title: Antibodies against major histocompatibility complex class I-related chain A in transplant recipients.
abstract: OBJECTIVE
  To review the role of polymorphism of major histocompatibility complex class I-related chain A (MICA) gene and antibodies against MICA antigens in transplant immunology.
  
  
  METHODS
  The data used in this review were mainly from our own results and from the relevant English language literatures published from 1999 to 2010. Some data presented in this review are in press.
  
  
  METHODS
  Articles regarding MICA gene discovery and pioneering finding of antibodies against MICA antigen and allograft rejection were selected. This review chronicles the development of our understanding of the role that MICA antigens and antibodies may play in organ transplantation.
  
  
  RESULTS
  Polymorphic glycoprotein MICA antigens were detected on freshly isolated human umbilical cord endothelial cells, but not on peripheral lymphocytes. Antibodies were found and typing of recipients and donors by sequencing the MICA alleles has established that de novo antibodies produced in kidney transplant recipients are directed at mismatched MICA epitopes and are associated with acute rejection and chronic transplant failure. The specificity of antibodies against the epitopes of MICA antigens were well characterized by donor MICA typing, single antigen array testing with antibody absorption and elution. Acute graft-versus-host disease was observed in stem-cell recipients who were mismatched for MICA.
  
  
  CONCLUSIONS
  Immunization against mismatched MICA epitopes encountered in donor organs after transplantation may result in antibodies against MICA alleles. Testing for MICA donor-specific antibodies (DSA) which are associated with early failure of kidney transplants may be helpful for identifying some of the targets of antibodies against antigens other than the human leukocyte antigen (HLA) and for improving transplantation outcome.
authors.affiliation: Transplantation Immunology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, USA.
authors.forename: Yizhou
authors.initials: Y
authors.lastname: Zou
authors.forename: Peter
authors.initials: P
authors.lastname: Stastny
mesh_terms: D000906:Antibodies / Q000276:immunology*; D006084:Graft Rejection / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006801:Humans; D016377:Organ Transplantation
chemical_list: D000906:Antibodies; D015395:Histocompatibility Antigens Class I; C099187:MHC class I-related chain A