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Hiho SJ, Levvey BJ, Diviney MB, Snell GI, Sullivan LC, Westall GP. Comparison of human leukocyte antigen immunologic risk stratification methods in lung transplantation. Am J Transplant 2024; 24:827-838. [PMID: 37981213 DOI: 10.1016/j.ajt.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Abstract
Outcomes after lung transplantation (LTx) remain poor, despite advances in sequencing technology and development of algorithms defining immunologic compatibility. Presently, there is no consensus regarding the best approach to define human leukocyte antigen (HLA) compatibility in LTx. In this study, we compared 5 different HLA compatibility tools in a high-resolution HLA-typed, clinically characterized cohort, to determine which approach predicts outcomes after LTx. In this retrospective single-center study, 277 donor-recipient transplant pairs were HLA-typed using next generation sequencing. HLA compatibility was defined using HLAMatchmaker, HLA epitope mismatch algorithm (HLA-EMMA), predicted indirectly recognizable HLA epitopes (PIRCHE), electrostatic mismatch score (EMS), and amino acid mismatches (AAMMs). Associations with HLA mismatching and survival, chronic lung allograft dysfunction (CLAD), and anti-HLA donor-specific antibody (DSA) were calculated using adjusted Cox proportional modeling. Lower HLA class II mismatching was associated with improved survival as defined by HLAMatchmaker (P < .01), HLA-EMMA (P < .05), PIRCHE (P < .05), EMS (P < .001), and AAMM (P < .01). All approaches demonstrated that HLA-DRB1345 matching was associated with freedom from restrictive allograft syndrome and HLA-DQ matching with reduced DSA development. Reducing the level of HLA mismatching, in T cell or B cell epitopes, electrostatic differences, or amino acid, can improve outcomes after LTx and potentially guide immunosuppression strategies.
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Affiliation(s)
- Steven J Hiho
- Lung Transplant Service, Department of Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia; Australian Red Cross LifeBlood, Victorian Transplantation and Immunogenetics Service, Melbourne, Victoria, Australia.
| | - Bronwyn J Levvey
- Lung Transplant Service, Department of Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Mary B Diviney
- Australian Red Cross LifeBlood, Victorian Transplantation and Immunogenetics Service, Melbourne, Victoria, Australia
| | - Gregory I Snell
- Lung Transplant Service, Department of Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Lucy C Sullivan
- Lung Transplant Service, Department of Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia; Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Australian Red Cross LifeBlood, South Australian Transplantation and Immunogenetics Service, Adelaide, South Australia, Australia
| | - Glen P Westall
- Lung Transplant Service, Department of Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
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Grubic Z, Maskalan M, Burek Kamenaric M, Desnica L, Mikulic M, Stingl Jankovic K, Durakovic N, Serventi Seiwerth R, Vrhovac R, Zunec R. Alternative donor strategy in unrelated hematopoietic stem cell transplantation - outcome with mismatched donors. Adv Med Sci 2023; 68:332-340. [PMID: 37741003 DOI: 10.1016/j.advms.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/06/2023] [Accepted: 09/06/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE This study retrospectively investigated the association between the level of human leukocyte antigen (HLA) mismatches (MMs), direction of disparities and differences at particular HLA locus on clinical outcomes of hematopoietic stem cell transplantation (HSCT). Investigated outcomes were overall survival (OS) and disease-free survival (DFS), graft-versus-host disease (GvHD), relapse and non-relapse mortality (NRM). PATIENTS AND METHODS Study cohort included 108 adult patients transplanted between 2011 and 2021 and their 9/10 mismatched unrelated donors (MMUD). All individuals were typed for HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1 loci using Polymerase Chain Reaction-Sequence Specific Primers, PCR-Sequence Based Typing and Next-Generation Sequencing. All statistical analyses were done in the MedCalc software, version 19.2.6. RESULTS Patients with MMs at HLA-B locus demonstrated worse OS (P = 0.0440, HR = 2.00, n = 20). Absence of HLA-DRB5 was associated with a higher incidence of GvHD (P = 0.0112, HR = 1.93, n = 67). A lower incidence of GvHD was observed in patients with HLA class II MMs compared to patients with HLA class I MMs (P = 0.0166, HR = 1.94, n = 29). Finally, analysis of PIRCHE score (PS) impact revealed that patients with HLA class II PS > 10 in GvH direction showed higher incidence of GvHD compared to patients with HLA class II PS < 10 (P = 0.0073, HR = 2.01, n = 55). CONCLUSION Obtained results undisputedly indicate the necessity to further investigate this matter on a larger patient group, with focus on specific HLA alleles to define precisely priority criteria for selecting the best donor for all patients, thus improving the outcome of HSCT with an MMUD.
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Affiliation(s)
- Zorana Grubic
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Marija Maskalan
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Marija Burek Kamenaric
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Lana Desnica
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mirta Mikulic
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Katarina Stingl Jankovic
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Nadira Durakovic
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ranka Serventi Seiwerth
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Radovan Vrhovac
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Renata Zunec
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
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3
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Stenger W, Künkele A, Niemann M, Todorova K, Pruß A, Schulte JH, Eggert A, Oevermann L. Donor selection in a pediatric stem cell transplantation cohort using PIRCHE and HLA-DPB1 typing. Pediatr Blood Cancer 2020; 67:e28127. [PMID: 31850671 DOI: 10.1002/pbc.28127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/24/2019] [Accepted: 11/25/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND New strategies to optimize donor selection for hematopoietic stem cell transplantation (HSCT) have mainly been evaluated in adults, but the disease spectrum requiring HSCT differs significantly in children and has consequences for the risk of complications, such as graft-versus-host disease (GvHD). PROCEDURES Here we evaluated whether HLA-DPB1 and Predicted Indirectly ReCognizable HLA-Epitope (PIRCHE) matching can improve donor selection and minimize risks specific for a pediatric cohort undergoing HSCT in Berlin between 2014 and 2016. RESULTS The percentage of HLA-DPB1-mismatched HSCT in the pediatric cohort was in line with the general distribution among matched unrelated donor HSCT. Nonpermissive HLA-DPB1 mismatches were not associated with a higher incidence of GvHD, but the incidence of relapse was higher in patients undergoing HSCT from HLA-DPB1-matched transplantations. High PIRCHE-I scores were associated with a significantly higher risk for developing GvHD in patients undergoing HSCT from nine of ten matched unrelated donors. This finding persisted after including HLA-DPB1 into the PIRCHE analysis. CONCLUSIONS Implementing PIRCHE typing in the donor selection process for HSCT in children could particularly benefit children with nonmalignant diseases and support further validation of PIRCHE-based donor selection in a larger number of children treated at different sites.
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Affiliation(s)
- Wiebke Stenger
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Annette Künkele
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,German Cancer Consortium (DKTK), Berlin, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Kremena Todorova
- Center for Transfusion Medicine and Cell Therapies Berlin, Berlin, Germany
| | - Axel Pruß
- Center for Transfusion Medicine and Cell Therapies Berlin, Berlin, Germany
| | - Johannes H Schulte
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Cancer Consortium (DKTK), Berlin, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Angelika Eggert
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,German Cancer Consortium (DKTK), Berlin, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lena Oevermann
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,German Cancer Consortium (DKTK), Berlin, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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4
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Ayuk F, Bornhäuser M, Stelljes M, Zabelina T, Wagner EM, Schmid C, Christopeit M, Guellstorf M, Kröger N, Bethge W. Predicted Indirectly ReCognizable HLA Epitopes ( PIRCHE) Are Associated with Poorer Outcome after Single Mismatch Unrelated Donor Stem Cell Transplantation: A Study of the Cooperative Transplant Study Group (KTS) of the German Group for Bone Marrow and Stem Cell Transplantation (DAG-KBT). Transfus Med Hemother 2019; 46:370-375. [PMID: 31832062 DOI: 10.1159/000502389] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/21/2019] [Indexed: 11/19/2022] Open
Abstract
There is no established standard for selection of mismatched unrelated donors. Indirect recognition of HLA mismatches can be predicted using the model of "Predicted Indirectly ReCognizable HLA Epitopes" (PIRCHE). We performed a multicenter retrospective study evaluating the impact PIRCHE on outcome after allogeneic stem cell transplantation (allo-HSCT) from single mismatched (HLA 9/10 matched) unrelated donors. The study cohort included 424 adult recipients of HLA 9/10 matched unrelated donor transplants (9/10 MUD), treated for AML or MDS at 6 transplant centers across Germany. Detection of PIRCHE was associated with lower overall survival (OS) (47 vs. 57%, p = 0.04), higher non-relapse mortality (NRM) (32 vs. 20%, p = 0.05), and higher incidence of chronic graft-versus-host disease (GVHD) (49 vs. 31%, p = 0.04) at 2 years. Cumulative incidence of acute GVHD grade 2-4 at 6 months was not significantly different (30 vs. 23%, p = 0.2). OS for 9/10 MUD with no PIRCHE was similar to 10/10 MUD (57 vs. 55%). In multivariate analysis, PIRCHE retained negative impact on OS (RR 1.5, 95% CI 1.0-2.1, p = 0.03) and NRM (RR 1.7, 95% CI 1.0-2.9, p = 0.03). To the best of our knowledge, for the first time, we show the association of PIRCHE and survival outcome after allo-HSCT. The PIRCHE model, if validated in an independent cohort, may allow selection of permissible HLA mismatches that enable improved transplant outcome.
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Affiliation(s)
- Francis Ayuk
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - Matthias Stelljes
- Department of Medicine/Hematology and Oncology, University of Münster, Münster, Germany
| | - Tatjana Zabelina
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva-Maria Wagner
- Department of Internal Medicine III, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christoph Schmid
- Department of Haematology and Oncology, Klinikum Augsburg, University of Augsburg, Augsburg, Germany
| | - Maximilian Christopeit
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Guellstorf
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Bethge
- Hematology and Oncology, Medical Center, University of Tübingen, Tübingen, Germany
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5
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Geneugelijk K, Thus KA, van Deutekom HWM, Calis JJA, Borst E, Keşmir C, Oudshoorn M, van der Holt B, Meijer E, Zeerleder S, de Groot MR, von dem Borne PA, Schaap N, Cornelissen J, Kuball J, Spierings E. Exploratory Study of Predicted Indirectly ReCognizable HLA Epitopes in Mismatched Hematopoietic Cell Transplantations. Front Immunol 2019; 10:880. [PMID: 31068946 PMCID: PMC6491737 DOI: 10.3389/fimmu.2019.00880] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/05/2019] [Indexed: 12/31/2022] Open
Abstract
HLA-mismatches in hematopoietic stem-cell transplantation are associated with an impaired overall survival (OS). The aim of this study is to explore whether the Predicted Indirectly ReCognizable HLA-Epitopes (PIRCHE) algorithm can be used to identify HLA-mismatches that are related to an impaired transplant outcome. PIRCHE are computationally predicted peptides derived from the patient's mismatched-HLA molecules that can be presented by donor-patient shared HLA. We retrospectively scored PIRCHE numbers either presented on HLA class-I (PIRCHE-I) or class-II (PIRCHE-II) for a Dutch multicenter cohort of 103 patients who received a single HLA-mismatched (9/10) unrelated donor transplant in an early phase of their disease. These patients were divided into low and high PIRCHE-I and PIRCHE-II groups, based on their PIRCHE scores, and compared using multivariate statistical analysis methods. The high PIRCHE-II group had a significantly impaired OS compared to the low PIRCHE-II group and the 10/10 reference group (HR: 1.86, 95%-CI: 1.02–3.40; and HR: 2.65, 95%-CI: 1.53–4.60, respectively). Overall, PIRCHE-II seem to have a more prominent effect on OS than PIRCHE-I. This impaired OS is probably due to an increased risk for severe acute graft-vs.-host disease. These data suggest that high PIRCHE-II scores may be used to identify non-permissible HLA mismatches within single HLA-mismatched hematopoietic stem-cell transplantations.
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Affiliation(s)
- Kirsten Geneugelijk
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Kirsten A Thus
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Jorg J A Calis
- Department of Theoretical Biology and Bioinformatics, Utrecht University, Utrecht, Netherlands
| | - Eric Borst
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Can Keşmir
- Department of Theoretical Biology and Bioinformatics, Utrecht University, Utrecht, Netherlands
| | - Machteld Oudshoorn
- Matchis Foundation, Leiden, Netherlands.,Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, Netherlands
| | - Bronno van der Holt
- HOVON Data Center, Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Ellen Meijer
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, VU Medical Center, Amsterdam, Netherlands
| | - Sacha Zeerleder
- Department of Hematology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Marco R de Groot
- Department of Haematology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | | | - Nicolaas Schaap
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jan Cornelissen
- Department of Hematology, Erasmus Medical Center-Daniel Den Hoed Cancer Center, Rotterdam, Netherlands
| | - Jürgen Kuball
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands.,Department of Hematology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eric Spierings
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
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6
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Kramer C, Heidt S, Claas FHJ. Towards the identification of the relative immunogenicity of individual HLA antibody epitopes. Hum Immunol 2019; 80:218-20. [PMID: 30735757 DOI: 10.1016/j.humimm.2019.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 12/09/2018] [Accepted: 02/01/2019] [Indexed: 12/17/2022]
Abstract
Recent data suggest that HLA epitope matching is more predictive for the formation of donor specific antibodies (DSA) after transplantation than classical HLA antigen matching. A proper definition of the epitopes and their immunogenicity is crucial for a broad clinical application of epitope matching in solid organ transplantation. For that purpose, a novel epitope component was started during the 17th International Histocompatibility and Immunogenetics Workshop. Only a limited number of antibody data was available, resulting in a preliminary analysis confirming the potential relevance of epitope matching for the development of donor specific antibodies. During the actual workshop sessions the participants mainly discussed the future strategy to collect and analyze a large number of data in the framework of the 18th International Histocompatibility and Immunogenetics Workshop, which will take place in 2021. All practical issues can be found on the website www.ihiw18.org. Data collection will already start in early 2019 in order to have sufficient time for detailed analyses using several different algorithms.
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7
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D'Souza Y, Ferradji A, Saw C, Oualkacha K, Richard L, Popradi G, Sapir-Pichhadze R. Inaccuracies in epitope repertoire estimations when using Multi-Locus Allele-Level hla genotype imputation tools. HLA 2018; 92:33-39. [PMID: 29888504 DOI: 10.1111/tan.13307] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/04/2018] [Accepted: 06/07/2018] [Indexed: 02/28/2024]
Abstract
BACKGROUND Limited availability of allele-level HLA genotypes prompts their imputation from allele-group genotypes to estimate epitope mismatches. We evaluated the accuracy of epitope load and repertoire assignment when imputing allele-level HLA genotypes. METHODS Analyses were conducted on 175 hematopoietic stem cell (HSC) donors from the Héma-Québec registry (HQR) and 57 HSC donor-recipient pairs from McGill University Health Centre (MUHC), Québec, Canada, genotyped for HLA-A, -B, -C, -DRB1 and -DQB1. Multi-locus allele-level imputation was performed using HaploStats. Disagreement in B- and T-cell epitope assignment and epitope mismatches were ascertained for imputed vs. measured allele-level HLA genotypes in HSC donors and donor-recipient pairs, respectively. RESULTS Imputation resulted in no differences in overall eplet mismatches and PIRCHE-II for HLA-A, -B, and -C in 83.4% and 93.7% of HQR donors and 87.7% and 87.7% of MUHC donors, respectively. HLA-DRB1- and -DQB1-derived eplet mismatches and PIRCHE-II were correctly assigned in 72.0% and 85.1% of HQR donors and 70.2% and 71.9% of MUHC donors, respectively. No discrepancies in eplet load or PIRCHE-II were observed in 96.5% and 86.0% of HSC donor-recipient pairs and in 70.2% and 70.1% of pairs for HLA-A, -B and -C and -DRB1 and -DQB1, respectively. Kappa statistics of 0.9708 and 0.9725, 0.8724 and 0.8177, 0.9827 and 0.9022, 0.5644 and 0.4939, 0.5085 and 0.6361 were demonstrated when assessing agreement between eplet mismatches and PIRCHE-II of imputed vs. measured HLA-A, -B, -C, -DRB1 and -DQB1 types, respectively. CONCLUSIONS To avoid inaccuracies in epitope compatibility estimation, mainly for class II HLA, multi-locus allele-level genotype measurement is recommended. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Y D'Souza
- Research Institute, McGill University Health Centre, Montréal, Québec, Canada
| | - A Ferradji
- Research Institute, McGill University Health Centre, Montréal, Québec, Canada
| | - C Saw
- Histocompatibility Laboratory, Division of Hematology, Department of Medicine, McGill University, Montréal, Québec, Canada
| | - K Oualkacha
- Department of Mathematics, Université du Québec À Montréal, Montréal, Québec, Canada
| | - L Richard
- Héma-Québec, Saint-Laurent, Québec, Canada
| | - G Popradi
- Research Institute, McGill University Health Centre, Montréal, Québec, Canada
- Division of Hematology, Department of Medicine, McGill University, Montréal, Québec, Canada
| | - R Sapir-Pichhadze
- Research Institute, McGill University Health Centre, Montréal, Québec, Canada
- Division of Nephrology, Department of Medicine, McGill University, Montréal, Québec, Canada
- Centre for Outcomes Research and Evaluation (CORE), McGill University Health Centre, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
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8
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Geneugelijk K, Spierings E. Matching donor and recipient based on predicted indirectly recognizable human leucocyte antigen epitopes. Int J Immunogenet 2018; 45:41-53. [PMID: 29464898 DOI: 10.1111/iji.12359] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/21/2017] [Accepted: 02/01/2018] [Indexed: 12/27/2022]
Abstract
The predicted indirectly recognizable human leucocyte antigen (HLA) epitopes (PIRCHE) algorithm is a novel in silico algorithm to determine donor-recipient compatibility. The PIRCHE algorithm determines donor-recipient compatibility by counting the number of mismatched HLA-derived epitopes that are involved in indirect T-cell alloimmune responses; these epitopes are designated as PIRCHE. Over the last few years, the PIRCHE algorithm has been investigated in both hematopoietic stem cell transplantation and solid organ transplantation. This review describes the theory of the algorithm, its application in transplantation, and highlights the future perspectives on the clinical application of the PIRCHE algorithm.
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Affiliation(s)
- K Geneugelijk
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - E Spierings
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
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9
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Chaigne B, Geneugelijk K, Bédat B, Ahmed MA, Hönger G, De Seigneux S, Demuylder-Mischler S, Berney T, Spierings E, Ferrari-Lacraz S, Villard J. Immunogenicity of Anti-HLA Antibodies in Pancreas and Islet Transplantation. Cell Transplant 2018; 25:2041-2050. [PMID: 27196533 DOI: 10.3727/096368916x691673] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim of the current study was to characterize the anti-HLA antibodies before and after pancreatic islet or pancreas transplantation. We assessed the risk of anti-donor-specific antibody (DSA) sensitization in a single-center, retrospective clinical study at Geneva University Hospital. Data regarding clinical characteristics, graft outcome, HLA mismatch, donor HLA immunogenicity, and anti-HLA antibody characteristics were collected. Between January 2008 and July 2014, 18 patients received islet transplants, and 26 patients received a pancreas transplant. Eleven out of 18 patients (61.1%) in the islet group and 12 out of 26 patients (46.2%) in the pancreas group had anti-HLA antibodies. Six patients (33.3%) developed DSAs against HLA of the islets, and 10 patients (38.4%) developed DSAs against HLA of the pancreas. Most of the DSAs were at a low level. Several parameters such as gender, number of times cells were transplanted, HLA mismatch, eplet mismatch and PIRCHE-II numbers, rejection, and infection were analyzed. Only the number of PIRCHE-II was associated with the development of anti-HLA class II de novo DSAs. Overall, the development of de novo DSAs did not influence graft survival as estimated by insulin independence. Our results indicated that pretransplant DSAs at low levels do not restrict islet or pancreas transplantation [especially islet transplantation (27.8% vs. 15.4.%)]. De novo DSAs do occur at a similar rate in both pancreas and islet transplant recipients (mainly of class II), and the immunogenicity of donor HLA is a parameter that should be taken into consideration. When combined with an immunosuppressive regimen and close follow-up, development of low levels of DSAs was not found to result in reduced graft survival or graft function in the current study.
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Affiliation(s)
- Benjamin Chaigne
- Transplantation Immunology Unit, Service of Immunology and Allergy and Service of Laboratory Medicine, Geneva University Hospital and Medical School, Geneva, Switzerland
| | - Kirsten Geneugelijk
- Laboratory for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Benoît Bédat
- Service of Transplantation and Visceral Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
| | - Mohamed Alibashe Ahmed
- Service of Transplantation and Visceral Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
| | - Gideon Hönger
- Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | - Sophie De Seigneux
- Service of Nephrology, Geneva University Hospital and Medical School, Geneva, Switzerland
| | - Sandrine Demuylder-Mischler
- Service of Transplantation and Visceral Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
| | - Thierry Berney
- Service of Transplantation and Visceral Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland
| | - Eric Spierings
- Laboratory for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sylvie Ferrari-Lacraz
- Transplantation Immunology Unit, Service of Immunology and Allergy and Service of Laboratory Medicine, Geneva University Hospital and Medical School, Geneva, Switzerland
| | - Jean Villard
- Transplantation Immunology Unit, Service of Immunology and Allergy and Service of Laboratory Medicine, Geneva University Hospital and Medical School, Geneva, Switzerland
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10
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Huo MR, Li D, Chang YJ, Xu LP, Zhang XH, Liu KY, Huang XJ. Predicted indirectly recognizable HLA epitopes are not associated with clinical outcomes after haploidentical hematopoietic stem cell transplantation. Hum Immunol 2017; 79:117-121. [PMID: 29155367 DOI: 10.1016/j.humimm.2017.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 11/07/2017] [Accepted: 11/09/2017] [Indexed: 10/18/2022]
Abstract
Haploidentical stem cell transplantation (haplo-SCT) provides an alternative method to cure patients with malignant and nonmalignant hematologic diseases who lack a human leukocyte antigen (HLA) matched related or unrelated donor. HLA disparity between donor and patient was the main reason causing lots of clinical immune response. The aim of this study was to investigate whether indirect recognition of mismatched HLA could predict the clinical outcomes in haplo-SCT. The probability of indirect recognition was predicted by the Predicted Indirectly ReCognizable HLA Epitopes (PIRCHE) model. 577 patients with acute leukemia or myelodysplastic syndrome receiving haplo-SCT were enrolled in the study. Patients were divided into 4 quartiles according to PIRCHE-Ⅰ or PIRCHE-Ⅱ. Although the cumulative incidences of chronic graft-versus-host disease (GVHD) were significantly different among the 4 PIRCHE-Ⅰgroups, with 20.4% for group 0-6, 40.5% for group >6-11, 26.1% for group >11-19 and 23.9% for group >19 (P = .007), PIRCHE-Ⅰ was not significantly associated with chronic GVHD in multivariate models (RR, 0.993; 95% CI, 0.858-1.149; P = .926). And no significant associations were observed between PIRCHE-Ⅰ or PIRCHE-Ⅱ and other clinical outcomes. In summary, PIRCHE did not correlate with clinical outcomes and could not predict haplo-SCT outcomes.
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Affiliation(s)
- Ming-Rui Huo
- Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Dan Li
- Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Ying-Jun Chang
- Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Lan-Ping Xu
- Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Xiao-Hui Zhang
- Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Kai-Yan Liu
- Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China
| | - Xiao-Jun Huang
- Peking University People's Hospital & Peking University Institute of Hematology, Beijing, China; Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China; Peking-Tsinghua Center for Life Sciences, Beijing, China.
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11
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Thus KA, de Weger RA, de Hoop TA, Boers Trilles VE, Kuball J, Spierings E. Complete donor chimerism is a prerequisite for the effect of Predicted Indirectly ReCognizable HLA Epitopes ( PIRCHE) on acute graft-versus-host disease. Chimerism 2015; 5:94-8. [PMID: 26669207 DOI: 10.1080/19381956.2015.1097025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Predicted indirectly recognizable HLA epitopes (PIRCHE) computationally predict donor T-cell recognition of mismatched-HLA derived peptides following allogeneic haematopoietic stem-cell transplantation (allo-HSCT), as is evidenced by the correlation between presence of HLA-DPB1-derived PIRCHE and the occurrence of graft-vs.-host disease (GVHD). Complete donor T-cell chimerism associates with an increased GVHD risk compared to mixed patient and donor chimerism. If the correlation between the presence of PIRCHE and GVHD occurrence is indeed mediated by donor T cells, the presence of donor T cells should be required to observe such a correlation. This study was initiated to investigate whether the effect of PIRCHE is different in patients with complete chimerism compared to those with mixed chimerism. Indeed, the correlation between PIRCHE and GVHD is present in patients with complete chimerism, whereas it is absent in those with mixed chimerism. The data presented here suggest that chimerism status is important for the detection of potential GVHD epitopes.
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Affiliation(s)
- Kirsten A Thus
- a Laboratory of Translational Immunology; University Medical Center Utrecht ; Utrecht , the Netherlands
| | - Roel A de Weger
- b Department of Pathology ; University Medical Center Utrecht ; Utrecht , the Netherlands
| | - Talitha A de Hoop
- a Laboratory of Translational Immunology; University Medical Center Utrecht ; Utrecht , the Netherlands
| | - Valeria E Boers Trilles
- a Laboratory of Translational Immunology; University Medical Center Utrecht ; Utrecht , the Netherlands
| | - Jürgen Kuball
- a Laboratory of Translational Immunology; University Medical Center Utrecht ; Utrecht , the Netherlands.,c Department of Hematology ; University Medical Center Utrecht ; Utrecht , the Netherlands
| | - Eric Spierings
- a Laboratory of Translational Immunology; University Medical Center Utrecht ; Utrecht , the Netherlands
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Thus KA, de Hoop TA, de Weger RA, Bierings MB, Boelens JJ, Spierings E. Predicted Indirectly ReCognizable HLA Epitopes Class I Promote Antileukemia Responses after Cord Blood Transplantation: Indications for a Potential Novel Donor Selection Tool. Biol Blood Marrow Transplant 2015; 22:170-3. [PMID: 26319093 DOI: 10.1016/j.bbmt.2015.08.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 08/07/2015] [Indexed: 11/30/2022]
Abstract
Unrelated cord blood transplantation (UCBT) provides a curative therapy for patients with hematological malignancies. The effect of HLA mismatches in UCBT is currently the subject of debate. HLA-mismatched UCBT may lead to improved leukemia control but also to graft-versus-host disease (GVHD), resulting in nonrelapse mortality (NRM). The aim of this study was to investigate whether indirect recognition of mismatched HLA provides an explanation for the graft-versus-tumor effect and risk of GVHD. The probability of indirect recognition was predicted by the Predicted Indirectly ReCognizable HLA Epitopes (PIRCHE) model. The effect of the numbers of PIRCHE presented on HLA class I and II (PIRCHE-I and -II) was studied in 134 pediatric patients. To study the effects of higher numbers of PIRCHE, patients were divided in 2 equally sized groups, using the median number of PIRCHE as cutoff values. Proportional hazard models and competing risk analyses were performed to study the effect of PIRCHE on the clinical outcomes relapse, acute and chronic GVHD, NRM, and disease-free and overall survival. Above median PIRCHE-I were associated with reduced relapse risk (HR, .26; 95% CI, .07 to .94; P = .04), evaluating the 50 patients transplanted for a malignancy. Both PIRCHE-I and -II were not associated with other clinical outcomes, including GVHD and NRM. These data suggest that high PIRCHE-I may lead to improved graft-versus-tumor effects after UCBT, without an accompanying GVHD risk. Inclusion of PIRCHE in UCB selection criteria may enhance UCBT outcome, which needs to be tested in prospective studies.
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Affiliation(s)
- Kirsten A Thus
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Talitha A de Hoop
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Roel A de Weger
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marc B Bierings
- Pediatric Blood and Marrow Transplantation Program, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jaap Jan Boelens
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands; Pediatric Blood and Marrow Transplantation Program, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Eric Spierings
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.
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Geneugelijk K, Spierings E. Immunogenetic factors in the selection of cord blood units for transplantation: current search strategies and future perspectives. Cytotherapy 2015; 17:702-710. [PMID: 25770679 DOI: 10.1016/j.jcyt.2015.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 01/06/2023]
Abstract
Hematopoietic stem cell transplantation is currently used as a curative treatment for patients with malignant and non-malignant hematologic diseases. Human leukocyte antigen (HLA) matching is a major determinant for hematopoietic stem cell transplantation outcome. For patients lacking a fully HLA-matched donor, umbilical cord blood (UCB) units are alternative sources of hematopoietic stem cells because UCB transplantation allows a less stringent HLA matching. However, selection of the optimal UCB units remains challenging. The current UCB donor selection strategies are based on both cell dose and HLA matching. This Review focuses on the immunogenetic factors that influence UCB donor selection and highlights the future perspectives in UCB donor search.
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Affiliation(s)
- Kirsten Geneugelijk
- Laboratory of Translational Immunology, UMC Utrecht, Utrecht, The Netherlands
| | - Eric Spierings
- Laboratory of Translational Immunology, UMC Utrecht, Utrecht, The Netherlands.
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