title: Association of C1q Binding Status With De Novo HLA Antibody Clinical Features and Allograft Function in Kidney Transplantation Patients During Eight Years of Dynamic Follow-up.
abstract: BACKGROUND
  C1q-binding donor-specific antibody (DSA) is detrimental to transplanted kidney function. However, the factors that affect C1q binding status are unclear.
  
  
  METHODS
  A total of 519 samples from 129 consecutive kidney transplantation patients during 8 years of dynamic follow-up were collected for HLA antibody (Ab) screening and C1q detection.
  
  
  RESULTS
  Among the detected HLA Abs, the majority were class II, and the DQ subtypes composed the highest proportion. The C1q-binding Abs were all HLA-II, and the DQ subtypes had the highest rate of C1q positivity. With a cutoff mean fluorescence intensity (MFI) value of 7349, the sensitivity and specificity of detecting C1q-binding Abs from all HLA-II Abs were 84.48% and 83.56%, respectively. Additionally, C1q is more likely to be bound by DSA than non-donor-specific antibody (NDSA). Compared with free DSA/NDSA, the MFI values of C1q-binding DSA/NDSA are more closely correlated with serum creatinine levels and reflect the effect of anti-antibody-mediated rejection treatment more sensitively.
  
  
  CONCLUSIONS
  HLA-II Abs (particularly DQ subtypes), high titers of Abs, and DSA are important relevant factors of C1q positivity. The MFI value of C1q-binding DSA may be a useful clinical indicator of HLA antibody-mediated graft injury before the appearance of histologically typical humoral rejection.
authors: Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors: X
authors: X
authors: Wei
authors: Department of HLA Laboratory, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors: X
authors: X
authors: Yuan
authors: Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors: M
authors: M
authors: Sun
authors: Department of HLA Laboratory, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors: Z
authors: Z
authors: Pan
authors: Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors: L
authors: L
authors: Hu
authors: Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors: L
authors: L
authors: Wang
authors: Department of HLA Laboratory, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. Electronic address: junhe1964@163.com.
authors: J
authors: J
authors: He
authors: Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. Electronic address: xf192@163.com.
authors: J
authors: J
authors: Hou
mesh_terms: D000328:Adult; D064591:Allografts / Q000276:immunology; D015922:Complement C1q / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies; D015922:Complement C1q