title: 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.
abstract: 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).
authors: Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors: Simrit
authors: S
authors: Parmar
authors: Marcos
authors: M
authors: Del Lima
authors: Yizhou
authors: Y
authors: Zou
authors: Poliana A
authors: PA
authors: Patah
authors: Ping
authors: P
authors: Liu
authors: Pedro
authors: P
authors: Cano
authors: Gabriela
authors: G
authors: Rondon
authors: Susana
authors: S
authors: Pesoa
authors: Leandro
authors: L
authors: de Padua Silva
authors: Muzaffar H
authors: MH
authors: Qazilbash
authors: Chitra
authors: C
authors: Hosing
authors: Uday
authors: U
authors: Popat
authors: Partow
authors: P
authors: Kebriaei
authors: Elizabeth J
authors: EJ
authors: Shpall
authors: Sergio
authors: S
authors: Giralt
authors: Richard E
authors: RE
authors: Champlin
authors: Peter
authors: P
authors: Stastny
authors: Marcelo
authors: M
authors: Fernandez-Vina
mesh_terms: 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