title: Non-human leukocyte antigen-specific antibodies in thoracic transplantation.
abstract: Development of donor human leukocyte antigen (HLA)-specific antibodies is associated with graft loss, yet the role of non-HLA antibodies in solid organ transplant needs to be further defined. It is suggested that HLA antibodies and non-HLA antibodies collaborate together to impact graft outcome. This review focuses on the latest findings on antibodies against these non-HLA antigens in thoracic organ transplant.
  
  
  
  These non-HLA antigens include signaling proteins expressed on the cell surface, such as angiotensin II type 1 receptor (AT1R), endothelin type A receptor, and structure proteins, such as myosin, vimentin, and Kα1 tubulin, and extracellular matrix protein collagen. Antibodies against these antigens may impact the allograft in different ways. Although these non-HLA antibodies can damage the allograft through complement-mediated or cell-mediated cytotoxicity, antibodies against AT1R and endothelin type A receptor can also alter the endothelial cell function by activating intracellular signals. The presence of these non-HLA antibodies may predispose the patient to develop HLA-specific antibodies. Recently, it has been shown patients with AT1R antibodies pretransplant have a higher chance to develop de-novo donor-specific HLA antibodies.
  
  
  
  The findings suggest it is important to stratify the patient's immunologic risk by assessing both the HLA and non-HLA-specific antibodies.
authors.affiliation: HLA Laboratory, Cedars-Sinai Medical Center, Comprehensive Transplant Center, Los Angeles, California, USA.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Reinsmoen
authors.forename: Xiaohai
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000906:Antibodies; D006680:HLA Antigens / Q000276:immunology*; D000949:Histocompatibility Antigens Class II; D006801:Humans; D019616:Thoracic Surgical Procedures / Q000379:methods*; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000379:methods*
chemical_list: D000906:Antibodies; D006680:HLA Antigens; D000949:Histocompatibility Antigens Class II