title: Anti-HLA-A, -B, -DR, -DQB1 and -DQA1 antibodies reactive epitope determination with HLAMatchmaker in multipare awaiting list for heart transplant.
abstract: Human leukocyte antigen (HLA) antibodies represent a significant risk factor for transplant failure. It is very important to characterize anti-HLA antibodies as epitopes rather than antigens so that this knowledge can be applied clinically. The aim of the study was to investigate the extra reactivity patterns in sensitized multipare. Here, we have used the HLAMatchmaker program, a theoretical algorithm, to explain these unexpected antibody reactivity patterns in multipare awaiting for heart transplant. The patient was sensitized during pregnancy by alleles HLA-A(*)24:02, HLA-DRB1(*)07:01, HLA-DRB4(*)01:01, DQB1(*)02:02 and DQA1(*)02:01 mismatches with development of respective antibodies. However, the patient' sera were shown an unexpected reactivity not directed toward HLA mismatches of daughters: A(∗)23:01, A(*)24:03 and B(*)15:12 for class I and DRB4(*)01:03, DRB1(*)09:02, DRB1(*)09:01, DQB1(*)03:01, DQB1(*)03:03, DQB1(*)03:02, DQB1(*)04:02, DQB1(*)04:01 and DQB1(*)02:01 for class II. By HLAMatchmaker analysis we found that these antibodies reacted with eplet shared by antigens in single allele Luminex panels. These eplets were: 62EE, 66GKH, 70KAH, 71HS, 127K, 113YH, 144KR, 150AAH, 151AHV, 163TG and 167DG for class I and 4Q, 74RRAE, 71RRA, 98KN, 120N, and 135G, 25FT, 34HE, 41ER, 47EK2, 48LF for class II. Thus, HLAMatchmaker software together with to solid phase techniques could open new horizons for a more precise characterization of the HLA-antibodies.
authors.affiliation: U.O.C. Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Universitaria Policlinico (AOU), Second University of Naples, Italy. marianna.resse@unina2.it
authors.forename: Marianna
authors.initials: M
authors.lastname: Resse
authors.forename: Rossella
authors.initials: R
authors.lastname: Paolillo
authors.forename: Amelia
authors.initials: A
authors.lastname: Casamassimi
authors.forename: Francesco
authors.initials: F
authors.lastname: Cavalca
authors.forename: Carmela
authors.initials: C
authors.lastname: Fiorito
authors.forename: Ciro
authors.initials: C
authors.lastname: Maiello
authors.forename: Claudio
authors.initials: C
authors.lastname: Napoli
mesh_terms: D000328:Adult; D000483:Alleles; D000906:Antibodies / Q000276:immunology*; D000918:Antibody Specificity / Q000235:genetics / Q000276:immunology; D000939:Epitopes / Q000276:immunology*; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D016027:Heart Transplantation; D006648:Histocompatibility / Q000235:genetics / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D008875:Middle Aged
chemical_list: D000906:Antibodies; D000939:Epitopes; D006680:HLA Antigens
keywords: CDC; CDR; ELISA; HLA; MFI; PCR-SSP; PRA; SA; complement-dependent cytotoxicity crossmatch; complementary determining region; enzyme-linked immunosorbent assay; human leukocyte antigen; mean fluorescence intensity units; panel reactive antibody; polymerase chain reaction-sequence-specific primer; single antigens