Alloimmune response against donor glutathione S-transferase T1 antigen in renal transplant recipients.
BACKGROUND
The long-term outcome of kidney transplantation could be influenced by the appearance of antibodies against donor-specific antigens. Glutathione S-transferase T1 (GSTT1) is a protein preferentially expressed in liver and kidney cells. Deletion of the GSTT1 gene results in a complete lack of protein expression, which occurs in 20% of the white population. GSTT1 donor-recipient mismatch has been deleterious in liver transplantation. The purpose of this study is to examine immunologic and clinical consequences of a GSTT1 donor-recipient mismatch in kidney transplantation.


METHODS
The presence of anti-GSTT1 antibodies was studied retrospectively in sera from 135 patients who underwent transplantation before 1995. Samples from 89 patients who received a GSTT1-positive kidney graft between December 1998 and May 2001 were collected prospectively. GSTT1 genotypes and anti-GSTT1 antibodies were studied by using standard methods.


RESULTS
Seven patients, all with the null genotype, produced anti-GSTT1 antibodies. No transplant recipient with a positive genotype produced these antibodies. Six of 7 patients with antibodies also were positive for hepatitis C virus. Clinical outcomes of these patients did not differ from those of the entire group.


CONCLUSIONS
After kidney transplantation, some patients with the null GSTT1 genotype who received a GSTT1-positive graft developed an immune response, with production of anti-GSTT1 antibodies. The presence of these antibodies did not seem to produce functional impairment in the graft. Hepatitis C virus seems to have a prominent role in this particular allograft immune response.
Aguilera
Isabel
I
Hospital Universitario Virgen del Rocío, Sevilla, Spain. isabel.aguilera.exts@juntadeandalucia.es
Wichmann
Ingeborg
I
Gentil
Miguel Angel
MA
Gonzalez-Escribano
Francisca
F
Nuñez-Roldan
Antonio
A
D000328:Adult; D005260:Female; D005838:Genotype; D005982:Glutathione Transferase / Q000235:genetics / Q000276:immunology*; D006526:Hepatitis C / Q000150:complications; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007518:Isoantibodies / Q000096:biosynthesis* / Q000097:blood / Q000276:immunology; D007519:Isoantigens / Q000276:immunology*; D007668:Kidney / Q000201:enzymology / Q000276:immunology; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000276:immunology*; D016896:Treatment Outcome
D018937:Hepatitis C Antibodies; D007518:Isoantibodies; D007519:Isoantigens; C413545:glutathione S-transferase T1; D005982:Glutathione Transferase