Chronic humoral rejection mediated by anti-HLA-DP alloantibodies: insights into the role of epitope sharing in donor-specific and non-donor specific alloantibodies generation.
We report the case of a renal transplanted patient, in whom the detection of a unique anti HLA-DP antibody response preceded the development of chronic humoral rejection. In addition to donor-specific anti-DP alloantibodies, the patient displayed reactions against several non-donor-specific DP antigens (NDSA). Interestingly, we found that all the DP molecules recognized by the alloantibodies displayed the same amino-acid sequence suggesting that epitope sharing between unrelated HLA molecules was the mechanism underlying NDSA generation. This case highlights the pathogenicity of anti-DP alloantibodies and suggests that it could be more meaningful to match the epitopes than the HLA antigens for the prevention of rejection.
Thaunat
Olivier
O
Université de Lyon, F-69622, Lyon, France. olivier.thaunatpastu@free.fr
Hanf
William
W
Dubois
Valérie
V
McGregor
Brigitte
B
Perrat
Gisèle
G
Chauvet
Cécile
C
Touraine
Jean-Louis
JL
Morelon
Emmanuel
E
D000328:Adult; D000743:Anemia, Hemolytic; D019867:Anti-Glomerular Basement Membrane Disease / Q000276:immunology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D000917:Antibody Formation; D000920:Antibody-Dependent Cell Cytotoxicity; D000939:Epitopes; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000473:pathology; D006682:HLA-DP Antigens / Q000276:immunology*; D006801:Humans; D016056:Immunodominant Epitopes; D007156:Immunologic Memory; D007518:Isoantibodies / Q000276:immunology* / Q000378:metabolism; D016030:Kidney Transplantation; D011247:Pregnancy; D051437:Renal Insufficiency / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D017385:Sequence Homology
D000939:Epitopes; D006682:HLA-DP Antigens; D016056:Immunodominant Epitopes; D007518:Isoantibodies