Antibodies against glutathione S-transferase T1 in non-solid organ transplanted patients.
BACKGROUND
This article describes the presence of antibodies against glutathione S-transferase T1 (GSTT1) in a group of patients who never received a solid organ graft. These antibodies have been previously detected in liver and kidney transplant subjects with donor-recipient mismatch for this enzyme at the genetic level. In liver-grafted subjects, the appearance of these antibodies correlated with de novo immune hepatitis.


METHODS
To obtain some insights in this phenomenon, the clinical records of these patients were reviewed, and the possible causes leading to the production of these antibodies and possible clinical consequences were analyzed.


RESULTS
The clinical situation of these patients was very heterogeneous, but they had in common the need for transfusions or a previous pregnancy. GSTT1 antigen is present in red blood cells, liver, kidney, and other tissues. Because the presence of the GSTT1-null allele in seven of these patients has been demonstrated, it can be hypothesized that both GSTT1-positive transfusions or pregnancy of a GSTT1-positive fetus could induce these antibodies. Because the recipient is allele-null, no adverse effects in the host are expected to occur. The longest follow-up (5 years) shows no antibody-derived diseases.


CONCLUSIONS
It is concluded that anti-GSTT1 can appear in a context different from the previously published alloreactivity after liver and kidney transplantation, as a consequence of transfusions and pregnancies. So far, no adverse clinical outcomes in our patients have been observed.
Wichmann
Ingeborg
I
Department of Immunology, Virgen del Rocío University Hospital, Andalusian Service of Health, Seville, Spain. iws2002@yahoo.es
Aguilera
Isabel
I
Sousa
José M
JM
Bernardos
Angel
A
García Núñez
Emilio J
EJ
Vigil
Eduardo
E
Magariño
Rosario
R
Magariño
Isabel
I
Torres
Antonia
A
Núñez-Roldán
Antonio
A
D000328:Adult; D000368:Aged; D000483:Alleles; D017707:Erythrocyte Transfusion; D005260:Female; D005500:Follow-Up Studies; D005982:Glutathione Transferase / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000096:biosynthesis* / Q000097:blood / Q000276:immunology; D007519:Isoantigens / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000276:immunology*; D016896:Treatment Outcome
D007518:Isoantibodies; D007519:Isoantigens; C413545:glutathione S-transferase T1; D005982:Glutathione Transferase