Restricted specificity of peripheral alloreactive memory B cells in HLA-sensitized patients awaiting a kidney

Renaud Snanoudj1, Frans H J Claas2, Sebastiaan Heidt2

  • 11] Institut Necker Enfants Malades, INSERM U1151-CNRS UMR 8253, Hôpital Necker, Paris, France [2] Université Paris Descartes, Sorbonne Paris Cite, Paris, France [3] Service de Transplantation Rénale Adulte, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France.

Kidney International
|January 8, 2015
PubMed

The contribution of memory B cells in alloreactive humoral responses remains poorly understood. Here we tested the presence of circulating alloreactive memory B cells in 69 patients with end-stage renal disease under renal replacement therapy, using an in vitro memory B cell-stimulation assay combined with identification of IgG human leukocyte antigen (HLA) antibodies in culture supernatant. HLA antibody-producing memory B cells were evidenced only in patients carrying serum HLA antibodies following multiple classical HLA-immunizing events. In patients with a previous renal allograft, alloreactive memory B cells could be detected ranging from 6 to 32 years (mean 13.2 years) after transplantation. HLA antibodies produced by memory B cells were also detected in the corresponding sera and showed a restricted reactivity, targeting only a few epitopes shared by several HLA antigens. In contrast, serum HLA antibodies, not associated with the detection of specific memory B cells, showed a broader pattern of specificities. Thus, expansion and survival of alloreactive memory B cells is alloantigen driven, and their frequency is related to the 'strength' of HLA immunization.

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