title: Renal transplantation dramatically reduces IgA anti-beta-2-glycoprotein I antibodies in patients with endstage renal disease.
abstract: IgA anti-beta-2-glycoprotein I (aB2GPI) antibodies have been related to vascular pathology in the general population and mainly in hemodialyzed patients (prevalence 33%) in whom an elevated incidence of thrombosis and mortality is found. In this paper we have studied the presence of IgA aB2GPI antibodies at pretransplant and their evolution after transplantation with a cross-sectional-based follow-up study of a cohort of 288 endstage renal disease (ESRD) patients treated with kidney transplantation. Pretransplant IgA aB2GPI levels were elevated 31.7 ± 4.2 U/mL without differences in age or type of dialysis. Patients with different etiologies of ESRD showed higher levels of IgA aB2GPI than blood donors, except the groups of non-IgA glomerular disease and systemic erythematosus lupus, whose nonsignificant differences were observed. IgA aB2GPI antibodies dropped immediately after transplantation (10.7 ± 1.0 U/mL, P < 0.0001), coinciding with a high degree of immunosuppression, and remained significantly lower than that observed in pretransplant status. Prevalence of patients with elevated antibodies was also less in transplanted patients (8.9% versus 30.4%, P < 0.0001). Among, positivity for IgA aB2GPI was higher than in patients who had received their first transplant that those were retransplanted. This finding could have important clinical implications and can suggest new therapeutic strategies in patients with IgA aB2GPI antibodies.
authors.affiliation: Servicio de Nefrología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain.
authors.forename: Manuel
authors.identifier: 0000-0002-7177-667X
authors.initials: M
authors.lastname: Serrano
authors.affiliation: Servicio de Inmunología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain.
authors.forename: Jose Angel
authors.initials: JA
authors.lastname: Martínez-Flores
authors.affiliation: Servicio de Inmunología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Castro
authors.affiliation: Servicio de Nefrología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain.
authors.forename: Florencio
authors.initials: F
authors.lastname: García
authors.affiliation: Servicio de Epidemiología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain.
authors.forename: David
authors.identifier: 0000-0002-3317-5689
authors.initials: D
authors.lastname: Lora
authors.affiliation: Servicio de Inmunología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Pérez
authors.affiliation: Servicio de Nefrología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Gonzalez
authors.affiliation: Servicio de Inmunología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain ; Sección de Inmunología, Universidad San Pablo-CEU, Campus de Monteprincipe, 28668 Madrid, Spain ; Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain.
authors.forename: Estela
authors.identifier: 0000-0002-0646-2375
authors.initials: E
authors.lastname: Paz-Artal
authors.affiliation: Servicio de Nefrología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain ; Facultad de Medicina, Universidad Complutense, 28040 Madrid, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Morales
authors.affiliation: Servicio de Inmunología, Instituto de Investigacion Hospital Universitario 12 de Octubre, Avenida Córdoba s/n, 28041 Madrid, Spain ; Sección de Inmunología, Universidad San Pablo-CEU, Campus de Monteprincipe, 28668 Madrid, Spain.
authors.forename: Antonio
authors.identifier: 0000-0003-1993-640X
authors.initials: A
authors.lastname: Serrano
mesh_terms: D000328:Adult; D000368:Aged; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A; D007166:Immunosuppressive Agents; C049937:anti-IgA