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Bhutani S, Harris S, Carr M, Russell-Lowe M, Worthington J, Wu HHL, Chinnadurai R, Poulton K. Evaluating the Clinical Relevance of Antibodies against Non-Human Leukocyte Antigen in Kidney Transplantation. Antibodies (Basel) 2024; 13:44. [PMID: 38920968 PMCID: PMC11201104 DOI: 10.3390/antib13020044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/22/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction: Kidney transplantation is the preferred modality of kidney replacement therapy for eligible patients with end-stage kidney disease (ESKD), given that it has been found to reduce mortality rates, improve quality of life, and is cost-effective compared to dialysis. Recent advancements in human leukocyte antigen (HLA) typing and donor-specific antibody (DSA) detection have helped to reduce the risk of rejection, but antibody-mediated rejection (AMR) can still occur without DSA. Previous studies suggest that rejection can be attributed to antibodies against Non-Human Leucocyte Antigens (non-HLAs). We aimed to acquire further understanding of the prevalence and distribution of non-HLA antibodies in our local population and attempt to correlate these findings with graft outcomes, as well as assess whether non-HLA antibodies can be utilized to determine graft impairment and dysfunction. Methods: We conducted a retrospective study involving kidney transplant recipients between January 2010 and December 2020. All included individuals were aged over 18 and underwent kidney-alone transplants; were ABO- and HLA-compatible; and were matched at A, B, and DR loci (mismatch 0:0:0). HLA testing was negative at the time of transplantation. The samples from both cases of early graft rejection and the control group were tested for non-HLA antibodies using One Lambda LABScreenTM, Autoantibody kit groups 1, 2, and 3, as well as the Immucor LIFECODES non-HLA autoantibody assay. Results: A total of 850 kidney transplant recipients were included, in which 12 patients experienced early graft rejection within the first month post transplant and 18 patients who did not experience graft rejection were selected as study controls. Our study reported no correlation between the total burden of non-HLA antibodies and early rejection, most likely as the result of a small sample size. Nevertheless, a sub-analysis revealed that specific high-frequency pre-transplant non-HLA antibodies such as GSTT, CXCL11, CXCL10, and HNR, detected by LIFECODES, were associated with rejection (Fisher's exact test with Bonferroni correction, p < 0.001). Most pre-transplant non-HLA antibody levels were reduced after transplantation, which was attributed to immunosuppression. Conclusion: The 'high frequency' non-HLA antibodies displayed an association with graft rejection, though the overall associations between the burden of non-HLA antibodies and rejection episodes remain inconclusive. Further work is needed to establish the rebound phenomenon of non-HLA antibodies, the development of de novo non-HLA antibodies in the long run, and their implications on graft survival.
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Affiliation(s)
- Shiv Bhutani
- Department of Renal Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
| | - Shelley Harris
- Department of Histocompatibility and Immunogenetics, Transplantation Laboratory, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (S.H.); (M.C.); (M.R.-L.); (J.W.); (K.P.)
| | - Michelle Carr
- Department of Histocompatibility and Immunogenetics, Transplantation Laboratory, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (S.H.); (M.C.); (M.R.-L.); (J.W.); (K.P.)
| | - Marcus Russell-Lowe
- Department of Histocompatibility and Immunogenetics, Transplantation Laboratory, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (S.H.); (M.C.); (M.R.-L.); (J.W.); (K.P.)
| | - Judith Worthington
- Department of Histocompatibility and Immunogenetics, Transplantation Laboratory, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (S.H.); (M.C.); (M.R.-L.); (J.W.); (K.P.)
| | - Henry H. L. Wu
- Renal Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital & The University of Sydney, Sydney, NSW 2065, Australia;
| | - Rajkumar Chinnadurai
- Department of Renal Medicine, Northern Care Alliance NHS Foundation Trust, Salford M6 8HD, UK;
| | - Kay Poulton
- Department of Histocompatibility and Immunogenetics, Transplantation Laboratory, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (S.H.); (M.C.); (M.R.-L.); (J.W.); (K.P.)
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Osoegawa K, Marsh SGE, Holdsworth R, Heidt S, Fischer G, Murphey C, Maiers M, Fernández Viňa MA. A new strategy for systematically classifying HLA alleles into serological specificities. HLA 2022; 100:193-231. [PMID: 35538616 DOI: 10.1111/tan.14662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/30/2022] [Accepted: 05/08/2022] [Indexed: 11/30/2022]
Abstract
HLA serological specificities were defined by the reactivity of HLA molecules with sets of sera and monoclonal antibodies. Many recently identified alleles defined by molecular typing lack their serotype assignment. We surveyed the literature describing the correlation of the reactivity of serologic reagents with AA residues. 20 - 25 AA residues determining epitopes (DEP) that correlated with 82 WHO serologic specificities were identified for HLA class I loci. Thirteen DEP each located in the beta-1 domains that correlated with 24 WHO serologic specificities were identified for HLA-DRB1 and -DQB1 loci. The designation of possible HLA-DPB1, -DQA1, -DPA1, and additional serological specificities that result from epitopes defined by residues located at both -DQA1 and -DQB1 subunits were also examined. HATS software was developed for automated serotype assignments to HLA alleles in one of the three hierarchical matching criteria: 1) all DEP (FULL); 2) selected DEP specific to each serological specificities (SEROTYPE); 3) one AA mismatch with one or more SEROTYPES (INCOMPLETE). Results were validated by evaluating the alleles whose serotypes do not correspond to the first field of the allele name listed in the HLA dictionary. Additional 85 and 21 DEP patterns that do not correspond to any WHO serologic specificities for common HLA class I and DRB1 alleles were identified, respectively. A comprehensive antibody identification panel would allow for accurate unacceptable antigen listing and compatibility predictions in solid organ transplantations. We propose that antibody-screening panels should include all serologic specificities identified in this study. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kazutoyo Osoegawa
- Histocompatibility and Immunogenetics Laboratory, Stanford Blood Center, Palo Alto, CA, USA
| | - Steven G E Marsh
- Anthony Nolan Research Institute & UCL Cancer Institute, Royal Free Campus, London, United Kingdom
| | | | - Sebastiaan Heidt
- Department of Immunology, Leiden University Medical Center, Leiden, the Netherlands
| | - Gottfried Fischer
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Cathi Murphey
- Histocompatibility and Immunogenetics Laboratory at Southwest Immunodiagnostics, Inc, San Antonio, TX, USA
| | - Martin Maiers
- Innovation, National Marrow Donor Program, Minneapolis, MN, USA
| | - Marcelo A Fernández Viňa
- Histocompatibility and Immunogenetics Laboratory, Stanford Blood Center, Palo Alto, CA, USA.,Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
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3
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El-Awar N. HLA epitopes – Empirically defined as conformational amino acids sequences of the HLA antigen and are likely to be part of the binding sites of anti-HLA antibodies. Hum Immunol 2022; 83:204-218. [DOI: 10.1016/j.humimm.2021.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/04/2021] [Accepted: 12/20/2021] [Indexed: 11/26/2022]
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Aita KS, Monte SJ, Silva AS, Moita Neto JM, Vieira RS, Machado VP, Sousa LCD. Time is life: EpAssistant - a new tool for the automatic identification of anti-HLA antibody epitope specificity in transplant programs. Transpl Immunol 2018; 51:1-5. [DOI: 10.1016/j.trim.2018.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 01/05/2023]
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5
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Duquesnoy RJ, Hönger G, Hösli I, Marrari M, Schaub S. Detection of newly antibody-defined epitopes on HLA class I alleles reacting with antibodies induced during pregnancy. Int J Immunogenet 2016; 43:200-8. [DOI: 10.1111/iji.12280] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/10/2016] [Accepted: 05/19/2016] [Indexed: 11/30/2022]
Affiliation(s)
- R. J. Duquesnoy
- Thomas E. Starzl Transplantation Institute; University of Pittsburgh Medical Center; Pittsburgh PA USA
| | - G. Hönger
- Immunobiology; University Hospital Basel; Switzerland
| | - I. Hösli
- Department of Obstetrics and Fetomaternal Medicine; University Hospital Basel; Switzerland
| | - M. Marrari
- Thomas E. Starzl Transplantation Institute; University of Pittsburgh Medical Center; Pittsburgh PA USA
| | - S. Schaub
- Transplantation Immunology and Nephrology; University Hospital Basel; Basel Switzerland
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Vallin P, Désy O, Béland S, Wagner E, De Serres SA. Clinical relevance of circulating antibodies and B lymphocyte markers in allograft rejection. Clin Biochem 2016; 49:385-93. [PMID: 26721422 DOI: 10.1016/j.clinbiochem.2015.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/27/2015] [Accepted: 12/06/2015] [Indexed: 01/08/2023]
Abstract
The main challenge in solid organ transplantation remains to tackle antibody-mediated rejection. Our understanding of the antibody-mediated response and the capacity to detect it has improved in the last decade. However, the sensitivity and specificity of the current clinical tools to monitor B cell activation are perfectible. New strategies, including the refinement in the characterization of HLA and non-HLA antibodies, as well as a better understanding of the circulating B cell phenotype will hopefully help to non-invasively identify patients at risk or undergoing antibody-mediated allograft damage. The current review discusses the current knowledge of the B cell biomarkers in solid organ transplantation, with a focus on circulating antibodies and peripheral B cells.
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Affiliation(s)
- Patrice Vallin
- Transplantation Unit, Renal Division, Department of Medicine, CHU de Québec, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - Olivier Désy
- Transplantation Unit, Renal Division, Department of Medicine, CHU de Québec, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - Stéphanie Béland
- Transplantation Unit, Renal Division, Department of Medicine, CHU de Québec, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - Eric Wagner
- Immunology and Histocompatibility Laboratory, CHU de Québec, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - Sacha A De Serres
- Transplantation Unit, Renal Division, Department of Medicine, CHU de Québec, Faculty of Medicine, Laval University, Québec, QC, Canada.
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7
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Identification of epitopes on HLA-DRB alleles reacting with antibodies in sera from women sensitized during pregnancy. Hum Immunol 2015; 77:214-22. [PMID: 26686763 DOI: 10.1016/j.humimm.2015.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/04/2015] [Accepted: 12/05/2015] [Indexed: 11/20/2022]
Abstract
This report describes a HLAMatchmaker-based antibody analysis of post-pregnancy sera with antibodies against child-specific HLA-DR epitopes. These sera were reactive in IgG-binding assays with single allele bead (SAB) panels on a Luminex platform. The antibody specificity analysis focused on DRB epitopes that have been recorded in the International HLA Epitope Registry (http://www.epregistry.com.br) as experimentally verified with informative antibodies but we also considered other eplets that predict potential epitopes. The SAB panel has in several instances two or more alleles corresponding to the same serologically defined DR antigen and we selected six sera were with different reactivity patterns with DR1, DR4, DR13 and/or DR52 alleles. We demonstrate here how amino acid differences between these alleles can provide useful information in the determination of new epitope specificities of antibodies in these sera. Eight newly antibody-verified epitopes were identified including three that correspond to eplets paired with self-residue configurations. Epitope specificity information appears to be useful in the prediction of mismatch acceptability of non-SAB alleles within serological DR antigen groups.
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Anunciação FAC, Sousa LCDDM, da Silva AS, Marroquim MSC, Coelho AGB, Willcox GH, de Andrade JMM, Corrêa BDM, Guimarães EL, do Monte SJH. EpViX: A cloud-based tool for epitope reactivity analysis and epitope virtual crossmatching to identify low immunologic risk donors for sensitized recipients. Transpl Immunol 2015; 33:153-8. [PMID: 26531328 DOI: 10.1016/j.trim.2015.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 09/30/2015] [Accepted: 09/30/2015] [Indexed: 11/25/2022]
Abstract
One of the challenges facing solid organ transplantation programs globally is the identification of low immunological risk donors for sensitized recipients by HLA allele genotype. Because recognition of donor HLA alleles by host antibodies is at the core of organ rejection, the objective of this work was to develop a new version of the EpHLA software, named EpViX, which uses an HLAMatchmaker algorithm and performs automated epitope virtual crossmatching at the initiation of the organ donation process. EpViX is a free, web-based application developed for use over the internet on a tablet, smartphone or computer. This program was developed using the Ruby programming language and the Ruby-on-Rails framework. To improve the user experience, the EpViX software interface was developed based on the best human–computer interface practices. To simplify epitope analysis and virtual crossmatching, the program was integrated with important available web-based resources, such as OPTN, IMGT/HLA and the International HLA Epitope Registry. We successfully developed a program that allows people to work collaboratively and effectively during the donation process by accurately predicting negative crossmatches, saving time and other resources.
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Affiliation(s)
- Fernando Antonio Costa Anunciação
- Immunogenetics and Molecular Biology Laboratory, Federal University of Piauí, Campus Ministro Petrônio Portela SG-16, Teresina, PI CEP: 64049-550, Brazil.
| | - Luiz Claudio Demes da Mata Sousa
- Immunogenetics and Molecular Biology Laboratory, Federal University of Piauí, Campus Ministro Petrônio Portela SG-16, Teresina, PI CEP: 64049-550, Brazil; Computation Department, Federal University of Piauí, Campus Ministro Petrônio Portela SG-9, Teresina, PI CEP: 64049-550, Brazil.
| | - Adalberto Socorro da Silva
- Immunogenetics and Molecular Biology Laboratory, Federal University of Piauí, Campus Ministro Petrônio Portela SG-16, Teresina, PI CEP: 64049-550, Brazil; Department of Biology, Federal University of Piauí, Campus Ministro Petrônio Portela SG-16, Teresina, PI CEP: 64049-550, Brazil.
| | - Mário Sérgio Coelho Marroquim
- Immunogenetics and Molecular Biology Laboratory, Federal University of Piauí, Campus Ministro Petrônio Portela SG-16, Teresina, PI CEP: 64049-550, Brazil.
| | - Antônio Gilberto Borges Coelho
- Immunogenetics and Molecular Biology Laboratory, Federal University of Piauí, Campus Ministro Petrônio Portela SG-16, Teresina, PI CEP: 64049-550, Brazil.
| | - Glauco Henrique Willcox
- HLA Diagnóstico, Rua Gonçalves Maia, 113 Bairro Soledade, Recife, PE CEP: 50070-065, Brazil.
| | | | - Bruno de Melo Corrêa
- HLA Diagnóstico, Rua Gonçalves Maia, 113 Bairro Soledade, Recife, PE CEP: 50070-065, Brazil.
| | | | - Semiramis Jamil Hadad do Monte
- Immunogenetics and Molecular Biology Laboratory, Federal University of Piauí, Campus Ministro Petrônio Portela SG-16, Teresina, PI CEP: 64049-550, Brazil; Department of Biology, Federal University of Piauí, Campus Ministro Petrônio Portela SG-16, Teresina, PI CEP: 64049-550, Brazil.
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Duquesnoy RJ, Gebel HM, Woodle ES, Nickerson P, Baxter-Lowe LA, Bray RA, Claas FHJ, Eckels DD, Friedewald JJ, Fuggle SV, Gerlach JA, Fung JJ, Kamoun M, Middleton D, Shapiro R, Tambur AR, Taylor CJ, Tinckam K, Zeevi A. High-Resolution HLA Typing for Sensitized Patients: Advances in Medicine and Science Require Us to Challenge Existing Paradigms. Am J Transplant 2015; 15:2780-1. [PMID: 26177785 DOI: 10.1111/ajt.13376] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 04/26/2015] [Accepted: 04/26/2015] [Indexed: 01/25/2023]
Affiliation(s)
- R J Duquesnoy
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - H M Gebel
- HLA Laboratory, Emory University Hospital, Atlanta, GA
| | - E S Woodle
- University of Cincinnati, Cincinnati, OH
| | - P Nickerson
- Department of Internal Medicine and Immunology, University of Manitoba, Winnipeg, Canada
| | | | - R A Bray
- Emory University Hospital, Atlanta, GA
| | - F H J Claas
- Department of Immunohematology and Transfusion, Leiden University Medical Center, Leiden, the Netherlands
| | | | - J J Friedewald
- Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - S V Fuggle
- Transplant Immunology Laboratory, Oxford Transplant Centre, Oxford University Hospitals, Oxford University, Oxford, United Kingdom
| | - J A Gerlach
- Biomedical Laboratory Diagnostics Program, Michigan State University, East Lansing, MI
| | - J J Fung
- Digestive Disease Institute, Cleveland Clinic Main Campus, Cleveland, OH
| | - M Kamoun
- Immunology & Histocompatibility Testing Laboratories, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - D Middleton
- Department of Transplant Immunology, Royal Liverpool and Broadgreen University Hospital, Liverpool, United Kingdom
| | - R Shapiro
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mt. Sinai, New York, NY
| | - A R Tambur
- Transplant Immunology Laboratory, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - C J Taylor
- Addenbrooke's Hospital, Cambridge University, Cambridge, United Kingdom
| | - K Tinckam
- Division of Nephrology and HLA Laboratory, University Health Network, Toronto, Canada
| | - A Zeevi
- Division of Transplant Pathology, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA
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Duquesnoy RJ, Marrari M, Mulder A. Usefulness of the Nonself-Self Algorithm of HLA Epitope Immunogenicity in the Specificity Analysis of Monospecific Antibodies Induced during Pregnancy. Front Immunol 2015; 6:180. [PMID: 26074914 PMCID: PMC4443772 DOI: 10.3389/fimmu.2015.00180] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 03/31/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND HLAMatchmaker is a program to analyze the epitope specificities of HLA antibodies. It considers each HLA allele as a string of eplets. Intralocus and interlocus comparisons between donor and recipient alleles offer a structural assessment of compatibility and an analysis of allele panel reactivity patterns can generate information about epitope specificities of HLA antibodies. However, HLAMatchmaker cannot always generate conclusive interpretations of reactivity patterns of all monospecific antibodies, which by definition recognize single epitopes. HYPOTHESIS We have therefore developed a new antibody analysis approach that utilizes the nonself-self algorithm of HLA epitope immunogenicity. It is based on the concept that HLA antibodies originate from B-cells with immunoglobulin receptors to self-HLA epitopes on one given allele and which can be activated by epitopes defined by a few nonself residue differences whereas the remainder of the structural epitope of the immunizing allele consists of self residues. METHODS Three human monoclonal class I antibodies from HLA typed women sensitized during pregnancy were tested in Ig-binding assays with single alleles on a Luminex platform. FINDINGS Three new HLA epitopes were identified; they are defined by combinations of nonself- and self-residues for one allele of the antibody producer. CONCLUSION The nonself-self paradigm of HLA epitope immunogenicity offers a second approach to analyze HLA antibody specificities.
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Affiliation(s)
| | - Marilyn Marrari
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Arend Mulder
- Leiden University Medical Center, Leiden, Netherlands
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Duquesnoy RJ, Marrari M, Mulder A, Sousa LCDDM, da Silva AS, do Monte SJH. First report on the antibody verification of HLA-ABC epitopes recorded in the website-based HLA Epitope Registry. ACTA ACUST UNITED AC 2015; 83:391-400. [PMID: 24828056 DOI: 10.1111/tan.12341] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/01/2014] [Accepted: 02/20/2014] [Indexed: 12/19/2022]
Abstract
The International Registry of Antibody-Defined HLA Epitopes ( http://www.epregistry.com.br) has been recently established as a tool to understand humoral responses to human leukocyte antigen (HLA) mismatches. These epitopes are defined structurally by three-dimensional molecular modeling and amino acid sequence differences between HLA antigens. So-called eplets represent essential components of HLA epitopes and they are defined by polymorphic residues. A major goal is to identify HLA epitopes that have been verified experimentally with informative antibodies. Our analysis has also included data in many publications. As of 1 November 2013, 95 HLA-ABC antibody-verified epitopes have been recorded, 62 correspond to eplets and 33 are defined by eplets paired with other residue configurations. The Registry is still a work-in-progress and will become a useful resource for HLA professionals interested in histocompatibility testing at the epitope level and investigating antibody responses to HLA mismatches in transplant patients.
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Affiliation(s)
- R J Duquesnoy
- Division of Transplant Pathology, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Duquesnoy RJ, Marrari M, Tambur AR, Mulder A, da Mata Sousa LCD, da Silva AS, do Monte SJ. First report on the antibody verification of HLA-DR, HLA-DQ and HLA-DP epitopes recorded in the HLA Epitope Registry. Hum Immunol 2014; 75:1097-103. [DOI: 10.1016/j.humimm.2014.09.012] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 09/25/2014] [Accepted: 09/25/2014] [Indexed: 01/07/2023]
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13
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Duquesnoy RJ. HLA epitope based matching for transplantation. Transpl Immunol 2014; 31:1-6. [PMID: 24769079 DOI: 10.1016/j.trim.2014.04.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 04/14/2014] [Indexed: 12/22/2022]
Abstract
As important risk factors for transplant rejection and failure, HLA antibodies are now recognized as being specific for epitopes which can be defined structurally with amino acid differences between HLA alleles. Donor-recipient compatibility should therefore be assessed at the epitope rather than the antigen level. HLAMatchmaker is a computer algorithm that considers each HLA antigen as a series of small configurations of polymorphic residues referred to as eplets as essential components of HLA epitopes. It includes epitopes on antigens encoded by all HLA-A, B, C, DR, DQ and DP loci as well as MICA. HLA epitopes have two characteristics namely antigenicity, i.e. the reactivity with antibody and immunogenicity, i.e. the ability of eliciting an antibody response. This article addresses the relevance of determining epitope-specificities of HLA antibodies, the effect of epitope structure on technique-dependent antibody reactivity and the identification of acceptable mismatches for sensitized patients considered for transplantation. Permissible mismatching for non-sensitized patients aimed to prevent or reduce HLA antibody responses could consider epitope loads of mismatched antigens and the recently developed nonself-self paradigm of epitope immunogenicity.
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Affiliation(s)
- René J Duquesnoy
- Division of Transplantation Pathology, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, United States
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