1
|
Porfirio B, Paganini M, Mazzanti B, Bagnoli S, Bucciantini S, Ghelli E, Nacmias B, Putignano AL, Rombolà G, Saccardi R, Lombardini L, Di Lorenzo N, Vannelli GB, Gallina P. Donor-Specific Anti-HLA Antibodies in Huntington's Disease Recipients of Human Fetal Striatal Grafts. Cell Transplant 2015; 24:811-7. [DOI: 10.3727/096368913x676222] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Fetal grafting in a human diseased brain was thought to be less immunogenic than other solid organ transplants, hence the minor impact on the efficacy of the transplant. How much prophylactic immune protection is required for neural allotransplantation is also debated. High-sensitive anti-HLA antibody screening in this field has never been reported. Sixteen patients with Huntington's disease underwent human fetal striatal transplantation in the frame of an open-label observational trial, which is being carried out at Florence University. All patients had both brain hemispheres grafted in two separate robotic-stereotactic procedures. The trial started in February 2006 with the first graft to the first patient (R1). R16 was given his second graft on March 2011. All patients received triple immunosuppressive treatment. Pre- and posttransplant sera were analyzed for the presence of anti-HLA antibodies using the multiplexed microsphere-based suspension array Luminex xMAP technology. Median follow-up was 38.5 months (range 13-85). Six patients developed anti-HLA antibodies, which turned out to be donor specific. Alloimmunization occurred in a time window of 0–49 months after the first neurosurgical procedure. The immunogenic determinants were non-self-epitopes from mismatched HLA antigens. These determinants were both public epitopes shared by two or more HLA molecules and private epitopes unique to individual HLA molecules. One patient had non-donor-specific anti-HLA antibodies in her pretransplant serum sample, possibly due to previous sensitization events. Although the clinical significance of donor-specific antibodies is far from being established, particularly in the setting of neuronal transplantation, these findings underline the need of careful pre- and posttransplant immunogenetic evaluation of patients with intracerebral grafts.
Collapse
Affiliation(s)
- Berardino Porfirio
- Careggi University Hospital, Florence, Italy
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | | | | | - Silvia Bagnoli
- Department of Neurosciences, University of Florence, Florence, Italy
| | | | | | - Benedetta Nacmias
- Careggi University Hospital, Florence, Italy
- Department of Neurosciences, University of Florence, Florence, Italy
| | | | | | | | | | - Nicola Di Lorenzo
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Gabriella B. Vannelli
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Pasquale Gallina
- Careggi University Hospital, Florence, Italy
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| |
Collapse
|
2
|
Mota MA. Red cell and human leukocyte antigen alloimmunization in candidates for renal transplantation: a reality. Rev Bras Hematol Hemoter 2013; 35:160-1. [PMID: 23904801 PMCID: PMC3728124 DOI: 10.5581/1516-8484.20130046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 04/02/2013] [Indexed: 12/03/2022] Open
Affiliation(s)
- Mariza Aparecida Mota
- Instituto Israelita de Ensino e Pesquisa, Hospital Albert Einstein - IIEPAE, São Paulo, SP, Brazil
| |
Collapse
|