title: Angiotensin II type 1 receptor antibodies in childhood kidney transplantation.
abstract: Angiotensin II type 1 receptor antibodies (AT1 RAb) have emerged as non-HLA Ab present in patients with acute AMR and risk of graft loss. Furthermore, AT1 RAb have been shown to increase angiotensin II sensitivity which may play a role in the development of CVD and hypertension. Data on AT1 RAb in stable transplant recipients are lacking. The aim of this study was to analyze the levels of AT1 RAb in a cohort of stable patients after kidney transplantation (tx) in childhood. A cross-sectional study of 30 children (median age 14, range 3-19 yr, median time since tx five yr) and 28 adults who were transplanted in childhood (median age 26, range 20-40 yr, median time since tx 18 yr) transplanted between 1993-2006 and 1983-2002, respectively, was performed. Healthy controls were 51 healthy children (5-8 yr) and 199 healthy donors (median age 56.5 yr, range 42-83 yr). Plasma AT1 RAb were analyzed by immunoassay. Median total AT1 RAb IgG concentration was significantly higher in the pediatric-tx group as compared to the adult-tx group (40.0 and 10.95 U/mL, p < 0.0001). For both groups, the tx group showed higher levels: the pediatric-tx group vs. control group (40.0 vs. 13.3 U/mL, p = 0.0006) and the adult-tx group vs. adult control group (10.95 vs. 6.5 U/mL, p < 0.0001). Age was the strongest indicator of high levels of AT1 RAb IgG (p = 0.0003). AT1 RAb total IgG levels are significantly higher in a stable pediatric-tx cohort as compared to adult-tx patients and healthy controls of comparable age groups. The relevance of our findings in relation to age, time since tx, previous or future rejection, and CVD risk merits future studies.
authors.affiliation: Department of Pediatrics, Oslo University Hospital, Oslo, Norway.
authors.forename: Anna
authors.initials: A
authors.lastname: Bjerre
authors.affiliation: Department of Pediatrics, Oslo University Hospital, Oslo, Norway.
authors.forename: Trine
authors.initials: T
authors.lastname: Tangeraas
authors.affiliation: CellTrend GmbH, Luckenwalde, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Heidecke
authors.affiliation: Department of Nephrology and Intensive Care Medicine, Charité Hospital, Berlin, Germany.
authors.forename: Duska
authors.initials: D
authors.lastname: Dragun
authors.affiliation: Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine, and HELIOS Clinic-Berlin, Berlin, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Dechend
authors.affiliation: Department of Obstetrics and Department of Gynecology, Oslo University Hospital and University of Oslo, Oslo, Norway.
authors.forename: Anne Cathrine
authors.initials: AC
authors.lastname: Staff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D044140:Receptor, Angiotensin, Type 1 / Q000276:immunology*; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G; D044140:Receptor, Angiotensin, Type 1
keywords: angiotensin II type 1 receptor antibodies; cardiovascular disease; children; hypertension; kidney transplantation; rejection