BACKGROUND: B cells play an important role in renal allograft pathology, particularly in acute and chronic antibody-mediated rejection (AMR). B-cell activating factor belonging to the tumor necrosis factor family (BAFF; also known as BLyS) is a cytokine that enhances B-cell survival and proliferation. METHODS: We analyzed serum BAFF levels in 32 patients undergoing antibody-incompatible (Ai) renal transplantation and 319 antibody-compatible transplant recipients and sought to determine whether there was a correlation with acute rejection and with transplant function and survival. RESULTS: We demonstrate that, in patients undergoing Ai transplantation, elevated serum BAFF levels at baseline (before both antibody removal/desensitization and transplantation) are associated with an increased risk of subsequent AMR. In antibody-compatible transplant recipients at lower risk of AMR, no statistically significant association was observed between pretransplantation serum BAFF and AMR. CONCLUSIONS: These data raise the possibility that, in high immunologic risk patients undergoing Ai transplantation, the presence of elevated pretransplantation serum BAFF might identify those at increased risk of AMR. BAFF neutralization may be an interesting therapeutic strategy to explore in these patients, particularly because such agents are available and have already been used in the treatment of autoimmunity.
BACKGROUND: B cells play an important role in renal allograft pathology, particularly in acute and chronic antibody-mediated rejection (AMR). B-cell activating factor belonging to the tumor necrosis factor family (BAFF; also known as BLyS) is a cytokine that enhances B-cell survival and proliferation. METHODS: We analyzed serum BAFF levels in 32 patients undergoing antibody-incompatible (Ai) renal transplantation and 319 antibody-compatible transplant recipients and sought to determine whether there was a correlation with acute rejection and with transplant function and survival. RESULTS: We demonstrate that, in patients undergoing Ai transplantation, elevated serum BAFF levels at baseline (before both antibody removal/desensitization and transplantation) are associated with an increased risk of subsequent AMR. In antibody-compatible transplant recipients at lower risk of AMR, no statistically significant association was observed between pretransplantation serum BAFF and AMR. CONCLUSIONS: These data raise the possibility that, in high immunologic risk patients undergoing Ai transplantation, the presence of elevated pretransplantation serum BAFF might identify those at increased risk of AMR. BAFF neutralization may be an interesting therapeutic strategy to explore in these patients, particularly because such agents are available and have already been used in the treatment of autoimmunity.
Authors: Anne J Novak; Deanna M Grote; Steven C Ziesmer; Michael P Kline; Michelle K Manske; Susan Slager; Thomas E Witzig; Tait Shanafelt; Timothy G Call; Neil E Kay; Diane F Jelinek; James R Cerhan; Jane A Gross; Brandon Harder; Stacey R Dillon; Stephen M Ansell Journal: J Clin Oncol Date: 2006-01-23 Impact factor: 44.544
Authors: B Nardelli; O Belvedere; V Roschke; P A Moore; H S Olsen; T S Migone; S Sosnovtseva; J A Carrell; P Feng; J G Giri; D M Hilbert Journal: Blood Date: 2001-01-01 Impact factor: 22.113
Authors: G Fernández-Fresnedo; M A Ramos; M C González-Pardo; A L de Francisco; M López-Hoyos; M Arias Journal: Nephrol Dial Transplant Date: 2000-04 Impact factor: 5.992
Authors: Danielle T Avery; Susan L Kalled; Julia I Ellyard; Christine Ambrose; Sarah A Bixler; Marilyn Thien; Robert Brink; Fabienne Mackay; Philip D Hodgkin; Stuart G Tangye Journal: J Clin Invest Date: 2003-07 Impact factor: 14.808
Authors: Qunrui Ye; Liqing Wang; Andrew D Wells; Ran Tao; Rongxiang Han; Anne Davidson; Martin L Scott; Wayne W Hancock Journal: Eur J Immunol Date: 2004-10 Impact factor: 5.532