title: Sialylation of antibodies in kidney recipients with de novo donor specific antibody, with or without antibody mediated rejection.
abstract: BACKGROUND
  DSA are associated with reduced long-term transplant function and increased prevalence of chronic rejection in some patients, whereas others do not: our goal was to determine whether the sialylation of IgG and DSA could help to explain in these last cases their "non-aggressive" and/or "protective" biological activity.
  
  
  METHODS
  The sialylation level of total IgG in blood from two groups of kidney-transplant patients with de novo DSA, one with an AMR (DSA+AMR+), and the other without were studied.
  
  
  RESULTS
  In the DSA+AMR-patients total IgG were more sialylated at time of transplant, and at the first detection of DSA, class I DSA were 2.6-fold more sialylated (mean 9.943±1.801 versus 3.898±2.475, p=0.058); DSA+AMR+patients exhibited higher levels of class II DSA.
  
  
  CONCLUSIONS
  In our study, higher levels of sialylated IgG are detectable on day of transplant in patients who do not develop AMR, they have higher sialylated class I DSA at the initial detection of DSA, whereas class II DSA are significantly higher in patients who develop AMR. This is the first report suggesting that transplant outcome, and particularly AMR, is associated with levels of sialylated IgG antibodies. Our data suggest that DSA are functionally heterogeneous and that further studies with an enlarged cohort may improve our understanding of their clinical impact.
authors.affiliation: Etablissement Français du sang, Pays de la Loire, HLA Laboratory, 34 Boulevard Jean Monnet, 44011 Nantes, France; Institut National de la Sante Et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, LabEx Transplantex, CHU de Nantes, 30 Boulevard Jean Monnet, 44093 Nantes Cedex 01, France. Electronic address: casteph@live.fr.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Malard-Castagnet
authors.affiliation: Institut National de la Sante Et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, LabEx Transplantex, CHU de Nantes, 30 Boulevard Jean Monnet, 44093 Nantes Cedex 01, France; Université de Nantes, Faculté de Médecine, Nantes, France. Electronic address: Emilie.dugast@univ-nantes.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Dugast
authors.affiliation: Institut National de la Sante Et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, LabEx Transplantex, CHU de Nantes, 30 Boulevard Jean Monnet, 44093 Nantes Cedex 01, France; Université de Nantes, Faculté de Médecine, Nantes, France. Electronic address: Nicolas.degauque@univ-nantes.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Degauque
authors.affiliation: Institut National de la Sante Et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, LabEx Transplantex, CHU de Nantes, 30 Boulevard Jean Monnet, 44093 Nantes Cedex 01, France. Electronic address: Annaik.pallier@univ-nantes.fr.
authors.forename: Annaïck
authors.initials: A
authors.lastname: Pallier
authors.affiliation: Institut National de la Sante Et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, LabEx Transplantex, CHU de Nantes, 30 Boulevard Jean Monnet, 44093 Nantes Cedex 01, France; Université de Nantes, Faculté de Médecine, Nantes, France. Electronic address: jean-paul.soulillou@univ-nantes.fr.
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Soulillou
authors.affiliation: Etablissement Français du sang, Pays de la Loire, HLA Laboratory, 34 Boulevard Jean Monnet, 44011 Nantes, France. Electronic address: Anne.cesbron@efs.sante.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Cesbron
authors.affiliation: Institut National de la Sante Et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, LabEx Transplantex, CHU de Nantes, 30 Boulevard Jean Monnet, 44093 Nantes Cedex 01, France; Université de Nantes, Faculté de Médecine, Nantes, France; CIC Biothérapie, 5, allée de l'Ile Gloriette, 44093 Nantes Cedex 0144035, Nantes, France; CHU Nantes, CRB, 9 quai Moncousu, 44093 Nantes Cedex 1, Nantes F-44093, France. Electronic address: Magali.giral@chu-nantes.fr.
authors.forename: Magali
authors.initials: M
authors.lastname: Giral
authors.affiliation: Institut National de la Sante Et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, LabEx Transplantex, CHU de Nantes, 30 Boulevard Jean Monnet, 44093 Nantes Cedex 01, France; Université de Nantes, Faculté de Médecine, Nantes, France. Electronic address: Jean.harb@univ-nantes.fr.
authors.forename: Jean
authors.initials: J
authors.lastname: Harb
authors.affiliation: Institut National de la Sante Et de la Recherche Médicale INSERM U1064, and Institut de Transplantation Urologie Néphrologie du Centre Hospitalier Universitaire Hôtel Dieu, LabEx Transplantex, CHU de Nantes, 30 Boulevard Jean Monnet, 44093 Nantes Cedex 01, France; CIC Biothérapie, 5, allée de l'Ile Gloriette, 44093 Nantes Cedex 0144035, Nantes, France; CHU Nantes, CRB, 9 quai Moncousu, 44093 Nantes Cedex 1, Nantes F-44093, France. Electronic address: sophie.brouard@univ-nantes.fr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Brouard
mesh_terms: D000328:Adult; D000368:Aged; D000920:Antibody-Dependent Cell Cytotoxicity; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D056724:Immunity, Humoral; D007074:Immunoglobulin G / Q000737:chemistry / Q000378:metabolism*; D007518:Isoantibodies / Q000737:chemistry / Q000378:metabolism*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012794:Sialic Acids / Q000737:chemistry; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D007074:Immunoglobulin G; D007518:Isoantibodies; D012794:Sialic Acids
keywords: Donor specific antibody; Humoral rejection; Kidney transplantation; Sialylation