Induction of antibody-dependent cellular cytotoxicity against endothelial cells by renal transplantation.

Antibodies that induce antibody-dependent cellular cytotoxicity (ADCC) of human umbilical-vein endothelial cells (EC) were detected using serum of a renal transplant patient who had experienced a severe vascular rejection episode after receiving an HLA-identical kidney graft from a living-related donor. This reactivity was absent in sera obtained before transplantation. The antibody nature of the reactivity present in the post-transplantation sera was proven by gelfiltration studies, protein A absorption, pepsin-digestion experiments, and incubation with subclass specific monoclonal antibodies; predominantly IgG1 antibodies were found to bind to EC and induce ADCC. The specificity of the antibodies could be shown in panel studies using EC lines of various donors. In order to investigate the clinical relevance and incidence of anti-EC ADCC, we examined whether anti-EC reactivity could be observed in 9 additional renal transplant patients. Sera of 2 of these patients were found positive in the ADCC assay, whereas 20 normal serum donors were negative. ADCC against EC in these patients was not caused by classic antiendothelial-monocyte (EM) antibodies. Using various experimental systems (adherent cell depletion, monoclonal antibody blocking, cold target cell inhibition) it was shown that the natural killer/killer (NK/K) cells present within the peripheral blood mononuclear cell population were responsible for EC lysis. These findings demonstrate that IgG1 antibodies directed against polymorphic non-HLA, non-EM antigens on EC can be induced by renal allotransplantation. Via Fc-receptor interaction with NK/K cells, these antibodies can be responsible for ADCC against EC.