在移植前对细胞外抗原检测HLA和非HLA抗体的基础上,对抗体中介损伤的风险评估
在PubMed上查看摘要
概括
此摘要是机器生成的。独立于HLA抗体的非HLA抗体增加了移植后抗体中介排斥 (ABMR) 和微血管炎症 (MVI) 的风险. 在移植前和活检时评估非HLA抗体可以改善ABMR/MVI风险预测.
科学领域
- 免疫学
- 移植科学
- 肝脏病学
背景情况
- 捐赠者特异性人类白细胞抗原抗体 (HLA- DSA) 是移植后抗体中介排斥 (ABMR) 的关键驱动因素.
- 即使没有HLA- DSA,非HLA抗体也可能导致ABMR或微血管炎症 (MVI).
- 评估HLA和非HLA抗体可以完善KT受体的风险分层.
研究的目的
- 在移植患者中研究非HLA抗体与ABMR/MVI的相关性.
- 为了确定非HLA抗体是否独立于HLA敏感性来预测ABMR/MVI.
- 探索不同非HLA抗体标 (细胞外与细胞内) 在ABMR/MVI中的作用.
主要方法
- 一项涉及121名KT受试者 (46名ABMR/MVI受试者,75名对照受试者) 的病例控制研究.
- 在KT前后收集的血清使用多重检测分析了60种非HLA抗体.
- 使用非HLA抗体的中位数光强度 (MFI) 的总和来评估与ABMR/ MVI的相关性.
主要成果
- 在KT前的87%患者中检测到非HLA抗体.
- 在CT前和活检时非HLA抗体MFI比率的增加与ABMR/ MVI风险的增加相关 (分别为OR=1. 039, p=0. 014和OR=1. 036, p=0. 024),独立于HLA- DSA.
- 对细胞外非HLA抗体的抗体与ABMR/MVI前KT有关,而细胞内非HLA抗体在诊断时与该抗体有关.
结论
- 非HLA抗体评估为KT受体的ABMR/MVI风险分层提供了有价值的信息,不论HLA敏感性如何.
- 需要进一步研究以确定非HLA抗体检测的最佳截止值.
- 非HLA抗体是移植排斥的重要且可能独立的危险因素.
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