Donor-recipient mismatches in MHC class I chain-related gene A in unrelated donor transplantation lead to increased incidence of acute graft-versus-host disease.
The polymorphic products of major histocompatibility complex class I-related chain A (MICA) genes are important in solid organ transplantation rejection. MICA expression is limited to gut epithelium and may play a role in triggering acute graft-versus-host disease (aGVHD). A total of 236 recipients of unrelated donor transplantation were studied. Donor-recipient human leukocyte antigen (HLA) match was 10/10 human leukocyte antigen (HLA-A, -B, -C, -DRB1, -DQB1) in 73% and MICA mismatch in 8.4%. Because of physical vicinity of the loci, MICA mismatch was significantly associated with mismatch at HLA-B and HLA-C. A higher rate of grade II-IV aGVHD was seen in MICA-mismatched patients (80% vs 40%, P = .003) irrespective of degree of HLA matching (HLA 10/10 match: 75% vs 39%, P = .02) and HLA any mismatch (83% vs 46%, P = .003). The rate of grade II-IV gastrointestinal aGVHD was also higher in MICA-mismatched patients (35% vs 17%, P = .05). We conclude that MICA may represent novel a transplantation antigen recognized by human allogeneic T cells. This study was registered at ClinicalTrials.gov (Identifier NCT00506922).
Parmar
Simrit
S
Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Del Lima
Marcos
M
Zou
Yizhou
Y
Patah
Poliana A
PA
Liu
Ping
P
Cano
Pedro
P
Rondon
Gabriela
G
Pesoa
Susana
S
de Padua Silva
Leandro
L
Qazilbash
Muzaffar H
MH
Hosing
Chitra
C
Popat
Uday
U
Kebriaei
Partow
P
Shpall
Elizabeth J
EJ
Giralt
Sergio
S
Champlin
Richard E
RE
Stastny
Peter
P
Fernandez-Vina
Marcelo
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001782:Blood Donors; D005260:Female; D005805:Genes, MHC Class I / Q000235:genetics*; D005838:Genotype; D006084:Graft Rejection; D006086:Graft vs Host Disease / Q000209:etiology* / Q000401:mortality*; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult