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Süsal C, Groth J, Oberg HH, Terness P, May G, Staehler G, Opelz G. Pretransplant serum IgG-anti-F(ab′)2γ
activity and kidney graft outcome: comparison of results obtained at two centers. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zhu L, Aly M, Wang H, Karakizlis H, Weimer R, Morath C, Kuon RJ, Toth B, Ekpoom N, Opelz G, Daniel V. Increased natural killer cell subsets with inhibitory cytokines and inhibitory surface receptors in patients with recurrent miscarriage and decreased or normal subsets in kidney transplant recipients late post-transplant. Clin Exp Immunol 2018; 193:241-254. [PMID: 29679490 DOI: 10.1111/cei.13142] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 12/16/2022] Open
Abstract
Patients with recurrent miscarriage (RM) show up-regulated cytotoxic natural killer (NK) cells that are suspected to play a causal role in abortion. In the present study, we investigated counter-regulating inhibitory mechanisms and compared the results in RM patients with those of healthy controls (HC), patients with end-stage renal disease (ESRD) and kidney transplant recipients late post-transplant (TX). NK, NK T and T cell subsets were analysed in the peripheral blood of 31 RM, 14 female ESRD and nine female TX patients as well as 21 female HC using eight-colour fluorescence flow cytometry. Compared with HC, RM patients showed significantly higher absolute numbers of CD56+ NK cells co-expressing the phenotype interferon (IFN)-γR+ , IL-4+ , transforming growth factor (TGF)-β+ , IL-4+ human leucocyte antigen D-related (HLA-DR)+ , TGF-β+ HLA-DR+ , IL-4+ TGF-β+ , IL-4+ TGF-β- , IFN-γ+ and/or IL-10- IFN-γ+ (all P ≤ 0·01), more IL-17+ CD56bright (P = 0·028) NK cells and more CD56dim CD16+ NK cells co-expressing IFN-γR, IFN-γ, IL-4 and/or TGF-β (all P ≤ 0·01). When the same cell subsets were analysed in ESRD or TX patients, cytokine-producing NK cell subsets were not significantly different from those of HC. RM patients showed significantly higher absolute numbers of CD158a+ , CD158b+ , CD158a- CD158e+ (all P < 0·05), NKG2D+ NKG2A+ , NKG2D + NKG2A- , NKG2D+ and/or NKG2A+ (all P ≤ 0·01) CD56+ NK cells and higher CD158a+ , CD158b+ (all P < 0·05), NKG2D+ and/or NKG2A+ (all P < 0·01) CD56dim+ CD16+ NK cells than HC. In contrast, ESRD patients had normal and TX recipients had lower CD158a+ and NKG2D+ NKG2A- CD56+ NK cells and lower CD158a+ CD56dim+ CD16+ NK cells (all P < 0·05) than HC. RM patients have abnormally high circulating NK cells expressing inhibitory cytokines and inhibitory surface receptors which might contribute to the pathogenesis of RM.
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Affiliation(s)
- L Zhu
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Hematology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - M Aly
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Internal Medicine, University of Giessen, Giessen, Germany.,Nephrology Unit, Internal Medicine Department, Assiut University, Asyut, Egypt
| | - H Wang
- Department of Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - H Karakizlis
- Department of Internal Medicine, University of Giessen, Giessen, Germany
| | - R Weimer
- Department of Internal Medicine, University of Giessen, Giessen, Germany
| | | | - R J Kuon
- Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - B Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - N Ekpoom
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - G Opelz
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - V Daniel
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany
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Oweira H, Lahdou I, Opelz G, Daniel V, Terness P, Schmidt J, Mehrabi A, Fusch G, Schefold J, Zidan A, Sadeghi M. Association of pre- and early post-transplant serum amino acids and metabolites of amino acids and liver transplant outcome. Transpl Immunol 2017; 46:42-48. [PMID: 29258878 DOI: 10.1016/j.trim.2017.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 12/07/2017] [Indexed: 01/20/2023]
Abstract
The aim of the present study was to investigate association of serum amino (AA) acids and metabolites of AAs with post-transplant outcome in liver transplant recipients. Eighty-nine patients with end-stage liver diseases and available pre- and early post-transplant serum were characterised as patients with (GI) and without one-year mortality (GII) and patients with and without early graft dysfunction (EAD). A panel of pre- and early post-transplant serum levels of AAs and early and metabolites of tryptophan were measured using tandem mass spectrometry. Patient groups had significantly higher pre-transplant serum levels of phenylalanine, tryptophan, and tryptophan metabolites than healthy controls (for all p<0.001). Pre-transplant serum levels of all these parameters were significantly higher in GI than in GII (for all p<0.001). GI had a higher MELD score and re-transplantation number than GII (p≤0.005 for both investigations). Serum bilirubin on day 5 and serum phenylalanine on day 10 post-transplant were associated parameters of mortality, whereas day 1post-transplant phenylalanine and kynurenine and female gender were associated parameters of EAD. Our results indicate that pre- and early post-transplant levels of phenylalanine, tryptophan and metabolites of tryptophan are increased in patients and are associated with EAD and one-year mortality in liver transplant recipients.
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Affiliation(s)
- H Oweira
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany; General and Visceral Surgery, Hirslanden Private Hospital, Zurich, Switzerland.
| | - I Lahdou
- Transplantation-Immunology, University of Heidelberg, Germany
| | - G Opelz
- Transplantation-Immunology, University of Heidelberg, Germany.
| | - V Daniel
- Transplantation-Immunology, University of Heidelberg, Germany.
| | - P Terness
- Transplantation-Immunology, University of Heidelberg, Germany.
| | - J Schmidt
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany; General and Visceral Surgery, Hirslanden Private Hospital, Zurich, Switzerland.
| | - A Mehrabi
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
| | - G Fusch
- Department of Paediatrics, McMaster University, Hamilton, Canada.
| | - J Schefold
- Department of Intensive Care Medicine Inselspital, Bern University Hospital, Freiburgstrasse 18, CH-3012 Bern, Switzerland.
| | - A Zidan
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany; Department of HPB and liver transplantation, Rajhy Liver Hospital, Assiut University, Assiut, Egypt.
| | - M Sadeghi
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany; Transplantation-Immunology, University of Heidelberg, Germany.
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Süsal C, Lewin I, Stanworth D, Terness P, Daniel V, Oberg HH, Huth-Kühne A, Zimmermann R, Opelz G. Anti-IgG Autoantibodies in HIV-Infected Hemophilia Patients. Vox Sang 2017. [DOI: 10.1159/000462206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Rudy T, Opelz G, Gerlach R, Daniel V, Schimpf K. Correlation of in vitro Immune Defects with
Impaired Gamma Interferon Response in
Human-Immunodeficiency-Virus-Infected Individuals. Vox Sang 2017. [DOI: 10.1159/000461774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Adamek M, Döhler B, Hasan KK, Fiedler G, Scherer S, Opelz G, Tran TH. Assessing the impact of FoxP3 and Vav1 gene polymorphisms on kidney allograft survival. HLA 2017; 90:102-105. [DOI: 10.1111/tan.13049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 04/01/2017] [Accepted: 04/11/2017] [Indexed: 01/14/2023]
Affiliation(s)
- M. Adamek
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - B. Döhler
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - K. K. Hasan
- Department of Biology, College of Science; University of Baghdad; Baghdad Iraq
| | - G. Fiedler
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - S. Scherer
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - G. Opelz
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - T. H. Tran
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
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Trojan K, Zhu L, Aly M, Weimer R, Bulut N, Morath C, Opelz G, Daniel V. Association of peripheral NK cell counts with Helios + IFN-γ - T regs in patients with good long-term renal allograft function. Clin Exp Immunol 2017; 188:467-479. [PMID: 28194759 DOI: 10.1111/cei.12945] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 12/16/2022] Open
Abstract
Little is known about a possible interaction of natural killer (NK) cells with regulatory T cells (Treg ) in long-term stable kidney transplant recipients. Absolute counts of lymphocyte and Treg subsets were studied in whole blood samples of 136 long-term stable renal transplant recipients and 52 healthy controls using eight-colour fluorescence flow cytometry. Patients were 1946 ± 2201 days (153-10 268 days) post-transplant and showed a serum creatinine of 1·7 ± 0·7 mg/dl. Renal transplant recipients investigated > 1·5 years post-transplant showed higher total NK cell counts than recipients studied < 1·5 years after transplantation (P = 0·006). High NK cells were associated with high glomerular filtration rate (P = 0·002) and low serum creatinine (P = 0·005). Interestingly, high NK cells were associated with high CD4+ CD25+ CD127- forkhead box protein 3 (FoxP3+ ) Treg that co-express the phenotype Helios+ interferon (IFN)-γ- and appear to have stable FoxP3 expression and originate from the thymus. Furthermore, high total NK cells were associated with Treg that co-express the phenotypes interleukin (IL)-10- transforming growth factor (TGF)-β+ (P = 0·013), CD183+ CD62L- (P = 0·003), CD183+ CD62+ (P = 0·001), CD183- CD62L+ (P = 0·002), CD252- CD152+ (P < 0·001), CD28+ human leucocyte antigen D-related (HLA-DR- ) (P = 0·002), CD28+ HLA-DR+ (P < 0·001), CD95+ CD178- (P < 0·001) and CD279- CD152+ (P < 0·001), suggesting that these activated Treg home in peripheral tissues and suppress effector cells via TGF-β and cytotoxic T lymphocyte-associated protein 4 (CTLA-4). The higher numbers of NK and Treg cell counts in patients with long-term good allograft function and the statistical association of these two lymphocyte subsets with each other suggest a direct or indirect (via DC) interaction of these cell subpopulations that contributes to good long-term allograft acceptance. Moreover, we speculate that regulatory NK cells are formed late post-transplant that are able to inhibit graft-reactive effector cells.
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Affiliation(s)
- K Trojan
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - L Zhu
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Hematology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - M Aly
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany.,Nephrology Unit, Internal Medicine Department, Assiut University, Egypt
| | - R Weimer
- Department of Internal Medicine, University of Giessen, Giessen, Germany
| | - N Bulut
- Department of Internal Medicine, University of Giessen, Giessen, Germany
| | - C Morath
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - G Opelz
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - V Daniel
- Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany
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Gale RP, Opelz G. Paul I Terasaki (10 September, 1929-25 January, 2016). Bone Marrow Transplant 2016; 51:621-2. [PMID: 27142177 DOI: 10.1038/bmt.2016.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - G Opelz
- University of Heidelberg, Heidelberg, Germany
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11
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Schaefer SM, Süsal C, Opelz G, Döhler B, Becker LE, Klein K, Sickmüller S, Waldherr R, Macher-Goeppinger S, Schemmer P, Beimler J, Zeier M, Morath C. Pre-transplant soluble CD30 in combination with total DSA but not pre-transplant C1q-DSA predicts antibody-mediated graft loss in presensitized high-risk kidney transplant recipients. HLA 2016; 87:89-99. [DOI: 10.1111/tan.12735] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 12/11/2015] [Accepted: 01/04/2016] [Indexed: 02/01/2023]
Affiliation(s)
- S. M. Schaefer
- Division of Nephrology; University Hospital of Heidelberg; Heidelberg Germany
| | - C. Süsal
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - G. Opelz
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - B. Döhler
- Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - L. E. Becker
- Division of Nephrology; University Hospital of Heidelberg; Heidelberg Germany
| | - K. Klein
- Division of Nephrology; University Hospital of Heidelberg; Heidelberg Germany
| | - S. Sickmüller
- Division of Nephrology; University Hospital of Heidelberg; Heidelberg Germany
| | - R. Waldherr
- Department of Pathology; University of Heidelberg; Heidelberg Germany
| | | | - P. Schemmer
- Division of Transplantation Surgery; University of Heidelberg; Heidelberg Germany
| | - J. Beimler
- Division of Nephrology; University Hospital of Heidelberg; Heidelberg Germany
| | - M. Zeier
- Division of Nephrology; University Hospital of Heidelberg; Heidelberg Germany
| | - C. Morath
- Division of Nephrology; University Hospital of Heidelberg; Heidelberg Germany
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12
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Clatworthy MR, Matthews R, Doehler B, Willcocks L, Opelz G, Smith KGC. De-functioning polymorphism in the inhibitory receptor FcγRIIB does not impact upon kidney allograft survival. Clin Exp Immunol 2015; 178 Suppl 1:159-61. [PMID: 25546804 DOI: 10.1111/cei.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- M R Clatworthy
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK
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13
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Günesacar R, Opelz G, Erken E, Döhler B, Ruhenstroth A, Süsal C. Complement C5a receptor gene 450 C/T polymorphism in renal transplant recipients: association of the CT genotype with graft outcome. ACTA ACUST UNITED AC 2015; 85:104-7. [DOI: 10.1111/tan.12495] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 11/26/2014] [Accepted: 11/30/2014] [Indexed: 11/28/2022]
Affiliation(s)
- R. Günesacar
- Department of Medical Biology and Genetics, Faculty of Medicine; University of Kahramanmaras Sütcü Imam; Kahramanmaras Turkey
- Department of Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - G. Opelz
- Department of Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - E. Erken
- Department of Immunology-Rheumatology, Faculty of Medicine; University of Cukurova; Adana Turkey
| | - B. Döhler
- Department of Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - A. Ruhenstroth
- Department of Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
| | - C. Süsal
- Department of Transplantation Immunology, Institute of Immunology; University of Heidelberg; Heidelberg Germany
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Abstract
Inclusion of human leukocyte antigen (HLA) matching in donor kidney allocation schemes has been based solely on its association with graft survival. Other long-term effects associated with HLA incompatibility are largely unexplored. Data from deceased donor kidney transplants reported to the Collaborative Transplant Study have been analyzed to assess the relation between HLA mismatching and clinical events to 3 years post-transplant, and an overview of these analyses is presented. A significant correlation was observed between the number of mismatches and the need for anti-rejection therapy during the first year post-transplant, which was maintained for HLA-DR and HLA-A + B mismatching separately and at years 2 and 3 post-transplant. The number of HLA-DR mismatches and the number of HLA-A + B mismatches as well as rejection treatment showed significant associations with the dose of maintenance steroids. The cumulative incidences of death with a functioning graft from infection or cardiovascular causes, but not from cancer, were also significantly associated with HLA mismatching. The number of HLA-DR mismatches showed a significant association with the incidence of non-Hodgkin lymphoma and hip fractures. These findings show that the adverse consequences of HLA mismatching on kidney transplants extend beyond an effect on graft survival, and include an increased risk of death with a functioning graft, non-Hodgkin lymphoma and hip fracture.
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Affiliation(s)
- G Opelz
- Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany
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15
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Sadeghi M, Lahdou I, Oweira H, Daniel V, Terness P, Opelz G, Werner J, Schemmer P, Mehrabi A. Pre- and Early Post-Transplant Plasma Neopterin Correlates With One Year Mortality in Liver Transplant Recipients. Transplantation 2014. [DOI: 10.1097/00007890-201407151-00565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Suesal C, Opelz G. Association of Kidney Graft Loss With Posttransplant Presence of HLA Antibodies Detected By Single Antigen Testing. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Adamek M, Heyder J, Heinold A, Fiedler G, Opelz G, Tran TH. Characterization of mannose-binding lectin (MBL) variants by allele-specific sequencing of MBL2 and determination of serum MBL protein levels. ACTA ACUST UNITED AC 2013; 82:410-5. [PMID: 24134411 DOI: 10.1111/tan.12232] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/21/2013] [Accepted: 09/26/2013] [Indexed: 11/29/2022]
Abstract
Mannose-binding lectin (MBL) is a major component of the lectin pathway of complement activation. High and low MBL levels have been associated with susceptibility and severity of a variety of infectious and autoimmune diseases. Several single-nucleotide polymorphisms (SNPs) in the promoter region and exon 1 of the MBL2 gene are responsible for variations in serum MBL levels. We developed a sequence-based typing method for allele-specific MBL2 genotyping and measured serum MBL protein levels in 24 German blood donors. We identified the common MBL2 haplotypes including five promoter polymorphisms in linkage with the Q allele and correlated serum MBL levels with the respective genotypes. The genotyping method presented here could provide a basis for confirmatory studies in larger cohorts.
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Affiliation(s)
- M Adamek
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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Dierselhuis MP, Spierings E, Drabbels J, Hendriks M, Alaez C, Alberú J, Alvarez MB, Burlingham W, Campos E, Christiaans M, Claas F, Fasano ME, Gerbase-DeLima M, Gervais T, Gorodezky C, Larriba J, Lardy NM, Latinne D, Morales-Buenrostro LE, Moreno MJ, Oguz F, Opelz G, Sergeant R, Tambutti M, Teper S, Tilanus M, Turkmen A, Warrens AN, Weimar W, Goulmy E. Minor H antigen matches and mismatches are equally distributed among recipients with or without complications after HLA identical sibling renal transplantation. ACTA ACUST UNITED AC 2013; 82:312-6. [DOI: 10.1111/tan.12209] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 07/31/2013] [Accepted: 09/06/2013] [Indexed: 11/28/2022]
Affiliation(s)
- M. P. Dierselhuis
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
| | - E. Spierings
- Department of Immunology; University Medical Center Utrecht; Utrecht; The Netherlands
| | - J. Drabbels
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
| | - M. Hendriks
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
| | - C. Alaez
- Department of Immunology & Immunogenetics; Instituto de Diagnostico y Referencia Epidemiologicos; Mexico City; Mexico
| | - J. Alberú
- Department of Transplantation; Instituto Nacional de Ciencias, Médicas y de la Nutrición; Mexico City; Mexico
| | - M. B. Alvarez
- Centro de Inmunología y Genética molecular; Buenos Aires; Argentina
| | - W. Burlingham
- Department of Surgery; University of Wisconsin; Madison; WI; USA
| | - E. Campos
- Universidade Federal de São Paulo and Associação Fundo de Incentivo à Pesquisa; São Paulo; Brazil
| | - M. Christiaans
- Department of Nephrology; Maastricht University Medical Center; Maastricht; The Netherlands
| | - F. Claas
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
| | - M. E. Fasano
- Immunologia Trapianti c/o Genetica; Turin; Italy
| | - M. Gerbase-DeLima
- Universidade Federal de São Paulo and Associação Fundo de Incentivo à Pesquisa; São Paulo; Brazil
| | - T. Gervais
- Immunohaematology, Cliniques St. Luc; Université Catholique de Louvain; Brussels; Belgium
| | - C. Gorodezky
- Department of Immunology & Immunogenetics; Instituto de Diagnostico y Referencia Epidemiologicos; Mexico City; Mexico
| | - J. Larriba
- Histocompatibility and Immunogenetics-ICBME; Hospital Italiano de Buenos Aires; Buenos Aires; Argentina
| | - N. M. Lardy
- Sanquin-Diagnostic Services; Amsterdam; The Netherlands
| | - D. Latinne
- Immunohaematology, Cliniques St. Luc; Université Catholique de Louvain; Brussels; Belgium
| | - L.-E. Morales-Buenrostro
- Department of Nephrology and Mineral Metabolism; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran; México City; Mexico
| | - M. J. Moreno
- Histocompatibility Laboratory; CEMIC-Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno; Buenos Aires; Argentina
| | - F. Oguz
- Department of Medical Biology, Medical Faculty of Istanbul; Istanbul University; Istanbul; Turkey
| | - G. Opelz
- Institute of Immunology; University of Heidelberg; Heidelberg; Germany
| | - R. Sergeant
- Immunology; Imperial College Healthcare NHS Trust; London; UK
| | - M. Tambutti
- Histocompatibility and Immunogenetics-ICBME; Hospital Italiano de Buenos Aires; Buenos Aires; Argentina
| | - S. Teper
- Histocompatibility Laboratory; CEMIC-Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno; Buenos Aires; Argentina
| | - M. Tilanus
- Transplantation Immunology, Tissue Typing Laboratory; Maastricht University Medical Center; Maastricht; The Netherlands
| | - A. Turkmen
- Department of Medical Biology, Medical Faculty of Istanbul; Istanbul University; Istanbul; Turkey
| | - A. N. Warrens
- Immunology; Imperial College Healthcare NHS Trust; London; UK
| | - W. Weimar
- Internal medicine; Erasmus Medical Center; Rotterdam; The Netherlands
| | - E. Goulmy
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden; The Netherlands
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19
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Opelz G, Döhler B. Association between steroid dosage and death with a functioning graft after kidney transplantation. Am J Transplant 2013; 13:2096-105. [PMID: 23750878 DOI: 10.1111/ajt.12313] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/17/2013] [Accepted: 04/23/2013] [Indexed: 01/25/2023]
Abstract
Death with a functioning graft remains a major challenge following kidney transplantation. Steroid dosing may be a modifiable risk factor. Collaborative Transplant Study (CTS) data were analyzed to assess the relationship between long-term steroid dose and death with function during years 2-5 posttransplant in 41 953 adult recipients of a deceased-donor kidney transplant during 1995-2010. Steroid dose at year 1 correlated significantly with death with function overall, and with death due to cardiovascular disease or infection (all p < 0.001). In patients with optimal graft function (serum creatinine <130 µmol/L) and no anti-rejection treatment during (a) year 1 (b) years 1 and 2, these significant associations remained (all p < 0.001). The center-specific incidence of steroid withdrawal during year 2 showed a significant inverse association with death due to cardiovascular disease (p < 0.001) or infection (p < 0.001) overall, and within the subpopulation with good graft function and no rejection during year 1 (p = 0.002 and p < 0.001, respectively). Maintenance steroid dose shows a highly significant association with death with a functioning graft caused by cardiovascular disease or infection during years 2-5 after kidney transplantation, even in patients with good graft outcomes in whom steroid treatment would appear to be unnecessary.
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Affiliation(s)
- G Opelz
- Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany.
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Gombos P, Opelz G, Scherer S, Morath C, Zeier M, Schemmer P, Süsal C. Influence of test technique on sensitization status of patients on the kidney transplant waiting list. Am J Transplant 2013; 13:2075-82. [PMID: 23841891 DOI: 10.1111/ajt.12332] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 04/05/2013] [Accepted: 04/08/2013] [Indexed: 01/25/2023]
Abstract
The exquisitely sensitive single antigen bead (SAB) technique was shown to detect human leukocyte antigen (HLA) antibodies in sera of healthy male blood donors. Such false reactions can have an impact on critical decisions, especially with respect to the determination of unacceptable HLA-antigen mismatches in patients awaiting a kidney transplant. We tested pretransplant sera of 534 patients on the kidney waiting list using complement-dependent cytotoxicity (CDC), enzyme-linked immunosorbent assay (ELISA) and SAB in parallel. Evidence of HLA antibodies was obtained in 5% of patients using CDC, 14% using ELISA, and 81% using SAB. Among patients without history of an immunizing event, 77% showed evidence of HLA antibodies in SAB. In contrast 98% of these patients were negative in ELISA and CDC. In patients without an immunizing event, SAB-detected antibodies reacted not always weakly but with mean fluorescence intensity (MFI) values as high as 14 440. High-MFI-value antibodies were found in some of these patients with HLA specificities that are rather common in general population, consideration of which would lead to unjustified exclusion of potential kidney donors. False SAB reactions can be unveiled by testing with additional antibody assays. Denial of donor kidneys to recipients based on HLA-antibody specificities detected exclusively in the SAB assay is not advisable.
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Affiliation(s)
- P Gombos
- Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany
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Wang H, Daniel V, Sadeghi M, Opelz G. Differences in the Induction of Induced Human CD4+ CD25+ FoxP3+ T-Regulatory Cells and CD3+ CD8+ CD28− T-Suppressor Cells Subset Phenotypes In Vitro: Comparison of Phorbol 12-Myristate 13-Acetate/Ionomycin and Phytohemagglutinin Stimulation. Transplant Proc 2013; 45:1822-31. [DOI: 10.1016/j.transproceed.2012.10.061] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 10/09/2012] [Indexed: 12/22/2022]
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22
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Wang H, Daniel V, Sadeghi M, Opelz G. Plasticity and Overlap of In Vitro–Induced Regulatory T-Cell Markers in Healthy Humans. Transplant Proc 2013; 45:1816-21. [DOI: 10.1016/j.transproceed.2012.10.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 10/09/2012] [Indexed: 12/30/2022]
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Tran TH, Unterrainer C, Fiedler G, Döhler B, Scherer S, Ruhenstroth A, Adamek M, Middleton D, Opelz G. No impact of KIR-ligand mismatch on allograft outcome in HLA-compatible kidney transplantation. Am J Transplant 2013; 13:1063-1068. [PMID: 23398855 DOI: 10.1111/ajt.12134] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 11/15/2012] [Accepted: 12/04/2012] [Indexed: 01/25/2023]
Abstract
Natural killer (NK) cell function can be modulated by the killer cell immunoglobulin-like receptors (KIR) which interact with human leukocyte antigen (HLA) class I molecules on target cells. KIR-ligand mismatching has recently been shown by van Bergen et al. (American Journal of Transplantation 2011; 11(9): 1959-1964) to be a significant risk factor for long-term graft loss in HLA-A, -B and -DR compatible kidney transplants. To verify this potentially important finding, we performed genotyping of 608 deceased-donor kidney graft recipients and their HLA-A, -B and -DR compatible donors for KIR and HLA, using samples and clinical data provided by the Collaborative Transplant Study. Graft survival of KIR-ligand-matched and -mismatched transplants was compared. We found no impact of KIR-ligand mismatching on 10-year graft survival in HLA-A, -B, -DR compatible kidney transplants. Further analysis did not reveal a significant effect of recipient activating/inhibitory KIR or KIR genotypes on graft survival. Our data do not support the concept that KIR-HLA matching might serve as a tool to improve long-term renal allograft survival.
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Affiliation(s)
- T H Tran
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
| | - C Unterrainer
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
| | - G Fiedler
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
| | - B Döhler
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
| | - S Scherer
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
| | - A Ruhenstroth
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
| | - M Adamek
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
| | - D Middleton
- Transplant Immunology, Royal Liverpool University Hospital, Liverpool, UK
| | - G Opelz
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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Abstract
Currently, there are two major options for the successful and timely transplantation of sensitized kidney transplant recipients: (1) avoidance of the sensitization barrier using special allocation programs, or (2) desensitization. In the case of broadly sensitized kidney patients, a combination of both options might be necessary. This review focuses on new advances in desensitization of crossmatch-positive kidney transplant recipients which include immunoadsorption and the administration of new substances such as the complement C5 inhibitor eculizumab. Finally, integrated algorithms that combine different measures are acknowledged.
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Affiliation(s)
- C Morath
- Department of Nephrology, University of Heidelberg, Germany
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Renner FC, Dietrich H, Bulut N, Celik D, Freitag E, Gaertner N, Karoui S, Mark J, Raatz C, Padberg W, Opelz G, Weimer R. Intracellular Cytokine Responses Allow Early Detection of Patients at Risk of Polyomavirus-Associated Graft Nephropathy. Transplantation 2012. [DOI: 10.1097/00007890-201211271-00224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Opelz G, Döhler B. Association of HLA mismatch with death with a functioning graft after kidney transplantation: a collaborative transplant study report. Am J Transplant 2012; 12:3031-8. [PMID: 22900931 DOI: 10.1111/j.1600-6143.2012.04226.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
HLA mismatches may correlate with risk of death with a functioning graft (DWFG) because of requirement for higher immunosuppression doses and more antirejection therapy. Deceased-donor kidney transplants (n = 177 584) performed 1990-2009 and reported to the Collaborative Transplant Study were analyzed. The incidence of DWFG was found to be 4.8% during year 1 posttransplant and 7.7% during years 2-5 (Kaplan-Meier estimates). Most frequent causes of DWFG were infection, cardiovascular disease and malignancy (32.2%, 30.9% and 3.6% in year 1; 16.4%, 29.6% and 15.9% in years 2-5). HLA-A + B + DR mismatches were significantly associated with DWFG during year 1 (p < 0.001), a correlation that diminished but persisted during years 2-5 (p < 0.001). HLA mismatch was associated with DWFG because of infection (p < 0.001 during year 1, p = 0.043 during years 2-5) or cardiovascular disease (p < 0.001 during year 1, p = 0.030 during years 2-5) but not malignancy. There was also a significant association between HLA mismatch and hospitalization for viral (p < 0.001) or bacterial (p = 0.002) infection. Multivariable analysis showed that mismatches for HLA class II were more strongly associated with both hospitalization and DWFG than mismatches for HLA class I.
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Affiliation(s)
- G Opelz
- Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany.
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Heyder J, Heinold A, Fiedler G, Opelz G, Tran TH. Characterization of four new HLA alleles: HLA-B*15:01:18, HLA-B*44:110, HLA-C*04:01:22 and HLA-DQB 1*05:14. ACTA ACUST UNITED AC 2011; 79:209-10. [DOI: 10.1111/j.1399-0039.2011.01805.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Opelz G, Döhler B. Treatment of kidney transplant recipients with ACEi/ARB and risk of respiratory tract cancer: a collaborative transplant study report. Am J Transplant 2011; 11:2483-9. [PMID: 21929646 DOI: 10.1111/j.1600-6143.2011.03681.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Whether treatment with angiotensin-converting enzyme inhibitors (ACEi) and/or angiotensin receptor blockers (ARB) increases the risk of cancer is controversial. Collaborative transplant study data were analyzed according to whether kidney transplant recipients were treated with ACEi/ARB at year 1. Twenty-four thousand and ninety patients were studied of whom 9079 (38%) patients received ACEi/ARB. There were 872 nonskin malignancies during years 2-8 posttransplant, including 107 respiratory/intrathoracic tumors. The standardized incidence ratio (SIR) for all nonskin malignancies was similar between the ACEi/ARB (1.91) and no ACEi/ARB (1.81) groups (p = 0.42). For respiratory/intrathoracic tumors, however, SIR was significantly higher with ACEi/ARB (1.65 vs. 1.09 for no ACEi/ARB, p = 0.033). Multivariate Cox regression analysis showed that ACEi/ARB treatment was not associated with an increased risk of respiratory/intrathoracic tumors in nonsmokers. In patients with a history of smoking, however, the risk of respiratory/intrathoracic tumors was 2.77 (95% CI 1.19-6.43, p = 0.018) in patients without ACEi/ARB treatment as compared to 7.10 (95% CI 3.27-15.4, p < 0.001) in patients treated with ACEi/ARB. Our data indicate that in kidney transplant recipients, ACEi/ARB treatment is associated with a significant increase in the rate of respiratory/intrathoracic tumors in the subpopulation of patients with a history of smoking.
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Affiliation(s)
- G Opelz
- Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany
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Abstract
Risk of developing some cancers is markedly increased in settings of immune suppression including after solid organ transplants and in persons with inherited immune-deficiency disorders and those with HIV-1 infection. These cancers include lymphomas, melanoma and non-melanoma skin cancers, kidney and cervical cancers, Kaposi sarcoma and neuroblastoma. There are no reports of an increased acute myeloid leukemia (AML) in settings of immune suppression. This is curious because some data suggest the immune suppression may be important in increasing AML risk in experimental settings, and that immune stimulation may be useful in treating AML. To see whether immune suppression is correlated with an increased risk of developing AML, we analyzed data from 248224 recipients of kidney (N=217219) and heart (N=31005) transplants. Among the kidney transplant recipients, the standardized incidence ratio (SIR) for developing AML was 1.90 (95% confidence interval, 1.4-2.4; P<0.001). Among the heart transplant recipients, the SIR was 5.1 (3.4-7.1; P<0.001). These data suggest immune suppression increases risk of developing AML and that this risk is even higher, following intense prolonged immune suppression. Implications for AML development and therapy are discussed.
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Affiliation(s)
- R P Gale
- Haematology Section, Division of Experimental Medicine, Department of Medicine, Imperial College, London, UK.
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Heyder J, Heinold A, Kudlek E, Opelz G, Tran TH. Characterization of three new alleles HLA-A*02:241, HLA-A*02:242 and HLA-A*30:04:02. ACTA ACUST UNITED AC 2011; 78:152-3. [DOI: 10.1111/j.1399-0039.2011.01667.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Knoch M, Schildhorn C, Hömme M, Döhler B, Opelz G, Melk A, Melk A. Seneszenz-assoziierte Polymorphismen gehen bei transplantierten Patienten mit einem erhöhten kardiovaskulären Mortalitätsrisiko einher. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Morath C, Schmied B, Mehrabi A, Weitz J, Schmidt J, Werner J, Buchler M, Morcos M, Nawroth P, Schwenger V, Doehler B, Opelz G, Zeier M. Angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor blockers after renal transplantation. Clin Transplant 2009; 23 Suppl 21:33-6. [DOI: 10.1111/j.1399-0012.2009.01107.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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33
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Morath C, Schmied B, Mehrabi A, Weitz J, Schmidt J, Werner J, Buchler M, Morcos M, Nawroth P, Schwenger V, Doehler B, Opelz G, Zeier M. Simultaneous pancreas-kidney transplantation in type 1 diabetes. Clin Transplant 2009; 23 Suppl 21:115-20. [DOI: 10.1111/j.1399-0012.2009.01116.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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34
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Tran TH, Middleton D, Döhler B, Scherer S, Meenagh A, Sleator C, Opelz G. Reassessing the impact of donor HLA-C genotype on long-term liver transplant survival. Am J Transplant 2009; 9:1674-8. [PMID: 19392983 DOI: 10.1111/j.1600-6143.2009.02609.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
HLA-C is the major inhibitory ligand for killer immunoglobulin-like receptors (KIRs) that are expressed on natural killer (NK) cells. Based on their KIR specificity, HLA-C alleles can be divided into two groups, termed HLA-C1 and HLA-C2. Donor HLA-C group has recently been identified by Hanvesakul et al. (Am J Transplant 2008) as a critical determinant of clinical outcome following liver transplantation: Possession of at least one HLA-C group 2 allele by the donor was associated with significantly improved long-term graft and patient survival, presumably due to an inhibition of host NK cell function. To verify this study, we performed genotyping of 913 deceased liver donors for the relevant KIR epitopes of HLA-C and correlated the presence or absence of donor HLA-C2 genotype with graft and patient survival. In our study, donor HLA-C2 genotype had no impact on 10-year graft or patient survival. We cannot confirm a major role of donor HLA-C2 genotype on long-term allograft survival after liver transplantation.
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Affiliation(s)
- T H Tran
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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35
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Opelz G, Döhler B. Comparison of histidine-tryptophan-ketoglutarate and University of Wisconsin preservation in renal transplantation. Am J Transplant 2008; 8:1957; author reply 1958. [PMID: 18510634 DOI: 10.1111/j.1600-6143.2008.02271.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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37
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Heinold A, Schaller-Suefling E, Opelz G, Scherer S, Tran TH. Identification of two novel HLA alleles, HLA-A*02010103 and HLA-B*4455, and characterization of the complete genomic sequence of HLA-A*290201. ACTA ACUST UNITED AC 2008; 72:397-400. [PMID: 18647362 DOI: 10.1111/j.1399-0039.2008.01100.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe two novel human leukocyte antigen (HLA) alleles, HLA-A*02010103 and HLA-B*4455, that were discovered in two unrelated Caucasian individuals. In addition, we report the full-length genomic sequence of HLA-A*290201. Compared with HLA-A*02010101, HLA-A*02010103 has three nucleotide (nt) changes within intron 1, which is altered to a sequence typical of the HLA-A*23/A*24 allele group. In HLA-B*4455, an nt exchange occurred in codon 9 of HLA-B*44020101, resulting in a change of the amino acid coding from tyrosine to histidine. We sequenced HLA-A*290201 from nt -108 to nt 2922, encompassing all exons and introns as well as parts of the 5' and 3' untranslated regions. Previously, the full-length genomic sequence was known only for HLA-A*29010101, which is found at a lower frequency in Caucasians than HLA-A*290201.
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Affiliation(s)
- A Heinold
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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Heinold A, Bauer M, Opelz G, Scherer S, Schmidt AH, Tran TH. Identification and characterization of three novel HLA alleles, HLA-A*240214, HLA-A*3215 and HLA-DQB1*060302. ACTA ACUST UNITED AC 2008; 70:511-4. [PMID: 17990990 DOI: 10.1111/j.1399-0039.2007.00958.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We describe three novel human leukocyte antigen (HLA) alleles found in three different Caucasians, HLA-A*240214, HLA-A*3215 and HLA-DQB1*060302. As compared with HLA-A*24020101, HLA-A*240214 has a synonymous nucleotide (nt) exchange in codon 132. HLA-A*240214 may have arisen from intergenic recombination between HLA-A*24020101 and an HLA-B or HLA-C allele. The second novel allele, HLA-A*3215, has three nucleotide exchanges as compared with HLA-A*320101. These variations result in amino acid exchanges in codons 62 and 63, generating the public epitope of the serological HLA-A10 group. The third novel allele, HLA-DQB1*060302, has one synonymous nucleotide exchange within codon 38 as compared with HLA-DQB1*060301. In a family segregation study, we found that HLA-DQB1*060302, similar to the known HLA-DQB1*060301 allele, cosegregates with HLA-DRB1*1301.
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Affiliation(s)
- A Heinold
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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Abstract
In hematopoietic stem cell transplantation (HSCT), disparities between recipients and donors for minor histocompatibility antigens (mHags) have been shown to be related to graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effects. We investigated the effect of mHag mismatches on kidney allograft survival. Out of 33 785 kidney transplants on which DNA and clinical data were available to the Collaborative Transplant Study (CTS), 702 recipient/donor pairs could be identified as HLA-A, -B and -DRB1 matched first transplants of Caucasian origin. These pairs were typed for genetic polymorphisms of the mHags HA-1, HA-2, HA-3, HA-8, HB-1, ACC-1 and UGT2B17. Because mHags are presented in an HLA-restricted manner, only HLA-A*02 positive pairs were included in the analysis of HA-1, HA-2 and HA-8. Similarly, only HLA-A*01, HLA-B*44 and HLA-A*24 positive pairs were considered for the evaluation of HA-3, HB-1 and ACC-1, respectively, whereas UGT2B17 compatible transplants were assessed in HLA-A*29 and HLA-B*44 positive pairs. None of the mHag disparities showed a statistically significant effect on death-censored 5-year graft survival. This report represents the first large-scale study on the relevance of mHags in kidney transplantation.
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Affiliation(s)
- A Heinold
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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Heinold A, Bauer M, Scherer S, Opelz G, Tran TH. Characterization of a new HLA-B allele, HLA-B*5312, and re-evaluation of the published sequences of the untranslated regions of HLA-B*35 and HLA-B*53. ACTA ACUST UNITED AC 2007; 70:319-23. [PMID: 17767554 DOI: 10.1111/j.1399-0039.2007.00900.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report a novel human leukocyte antigen (HLA)-B allele, HLA-B*5312. Compared with HLA-B*530101, there is one silent substitution at nucleotide 438 and two non-synonymous substitutions at nucleotides 431 and 440, causing a change of the amino acid sequence (Asn-->Ser at codon 77 and Ile-->Thr at codon 80, respectively) within the Bw4 epitope. In contrast to the published sequences (IMGT/HLA Database, version 2.16.0, January 2007), we found that HLA-B*530101 had a C instead of a T at nucleotide -221, whereas HLA-B*350101 had a C instead of an A at nucleotide 2992. According to our sequencing results, HLA-B*5312 resembles HLA-B*350101 regarding its sequence of the untranslated regions. HLA-B*5312 may have been the result of a double crossing over event during which HLA-B*350101 adopted a Bw4 motif.
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Affiliation(s)
- A Heinold
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Im Neuenheimer Feld 305, 69120 Heidelberg, Germany.
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41
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Abstract
HLA and immunology laboratories are an integral part of clinical kidney transplant programs. They assist transplant clinicians with evaluating the immunological suitability of potential recipients for transplantation and selecting donor-recipient combinations with a low risk of immunological failure. With sophisticated new techniques becoming available for posttransplant immunological monitoring, laboratories play an increasing supporting role during posttransplant follow up. The level of precision at which immunological testing predicts clinical outcome, however, leaves room for improvement. In this article, we summarize the current state of diagnostics, discuss problems, and point out promising developments.
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Affiliation(s)
- C Süsal
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, D-69120 Heidelberg, Germany
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42
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Staak A, Renner F, Suesal C, Dietrich H, Rainer L, Kamali-Ernst S, Ernst W, Padberg W, Opelz G, Weimer R. Immunoglobulin Induction Therapy in Renal Transplant Recipients: Effects on Immunoglobulin and Regulatory Antibody Levels. Transplant Proc 2006; 38:3483-5. [PMID: 17175311 DOI: 10.1016/j.transproceed.2006.10.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Indexed: 11/21/2022]
Abstract
We have previously shown that high pretransplant regulatory autoantibodies are associated with better kidney graft outcome. To analyze the effect of intravenous immunoglobulin (IVIG) induction therapy on these regulatory antibodies, we performed a prospective randomized study in 50 renal transplant recipients who were randomly assigned to receive 7 x 10 g IVIG or 7 x 10 g IV albumin infusions. Basic immunosuppressive therapy consisted of tacrolimus/azathioprine (n = 24) and tacrolimus/mycophenolate mofetil (n = 26), respectively. ELISA was used to assess IgG-/IgA-anti-Fab, -anti-F(ab)2 and -anti-hinge regulatory antibodies. IVIG induction therapy resulted in upregulation of serum IgG and IgA levels within the first 20 days posttransplant (P = .001, IgG; P = .04, IgA), so that a significant IgG deficiency was found only in non-IVIG patients (day 10: IgG <6 g/L: 7/25 (28%) non-IVIG versus 0/25 IVIG patients; P = .005). As the IVIG charges contained all of the regulatory antibodies tested, intravenous administration of these antibodies explain the elevated IgG- and IgA-anti-F(ab)2 antibody levels found in IVIG compared to non-IVIG patients on day 10 (P = .005 and P = .04, respectively). Our data indicated that IVIG induction prevented severe IgG deficiency in the early posttransplant period but had no impact on severe infectious complications. IVIG induction enhanced immunoregulatory antibody levels early posttransplant, which might provide graft protective effects.
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Affiliation(s)
- A Staak
- Department of Internal Medicine, University Clinic of Giessen and Marburg, Campus Giessen, Giessen, Germany.
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Weimer R, Süsal C, Yildiz S, Staak A, Pelzl S, Renner F, Dietrich H, Daniel V, Kamali-Ernst S, Ernst W, Padberg W, Opelz G. Post-transplant sCD30 and neopterin as predictors of chronic allograft nephropathy: impact of different immunosuppressive regimens. Am J Transplant 2006; 6:1865-74. [PMID: 16771810 DOI: 10.1111/j.1600-6143.2006.01407.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Immunological monitoring for chronic allograft nephropathy (CAN) is of great potential interest. We assessed serum soluble CD30 (sCD30) together with in vitro Th2-type responses (IL-4, IL-10, CD4 helper activity) and neopterin in a prospective study of 84 renal transplant recipients with 2-year follow-up. Patients were randomized to CsA/Aza, CsA/MMF and Tacr/Aza, respectively, to analyze the effect of immunosuppression on posttransplant sCD30 and neopterin. ATG induction and acute rejections did not alter sCD30 levels whereas CMV disease was associated with transient upregulation of sCD30 (p = 0.003 at 4 months) and sustained upregulation of neopterin (corrected for graft function (Neo/CR) p = 0.005 at 2 years). Tacr versus CsA treatment proved to be an independent variable associated with downregulation of 1-year sCD30, which was positively related to Neo/CR (p = 0.007 and 0.01, respectively; logistic regression). Importantly, increased 1-year sCD30 and Neo/CR were associated with decreased glomerular filtration rate at 2 years (p = 0.02 and p < 0.0005, respectively) and evidence of CAN (p < 0.0005). High 1-year sCD30 could not be attributed to enhanced Th2-type responses and was not associated with HLA antibody formation. Our data suggest that elevated sCD30 and neopterin predict graft deterioration by CAN. Tacr effectively downregulates these responses and might be of advantage in patients with elevated sCD30 or neopterin.
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Affiliation(s)
- R Weimer
- Department of Internal Medicine, University Clinic of Giessen and Marburg, Germany.
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Sadeghi M, Daniel V, Naujokat C, Weimer R, Opelz G. Strikingly higher interleukin (IL)-1alpha, IL-1beta and soluble interleukin-1 receptor antagonist (sIL-1RA) but similar IL-2, sIL-2R, IL-3, IL-4, IL-6, sIL-6R, IL-10, tumour necrosis factor (TNF)-alpha, transforming growth factor (TGF)-beta and interferon IFN-gamma urine levels in healthy females compared to healthy males: protection against urinary tract injury? Clin Exp Immunol 2005; 142:312-7. [PMID: 16232218 PMCID: PMC1809507 DOI: 10.1111/j.1365-2249.2005.02924.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The aim of this prospective study was to examine gender-related differences of cytokines in the plasma and urine of healthy individuals that might provide a clue concerning the lower rate of chronic renal diseases in females. Soluble interleukin-1 receptor antagonist (sIL-1RA), interleukin (IL)-1alpha, IL-1beta, IL-2, sIL-2R, IL-3, IL-4, IL-6, sIL-6R, IL-10, tumor necrosis factor (TNF)-alpha, transforming growth factor (TGF)-beta(2) and interferon (IFN)-gamma were determined using standard enzyme-linked immunosorbent assay (ELISA). Cytokine levels were determined in simultaneously obtained plasma and urine samples of 18 male and 28 female healthy members of our laboratory staff. Urine cytokine levels were studied three times at 1-month intervals. All individuals had a negative urine nitrite test and showed no symptoms of urinary tract infection (UTI). Plasma levels of all studied cytokines were similar in males and females (P = n.s.). However, females had significantly higher urine IL-1alpha (P < 0.0001; P < 0.0001; P < 0.0001) and sIL-1RA (P = 0.0001; P = 0.0003; P = 0.0002) than males at three and higher IL-1beta at one of the three investigations (P = 0.098; P = 0.003; P = 0.073). Urine levels of the other cytokines were similar in males and females. Higher urine levels of IL-1alpha, IL-1beta and sIL-1RA in females may result from stimulation of cells in the urinary tract. Increased sIL-1RA might block T lymphocyte activation. The elevated cytokines may play a role in the protection of the female urinary tract from certain renal diseases, such as pyelonephritis and other inflammatory and sclerotic kidney diseases.
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Affiliation(s)
- M Sadeghi
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Germany.
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Robson R, Cecka JM, Opelz G, Budde M, Sacks S. Prospective registry-based observational cohort study of the long-term risk of malignancies in renal transplant patients treated with mycophenolate mofetil. Am J Transplant 2005; 5:2954-60. [PMID: 16303010 DOI: 10.1111/j.1600-6143.2005.01125.x] [Citation(s) in RCA: 187] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This large prospectively conducted observational cohort study examined the risk of lymphoma and other malignancies with mycophenolate mofetil (MMF) in de novo renal transplant recipients. A total of 6751 patients receiving MMF, and an equal number of matched controls receiving non-MMF-based immunosuppression, were identified from two large registries (Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) and Collaborative Transplant Study (CTS)) and followed for 3 years. The primary endpoint was development of lymphoma. Secondary endpoints included development of any malignancy. There was no evidence of any increased risk of developing lymphoma or malignancy with MMF. The risk of developing lymphoma with MMF compared with the non-MMF cohort was not higher in either the CTS registry (relative risk (95% confidence interval); 0.4 (0.17-0.94)) or the OPTN/UNOS registry (1.04 (0.61-1.78)). In the MMF group, there was a trend toward a lower risk of malignancy in both registries (OPTN/UNOS 0.86 (0.69-1.07); CTS 0.79 (0.61-1.02)) and a significant increase in time to malignancy in the CTS dataset (p < 0.026). This study has demonstrated that MMF is not associated with an increased risk of lymphoma or other malignancies post-renal transplant, and may even be associated with a lower risk in some populations.
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Affiliation(s)
- R Robson
- Department of Nephrology, Christchurch Hospital, Christchurch, New Zealand.
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Meyer M, Czachurski D, Tran TH, Hien T, Opelz G, Mytilineos J. A new PCR-SSP typing method for six single-nucleotide polymorphisms impairing the blood-clotting cascade as well as T-cell stimulation. ACTA ACUST UNITED AC 2005; 66:650-5. [PMID: 16305681 DOI: 10.1111/j.1399-0039.2005.00493.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Single-nucleotide polymorphisms (SNPs) within the genes of factor V (FV) (G1691A; exon 10), prothrombin (FII) (G20210A; 3'untranslated - region) and methylenetetrahydrofolate reductase (MTHFR) (C677T; exon 4) are associated with hypercoagulability, and systematic screening of individuals being at higher risk of thrombosis has been suggested. SNPs in the 2q33 region within the genes of CD28 (+17T/C; intron 3) and CTLA4 (-318C/T; promoter and +49A/G; exon 1) are likely to affect T-cell proliferation and antigen presentation signaling, which may lead to altered sensitivity of allograft or self-tissue recognition and affect the incidence of autoimmune diseases. We developed primers that allow specific amplification of these six SNPs at test conditions identical with those used for HLA typing with the CTS PCR-SSP reagents. One hundred ninety-six healthy German Caucasian individuals were tested for the six SNPs. The genotype frequencies for all SNPs were in Hardy-Weinberg equilibrium. There was no significant difference in the distribution of genotypes when compared to other published studies in which these SNPs were tested. The described PCR-SSP method can be used to screen large numbers of patients for these SNPs.
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Affiliation(s)
- M Meyer
- Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany
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Czachurski D, Scollo A, Skambraks A, Perichon AM, Scherer S, Tran TH, Opelz G, Grappiolo I, Mytilineos J. Description and characterization of two new HLA alleles, B*4051 and DRB1*1364, identified by sequence-based typing*. ACTA ACUST UNITED AC 2005; 66:151-5. [PMID: 16029439 DOI: 10.1111/j.1399-0039.2005.00440.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Human leukocyte antigen (HLA)-B and HLA-DRB1 typing in two female individuals revealed reaction patterns that did not correspond to any known HLA-B specificity and appeared to identify a very rare HLA-DRB1 allele, respectively. Sequence-based analysis of these samples revealed two new HLA alleles, one similar to B*4023 and the other to DRB1*1308. The new HLA-B allele, which was assigned the name HLA-B*4051, could have been generated by a double crossing over recombination between B*4001 and B*1401 or 1402, whereas DRB1*1364, the new DRB1 allele, could have been generated either by a double crossing over recombination between DRB1*1308 and DRB1*1201, 1202, or 1203 or by two independent crossing over events between DRB1*1401, DRB1*1201, 1202, or 1203 and DRB1*1301.
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Affiliation(s)
- D Czachurski
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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Opelz G, Döhler B, Laux G. Steroid Maintenance Therapy after Transplantation—Quo Vadis? J Am Soc Nephrol 2005; 16:1875-1877. [PMID: 36996470 DOI: 10.1681/01.asn.0000926728.31649.5e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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Weimer R, Süsal C, Yildiz S, Streller S, Pelzl S, Staak A, Renner F, Dietrich H, Daniel V, Feuring E, Kamali-Ernst S, Ernst W, Padberg W, Opelz G. sCD30 and Neopterin as Risk Factors of Chronic Renal Transplant Rejection: Impact of Cyclosporine A, Tacrolimus, and Mycophenolate Mofetil. Transplant Proc 2005; 37:1776-8. [PMID: 15919463 DOI: 10.1016/j.transproceed.2005.02.088] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
High pretransplantation sCD30 levels have been shown to be associated with lower 5-year kidney graft survival in mainly Cyclosporine A (CsA)-treated recipients (Collaborative Transplant Study database). To analyze the effect of different immunosupressive regimens (CsA/Azathioprine [Aza], CsA/Mycophenolate Mofetil [MMF], Tacrolimus [Tacr]/Aza) on sCD30, we assessed serum sCD30 and neopterin together with in vitro cytokine responses in a prospective randomized study of 84 renal transplant recipients before, 4 months, and 1 year after transplantation. Panel-reactive antibody (PRA) formation, HLA matching, ATG induction therapy, and acute rejections had no impact on sCD30 levels, whereas cytomegalovirus (CMV) infections induced an up-regulation of sCD30 4 months posttransplantation (P = .003). Whereas MMF showed no effect on sCD30 compared with Aza therapy, we found a significant impact of Tacr versus CsA treatment (1-year sCD30 > or = 60 U/mL: 14/42 (33%), CsA; 1/38 (3%), Tacr; P < .0005). Chronic rejection 2 years posttransplantation was associated with elevated 1-year sCD30 (P = .001) and neopterin levels (P = .006). Our data indicate that the Th2 activation marker sCD30 provides a risk factor for chronic rejection independent of classical immunological risk factors and may be down-regulated using Tacr treatment.
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Affiliation(s)
- R Weimer
- Department of Internal Medicine, University of Giessen, Giessen, Germany.
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Czachurski D, Scherer S, Gehrke S, Laux G, Opelz G, Mytilineos J. Identification of two new HLA alleles: B*3546* and B*5611*. How reliable are the published HLA-B intron 2 sequences? ACTA ACUST UNITED AC 2005; 64:500-5. [PMID: 15361129 DOI: 10.1111/j.1399-0039.2004.00294.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Polymerase chain reaction-sequence-specific primer (PCR-SSP) typing for human leukocyte antigen (HLA)-B in a male 25-year-old Caucasian individual of Iranian origin and in a 42-year-old German Caucasian bone marrow donor revealed reaction patterns that did not agree with any known HLA specificity, thus suggesting in both cases the existence of a novel allele. Sequence-based typing (SBT) after allelic separation revealed the sequences of the new alleles HLA-B*5611 and B*3546. The sequence patterns of both new alleles might have been generated as the results of double crossing over, possibly over several generations. During the analysis of the HLA-B*3546 intron 2 sequence for possible crossing over points, a base insert, an additional G after position 700, was found. This insert was analyzed using SBT and PCR-SSP and was found to be present not only in all samples carrying B*35, but also in all HLA-B specificities tested. It appears that all known HLA-B alleles may contain a G insert at position 700 of intron 2, and that the published intron 2 sequence alignments of the HLA-B locus may contain errors at this position.
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Affiliation(s)
- D Czachurski
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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