Antibodies reactive to non-HLA antigens in transplant glomerulopathy

J Am Soc Nephrol. 2011 Jun;22(6):1168-78. doi: 10.1681/ASN.2010111183. Epub 2011 May 12.

Abstract

Although T and B cell alloimmunity contribute to transplant injury, autoimmunity directed at kidney-expressed, non-HLA antigens may also participate. Because the specificity, prevalence, and importance of antibodies to non-HLA antigens in late allograft injury are poorly characterized, we used a protein microarray to compare antibody repertoires in pre- and post-transplant sera from several cohorts of patients with and without transplant glomerulopathy. Transplantation routinely induced changes in antibody repertoires, but we did not identify any de novo non-HLA antibodies common to patients with transplant glomerulopathy. The screening studies identified three reactivities present before transplantation that persisted after transplant and strongly associated with transplant glomerulopathy. ELISA confirmed that reactivity against peroxisomal-trans-2-enoyl-coA-reductase strongly associated with the development of transplant glomerulopathy in independent validation sets. In addition to providing insight into effects of transplantation on non-HLA antibody repertoires, these results suggest that pretransplant serum antibodies to peroxisomal-trans-2-enoyl-coA-reductase may predict prognosis in kidney transplantation.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies / blood*
  • Antibodies / immunology
  • Case-Control Studies
  • Child
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Kidney Glomerulus / immunology
  • Kidney Glomerulus / pathology*
  • Kidney Transplantation / immunology
  • Kidney Transplantation / pathology*
  • Middle Aged
  • Oxidoreductases Acting on CH-CH Group Donors / immunology*
  • Predictive Value of Tests
  • Prognosis
  • Protein Array Analysis
  • Young Adult

Substances

  • Antibodies
  • Oxidoreductases Acting on CH-CH Group Donors
  • trans-2-enoyl-CoA reductase (NADPH)