title: Pathogenesis of non-HLA antibodies in solid organ transplantation: Where do we stand?
abstract: Antibody-mediated rejection (ABMR) is associated with poor transplant outcome. Pathogenic alloantibodies are usually directed against human leukocyte antigens (HLAs). Histological findings suggestive of ABMR usually demonstrate an anti-HLA donor-specific antibody (DSA)-mediated injury, while a small subset of patients develop acute dysfunction with histological lesions suggestive of ABMR in the absence of anti-HLA DSAs. Although this non-HLA ABMR is not well recognized by current diagnostic classifications, it is associated with graft dysfunction and allograft loss. These clinical descriptions suggest a pathogenic role for non-HLA anti-endothelial cell antibodies. Diverse antigenic targets have been described during the last decade. This review discusses recent findings in the field and addresses the clinical relevance of anti-endothelial cell antibodies (AECAs).
authors.affiliation: Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Descartes, Sorbonne Paris Cité University, Paris, France; Centaure Foundation and Labex Transplantex, Necker Hospital, Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Delville
authors.affiliation: Centaure Foundation and Labex Transplantex, Necker Hospital, Paris, France; INSERM UMR1064, LabEx IGO, LabEx Transplantex, CHU de Nantes, Institut de Transplantation-Urologie-Néphrologie, ITUN, Université de Nantes, Nantes, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Charreau
authors.affiliation: Department of Pathology, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Rabant
authors.affiliation: Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Descartes, Sorbonne Paris Cité University, Paris, France; Centaure Foundation and Labex Transplantex, Necker Hospital, Paris, France; Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Legendre
authors.affiliation: Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Descartes, Sorbonne Paris Cité University, Paris, France; Centaure Foundation and Labex Transplantex, Necker Hospital, Paris, France; Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France. Electronic address: dany.anglicheau@nck.aphp.fr.
authors.forename: Dany
authors.initials: D
authors.lastname: Anglicheau
mesh_terms: D000920:Antibody-Dependent Cell Cytotoxicity; D001323:Autoantibodies / Q000378:metabolism*; D006084:Graft Rejection / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D056724:Immunity, Humoral; D007518:Isoantibodies / Q000378:metabolism*; D016030:Kidney Transplantation; D014181:Transplantation Immunology
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens; D007518:Isoantibodies; C087589:anti-endothelial cell antibody
keywords: Anti-endothelial cell antibody; Endothelial injury; Humoral rejection; Transplantation