1. Detection of Angiotensin II type I-receptor antibodies in transplant glomerulopathy.
- Author
-
Bussolino S, Dolla C, Ariaudo C, Civiletti F, Messina M, Mella A, Caorsi C, Amoroso A, Barreca A, Papotti M, Giunti S, Fop F, and Biancone L
- Subjects
- Adolescent, Adult, Aged, Autoantibodies immunology, Female, Follow-Up Studies, Glomerulonephritis, Membranous blood, Glomerulonephritis, Membranous etiology, Graft Rejection blood, Graft Rejection etiology, Graft Survival, HLA Antigens immunology, Humans, Male, Middle Aged, Prognosis, Receptor, Angiotensin, Type 1 immunology, Retrospective Studies, Risk Factors, Young Adult, Autoantibodies blood, Glomerulonephritis, Membranous diagnosis, Graft Rejection diagnosis, HLA Antigens blood, Kidney Failure, Chronic surgery, Kidney Transplantation adverse effects, Receptor, Angiotensin, Type 1 blood
- Abstract
Background: Transplant glomerulopathy (TG) is an important cause of late graft loss. The role of angiotensin type 1-receptor antibodies (AT
1 R-Ab) in TG is not known., Methods: All the TG cases (N = 137) between January 2007 and December 2014 (N = 1410) were analyzed. Donor-specific anti-HLA antibodies (DSA) at the time of biopsy and AT1 R-Ab IgG (positive, >17 UI/mL; "at risk," 10-17 UI/mL; negative, <10 UI/mL) in pre-transplant sera (PT-Ab) and at biopsy time (BT-Ab) were studied., Results: AT1 R-PT-Ab+ and AT1 R-BT-Ab+ patients were 16.5% (51.5% "at risk") and 11.5% (27.4% "at risk"), respectively. Clinical correlations were found between AT1 R-Ab and HCV infection, number of transplants, and age. Considering Banff scores, ptc was higher in DSA+ patients vs AT1 R-PT-Ab+ (P = 0.002) or AT1 R-BT-Ab+ (P = 0.001) without differences in g and chronicity score (ci + ct); cg showed lower scores in DSA+ patients vs AT1 R-BT-Ab+ (P = 0.001). Graft survival was not influenced by the presence of AT1 R-Ab, AT1-R-Ab titer or MFI, but we observed a longer graft survival in patients with both AT1 R-BT-Ab+ or "at risk" and DSA+ vs patients positive only for DSA (P = 0.02), for AT1 R-BT-Ab (P = 0.019) or AT1 R-BT-Ab "at risk" (P = 0.039)., Conclusion: AT1 R-Ab showed no independent prognostic role in TG in this pilot analysis., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)- Published
- 2018
- Full Text
- View/download PDF