title: The effect of anti-human leukocyte antigen, anti-major histocompatibility complex class 1 chain-related antigen a, and anti-glutathione transferase-T1 antibodies on the long-term survival of renal allograft.
abstract: BACKGROUND
  One of the most important mechanisms of allograft rejection is the production of donor-specific antibodies (DSA). Anti-major histocompatibility complex class-I chain-related antigen A (MICA) and anti-glutathione S transferase-T1 (GSTT1) antibodies cause graft dysfunction and reduce graft survival. The aim of this study was to examine the effects of anti-human leukocyte antigen class I-II, anti-MICA, and anti-GSTT1 antibodies in development of antibody-mediated rejection.
  
  
  METHODS
  Among the 32 renal transplant patients included in this study 65% experienced antibody-mediated rejection (AMR; chronic active AMR [CAMR], n = 17; acute AMR [AAMR], n = 4) and 35%, ACR. The anti-HLA class I-II and anti-MICA antibodies were determined by using LUMINEX, anti-GSTT1 antibodies by enzyme-linked immunosorbent assay. GSTT1 genotyping of patients and donors was performed by polymerase chain reaction.
  
  
  RESULTS
  Antibody was detected in 19 of 21 patients undergoing antibody-mediated rejection (90%). We detected anti-GSTT1 in 4, anti-MICA in 8, anti-HLA class I in 5, and anti-HLA class II in 9 patients with CAMR (P = .007). If the patients were divided into 2 groups according to being C4d(+) and C4d(-) both anti-HLA class I and class II antibodies were found significantly more frequently among the C4d(+) group (P = .019, P = .024). No difference was determined between AMR and ACR groups in terms of anti-GSTT1 and anti-MICA antibodies.
  
  
  CONCLUSIONS
  In this study, we observed the role of anti-HLA class II antibodies in the development of CAMR and in long-term allograft survival. It is observed that anti-MICA and anti-GSTT1 antibodies showed no effect on rejection mechanisms.
authors.affiliation: Department of Medical Biology, I. U. Instanbul Medical Faculty, Istanbul, Turkey. sebahatakgul@gmail.com
authors.forename: S U
authors.initials: SU
authors.lastname: Akgul
authors.forename: F S
authors.initials: FS
authors.lastname: Oğuz
authors.forename: Y
authors.initials: Y
authors.lastname: Çalışkan
authors.forename: C
authors.initials: C
authors.lastname: Kekik
authors.forename: P
authors.initials: P
authors.lastname: Çağatay
authors.forename: A
authors.initials: A
authors.lastname: Türkmen
authors.forename: I
authors.initials: I
authors.lastname: Nane
authors.forename: F
authors.initials: F
authors.lastname: Aydın
authors.forename: S
authors.initials: S
authors.lastname: Temurhan
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000276:immunology*; D005260:Female; D005982:Glutathione Transferase / Q000276:immunology*; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens; D005982:Glutathione Transferase; C495790:glutathione transferase T1-1, human