title: HLA-restricted cell-mediated cytotoxicity directed against male specific (H-Y) antigen after acute rejection of an HLA-identical sibling kidney.
abstract: A 22-year old female patient who received a kidney from her HLA-A, -B, -C and D/DR identical brother (HLA-A2, 28; B7, 14; DR1/2) acutely rejected the graft 2 1/2 weeks post transplantation. In vitro tests 1 month later, using recipient responding cells and donor stimulating/target cells, revealed: No direct cell-mediated lympholysis (CML), but strong CML against donor target cells after priming in mixed lymphocyte cultures (MLC). Testing these cytotoxic cells from the patient on the panel of non-related target cells, we found positive CML only against target cells from male donors carrying HLA-A2 and/or -B7 specificities. Both MLC and CML tests using donor responding cells and recipient stimulating and target cells were negative. These findings indicate an HLA restricted cytotoxicity against a male-specific minor histocompatibility antigen, which may be the cause of rejection in this case.
mesh_terms: D000328:Adult; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D006084:Graft Rejection; D006182:H-Y Antigen / Q000235:genetics* / Q000276:immunology; D006680:HLA Antigens / Q000032:analysis* / Q000235:genetics / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation; D007959:Lymphocyte Culture Test, Mixed; D008297:Male; D014019:Tissue Donors; D014185:Transplantation, Isogeneic
chemical_list: D006182:H-Y Antigen; D006680:HLA Antigens