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Clinical relevance of antibody development in renal transplantation
Author(s) -
Mehra Narinder K.,
Siddiqui Jamshaid,
Baranwal Ajay,
Goswami Sanjeev,
Kaur Gurvinder
Publication year - 2013
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.12034
Subject(s) - antibody , human leukocyte antigen , transplantation , medicine , immunology , clinical significance , kidney transplantation , graft rejection , antigen , pathology
The detection and characterization of anti‐HLA antibodies and the clinical impact of their appearance following renal transplantation are areas of immense interest. In particular, de novo development of donor‐specific antibodies (DSA) has been associated with acute and chronic antibody‐mediated graft rejection (AMR). Recently, methods for antibody detection have evolved remarkably from conventional cell‐based assays to advanced solid phase systems. These systems have revolutionized the art of defining clinically relevant antibodies that are directed toward a renal graft. While anti‐HLA DSAs have been widely associated with poor graft survival, the role of non‐HLA antibodies, particularly those directed against endothelial cells, is beginning to be realized. Appreciation of the mechanisms underlying T cell recognition of alloantigens has generated great interest in the use of synthetic peptides to prevent graft rejection. Hopefully, continued progress in unraveling the molecular mechanisms of graft rejection and posttransplant monitoring of antibodies using highly sensitive testing systems will prove beneficial to immunological risk assessment and early prediction of renal allograft failure.