title: Humoral immunity in hand transplantation: anti-HLA and non-HLA response.
abstract: Antibodies against donor's HLA antigens and B cell activity are recognized modulators of immune response to allograft. The role of both anti-HLA and non-HLA antibodies is understood in solid organ transplantation, but has not been addressed in composite tissue allografts.
  
  
  OBJECTIVE
  We decided to evaluate the presence and role of anti-HLA and non-HLA antibodies after hand transplantation.
  
  
  METHODS
  We assayed anti-HLA and non-HLA antibodies in 5 consecutive hand transplant patients. The presence of anti-HLA antibodies was tested by flow-PRA method (One Lambda). Non-HLA antibodies were defined as anti-endothelial cell (AECA), anti-angiotensin II type 1 receptor (anti-AT1R), anti-endothelin receptor antibodies (anti-ETAR).
  
  
  RESULTS
  Anti-HLA antibodies were present in 1 patient in class I and in another one in class II. Both patients developed one episode of acute rejection. AECA were present in only one recipient with borderline activity. Both anti-AT1R and Anti-ETAR were found strongly positive in one patient who repeatedly developed acute rejection episodes.
  
  
  CONCLUSIONS
  The presence of non-HLA antibodies (anti-AT1R and anti-ETAR) and the occurrence of multiple rejection episodes found in one patient here require further investigation into a possible association and role of humoral immunity in composite tissue rejection.
authors: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland. Electronic address: m.banasik@interia.pl.
authors: Mirosław
authors: M
authors: Banasik
authors: Subdepartament of Replantation of Limbs, St. Hedwig District Hospital in Trzebnica, Poland.
authors: Jerzy
authors: J
authors: Jabłecki
authors: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland.
authors: Maria
authors: M
authors: Boratyńska
authors: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland.
authors: Dorota
authors: D
authors: Kamińska
authors: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland.
authors: Katarzyna
authors: K
authors: Kościelska-Kasprzak
authors: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland.
authors: Dorota
authors: D
authors: Bartoszek
authors: Subdepartament of Replantation of Limbs, St. Hedwig District Hospital in Trzebnica, Poland.
authors: Adam
authors: A
authors: Chełmoński
authors: Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Poland.
authors: Agnieszka
authors: A
authors: Hałoń
authors: Department of Dermatology, Venereology and Allergology,Wroclaw Medical University, Poland.
authors: Wojciech
authors: W
authors: Baran
authors: Subdepartament of Replantation of Limbs, St. Hedwig District Hospital in Trzebnica, Poland.
authors: Marian
authors: M
authors: Klinger
mesh_terms: D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000378:metabolism*; D065128:Endothelin Receptor Antagonists / Q000378:metabolism*; D005260:Female; D015870:Gene Expression; D006084:Graft Rejection / Q000276:immunology* / Q000473:pathology; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D063987:Hand Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D056724:Immunity, Humoral; D007518:Isoantibodies / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D044140:Receptor, Angiotensin, Type 1 / Q000235:genetics / Q000276:immunology; D017466:Receptors, Endothelin / Q000235:genetics / Q000276:immunology; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D065128:Endothelin Receptor Antagonists; D006680:HLA Antigens; D007518:Isoantibodies; D044140:Receptor, Angiotensin, Type 1; D017466:Receptors, Endothelin
keywords: Anti-HLA antibodies; Antibody mediated rejection; Hand transplantation; Non-HLA antibodies