Double Pretransplant Positivity for Autoantibodies to LG3 and Angiotensin II Type 1 Receptor Is Associated With Alloimmune Vascular Injury in Kidney Transplant Recipients.
Journal
Transplantation direct
ISSN: 2373-8731
Titre abrégé: Transplant Direct
Pays: United States
ID NLM: 101651609
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
11
11
2022
accepted:
26
11
2022
entrez:
6
2
2023
pubmed:
7
2
2023
medline:
7
2
2023
Statut:
epublish
Résumé
Both angiotensin II receptor autoantibodies (ATRabs) and autoantibodies to LG3 have been linked to kidney graft rejection with alloimmune vascular injury (AVI). We aimed to examine whether positivity for both anti-LG3 and ATRabs is associated with rejection with AVI in kidney transplant recipients. We performed a retrospective cohort study including consecutive kidney transplant recipients between 2013 and 2017 at a single center. The primary outcome was acute rejection with AVI (Banff grade 2 or 3 T-cell-mediated rejection and/or antibody-mediated rejection) in the first 3 mo posttransplant. The secondary outcome was death-censored allograft loss. The independent variables, anti-LG3 and ATRab, were measured pretransplant. Among the 328 study participants, 68 experienced acute rejection with AVI and 23 experienced graft loss over a median follow-up of 4.5 y. In a multivariable model, double pretransplant positivity for anti-LG3/ATRab was associated with acute rejection with AVI (odds ratio: 2.73, 95% confidence interval: 1.06-7.05). We did not observe an association between double positivity for anti-LG3/ATRab and death-censored graft loss. Double positivity for anti-LG3/ATRabs pretransplant is associated with a higher risk of acute rejection with AVI. Whether therapies that remove antibodies could decrease that risk remains to be studied.Supplemental Visual Abtract: http://links.lww.com/TXD/A494.
Identifiants
pubmed: 36743234
doi: 10.1097/TXD.0000000000001437
pmc: PMC9891448
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e1437Informations de copyright
Copyright © 2023 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Hum Immunol. 2016 Dec;77(12):1154-1158
pubmed: 27542526
Transpl Immunol. 2019 Feb;52:53-56
pubmed: 30458294
N Engl J Med. 2018 Dec 27;379(26):2580-2582
pubmed: 30586534
Transplantation. 2010 Dec 27;90(12):1473-7
pubmed: 21030904
Kidney Int. 2015 Aug;88(2):332-40
pubmed: 25738252
Clin Transplant. 2021 Jul;35(7):e14318
pubmed: 33871888
Hum Immunol. 2019 Aug;80(8):573-578
pubmed: 31014826
Am J Transplant. 2013 Oct;13(10):2590-600
pubmed: 23919437
Am J Pathol. 2007 Apr;170(4):1415-27
pubmed: 17392180
J Am Soc Nephrol. 2018 Feb;29(2):606-619
pubmed: 29255058
Am J Transplant. 2020 Sep;20(9):2318-2331
pubmed: 32463180
N Engl J Med. 2005 Feb 10;352(6):558-69
pubmed: 15703421
Am J Transplant. 2010 Feb;10(2):421-30
pubmed: 20055794
Am J Transplant. 2013 Oct;13(10):2577-89
pubmed: 23941128
Am J Transplant. 2013 Apr;13(4):861-874
pubmed: 23432943
Front Immunol. 2021 Jul 06;12:703457
pubmed: 34305943
Am J Transplant. 2020 Jan;20(1):282-288
pubmed: 31419065
Nephrology (Carlton). 2019 Mar;24(3):347-356
pubmed: 29451342
Kidney Int. 2019 Jul;96(1):189-201
pubmed: 31005275
Lancet. 2013 Jan 26;381(9863):313-9
pubmed: 23182298