增强B细胞对捐赠者抗原的呈现预测了移植后的急性细胞拒绝和晚期结果
Chethan Ashokkumar1, Mylarappa Ningappa1, Vikram Raghu2
1Department of Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh and the University of Pittsburgh, PA.
Transplantation direct
|February 28, 2024
概括
通过抗原呈现指数 (API) 测量的增强的B细胞抗原呈现预测了肝脏和肠道移植接受者的急性细胞排斥 (ACR). 较高的API值表明排斥的风险增加,捐赠者特异性抗体和移植损失.
科学领域:
- 移植免疫学 移植免疫学
- 免疫诊断 免疫诊断 免疫诊断 免疫诊断
- 实体器官移植 实体器官移植
背景情况:
- 急性细胞排斥 (ACR) 是肝脏和肠道移植 (LT和IT) 后的一个主要并发症.
- 增强B细胞对捐赠体抗原的呈现,用抗原呈现指数 (API) 量化,是ACR的潜在生物标志物.
研究的目的:
- 评估API试验在预测LT和IT接受者的ACR中的临床性能.
- 评估API与长期结果的关联,例如捐赠者特异性抗体 (DSA) 和移植损失.
主要方法:
- 在84名LT和54名IT接受者的6小时测试中测量了API.
- 接受者被归类为拒绝者,如果他们在测试后60天内经历了ACR.
- 使用后勤回归,接收器运行特征分析和时间到事件分析来评估API的预测性能.
主要成果:
- 与非排斥者相比,排斥者中的API显著更高 (2.2 ± 0.2对比0.6 ± 0.04,P = 1.7E-09).
- 具有≥1.1的API值显示在培训和独立验证集中预测ACR的高灵敏度和特异性.
- 提升的API预测了LT接收者中晚期DSA的发生率更高,IT接收者中移植损失更高.
结论:
- 通过循环B细胞增强的供体抗原呈现,如API所示,是LT和IT后排斥的可靠预测指标.
- API测量可以识别患有ACR,DSA和移植损失风险的患者,有助于移植后的管理.
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