Juhan Lee1, Kyu Ha Huh1, Yongjung Park2,3, Borae G Park2, Jaeseok Yang4, Jong Cheol Jeong4, Joongyup Lee5, Jae Berm Park6, Jang-Hee Cho7, Sik Lee8, Han Ro9, Seung-Yeup Han10, Myoung Soo Kim1, Yu Seun Kim1, Sung Joo Kim6, Chan-Duck Kim7, Wookyung Chung9, Sung-Bae Park10, Curie Ahn4,11. 1. Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Laboratory Medicine, NHIC Medical Center, Ilsan Hospital, Goyang, Republic of Korea. 4. Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea. 5. Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea. 6. Department of Surgery, Sungkyunkwan University, Seoul Samsung Medical Center, Seoul, Republic of Korea. 7. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea. 8. Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Republic of Korea. 9. Department of Internal Medicine, Gachon University, Gil Hospital, Incheon, Republic of Korea. 10. Department of Internal Medicine, Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea. 11. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: Anti-angiotensin II type 1 receptor antibodies (AT1R-Abs) have been suggested as a risk factor for graft failure and acute rejection (AR). However, the prevalence and clinical significance of pretransplant AT1R-Abs have seldom been evaluated in Asia. METHODS: In this multicenter, observational cohort study, we tested the AT1R-Abs in pretransplant serum samples obtained from 166 kidney transplant recipients. Statistical analysis was used to set a threshold AT1R-Abs level at 9.05 U/mL. RESULTS: Pretransplant AT1R-Abs were detected in 98/166 (59.0%) of the analyzed recipients. No graft loss or patient death was reported during the study period. AT1R-Abs (+) patients had a significantly higher incidence of biopsy-proven AR than AT1R-Abs (-) patients (27.6 versus 10.3%, P = 0.007). Recipients with pretransplant AT1R-Abs had a 3.2-fold higher risk of AR within a year of transplantation (P = 0.006). Five study subjects developed microcirculation inflammation (score ≥2). Four of them were presensitized to AT1R-Abs. In particular, three patients had a high titer of anti-AT1R-Abs (>22.7 U/mL). CONCLUSIONS: Pretransplant AT1R-Abs is an independent risk factor for AR, especially acute cellular rejection, and is possibly associated with the risk of antibody-mediated injury. Pretransplant assessment of AT1R-Abs may be useful for stratifying immunologic risks.
BACKGROUND: Anti-angiotensin II type 1 receptor antibodies (AT1R-Abs) have been suggested as a risk factor for graft failure and acute rejection (AR). However, the prevalence and clinical significance of pretransplant AT1R-Abs have seldom been evaluated in Asia. METHODS: In this multicenter, observational cohort study, we tested the AT1R-Abs in pretransplant serum samples obtained from 166 kidney transplant recipients. Statistical analysis was used to set a threshold AT1R-Abs level at 9.05 U/mL. RESULTS: Pretransplant AT1R-Abs were detected in 98/166 (59.0%) of the analyzed recipients. No graft loss or patient death was reported during the study period. AT1R-Abs (+) patients had a significantly higher incidence of biopsy-proven AR than AT1R-Abs (-) patients (27.6 versus 10.3%, P = 0.007). Recipients with pretransplant AT1R-Abs had a 3.2-fold higher risk of AR within a year of transplantation (P = 0.006). Five study subjects developed microcirculation inflammation (score ≥2). Four of them were presensitized to AT1R-Abs. In particular, three patients had a high titer of anti-AT1R-Abs (>22.7 U/mL). CONCLUSIONS: Pretransplant AT1R-Abs is an independent risk factor for AR, especially acute cellular rejection, and is possibly associated with the risk of antibody-mediated injury. Pretransplant assessment of AT1R-Abs may be useful for stratifying immunologic risks.
Authors: Meghan H Pearl; Qiuheng Zhang; Miguel Fernando Palma Diaz; Jonathan Grotts; Maura Rossetti; David Elashoff; David W Gjertson; Patricia Weng; Elaine F Reed; Eileen Tsai Chambers Journal: Kidney Int Date: 2017-09-18 Impact factor: 10.612
Authors: Jian Zhang; Mingxu Wang; Jun Liang; Ming Zhang; Xiao-Hong Liu; Le Ma Journal: Int J Environ Res Public Health Date: 2017-05-09 Impact factor: 3.390