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IgG subclass profile among anti‐Glutathione S‐transferase T1 antibodies in post‐transplant de novo immune hepatitis
Author(s) -
Aguilera Isabel,
MartinezBravo Maria José,
Sousa Jose Manuel,
PozoBorrego Antonio Jesús,
NúñezRoldán Antonio
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12675
Subject(s) - medicine , antibody , subclass , liver transplantation , immunology , immune system , liver disease , pathogenesis , hepatitis , transplantation , antigen
Although the pathogenic pathways leading to de novo immune hepatitis ( IH ) are not completely understood, we have shown strong evidences of an antidonor response against Glutathione S‐transferase T1 ( GSTT 1), an antigen exclusively expressed in the donor liver. The first sign of this process is the production of GSTT 1 antibodies that, in 25% of the cases, will precede de novo IH . Because the presence of the antibodies is not sufficient to trigger the disease, we aimed to study GSTT 1 IgG subclasses in a group of 18 liver transplant patients, 12 that developed de novo IH and 6 that remained free of disease. Surprisingly, the predominant subclasses were IgG1‐ GSTT 1 and IgG4‐ GSTT 1 . The presence of IgG4‐expressing plasma cells was also investigated in 10 available liver biopsies. Six biopsies coinciding with diagnosis showed a mean value of 32.8 IgG4+ plasma cells/hpf vs. 5.55 in patients without the disease. We have not found a distinctive GSTT 1‐IgG profile in patients with de novo IH , but the ratio IgG1‐ GSTT 1 /IgG4‐ GSTT 1 in samples from close to the time of diagnosis seemed to be important. The novel finding of abundant IgG4‐ GSTT 1 in liver transplantation is intriguing, but their possible role in pathogenesis of de novo IH remains unknown.