a vimentin-binding mini-peptide has generated further impetus for vimentin-targeted tumor-specific therapy. Furthermore, research directed toward elucidating the role of vimentin in various signaling pathways would reveal new approaches for the development of therapeutic agents. This review summarizes the expression and functions of vimentin in various types of cancer and suggests some directions toward future cancer therapy utilizing vimentin as a potential molecular target.
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Affiliation(s)
- Arun Satelli
- Department of Pediatrics, Unit 853, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX 77030 USA
| | - Shulin Li
- Department of Pediatrics, Unit 853, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX 77030 USA
- UTMD, Graduate School of Biomedical Science, Houston, TX 77030 USA
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Kahan BD. Forty years of publication of Transplantation Proceedings--the fourth decade: Globalization of the enterprise. Transplant Proc 2011; 43:3-29. [PMID: 21335147 DOI: 10.1016/j.transproceed.2010.12.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Barry D Kahan
- Division of Immunology and Organ Transplantation, The University of Texas-Health Science Center at Houston Medical School, Houston, Texas 77030, USA.
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