Investigation of Serum Angiotensin II Type 1 Receptor Antibodies at the Time of Renal Allograft Rejection.
10.3343/alm.2015.35.3.314
- Author:
Hyeyoung LEE
1
;
Ji Il KIM
;
In Sung MOON
;
Byung Ha CHUNG
;
Chul Woo YANG
;
Yonggoo KIM
;
Kyungja HAN
;
Eun Jee OH
Author Information
1. Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ejoh@catholic.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Angiotensin II receptor antibodies;
Rejection;
Renal transplantation;
Biopsy
- MeSH:
Adult;
Antibodies/blood;
Female;
Graft Rejection/*etiology;
HLA Antigens/immunology;
Humans;
Kidney/pathology;
Kidney Transplantation/*adverse effects;
Male;
Middle Aged;
Receptor, Angiotensin, Type 1/*immunology;
Tissue Donors;
Transplantation, Homologous
- From:Annals of Laboratory Medicine
2015;35(3):314-320
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Angiotensin II type 1 receptor (AT1R) is responsible for cardiovascular effects mediated by angiotensin II. This study aimed to investigate the impact of antibodies directed against AT1R (anti-AT1R) in renal allograft rejection. METHODS: We evaluated 53 patients who had biopsy-proven rejection including antibody-mediated rejection (AMR) (N=22), T-cell-mediated rejection (TCMR) (N=29), and mixed AMR and TCMR (N=2). Donor specific HLA antibodies (DSA) and anti-AT1Rs were simultaneously determined. RESULTS: Anti-AT1Rs were detected in 9.4% (5/53) of rejection patients (one with acute AMR, two with chronic active AMR, one with acute TCMR, and one with mixed acute AMR & TCMR). HLA antibodies and DSA were detected in 75.5% (40/53) and 49.1% (26/53) of patients, respectively. There was no significant difference in transplant characteristics between anti-AT1R(+) and anti-AT1R(-) patients except for the association of HLA class-I DSA(+) and anti-AT1R(+). Four of five anti-AT1R(+) patients had DSA and were also found to have AMR. A single anti-AT1R(+)/DSA(-) patient developed acute TCMR. Detection rates of DSA, HLA antibodies, or anti-AT1R were not different between AMR and TCMR. However, DSA(+)/anti-AT1R(+) was more frequently found in AMR than in TCMR (P=0.036). Patients with anti-AT1R showed a greater tendency to develop high-grade rejection as Banff IIA/IIB or AMR. CONCLUSIONS: The presence of anti-AT1R was significantly associated with HLA class-I DSA in renal allograft rejection patients. Both anti-AT1R and DSA positivity was associated with AMR in patients with renal allograft rejection.
