PRE-TRANSPLANT IgG REACTIVITY TO APOPTOTIC CELLS CORRELATES WITH LATE KIDNEY ALLOGRAFT LOSS

摘要

It has been discovered that significantly elevated levels of anti-apoptotic cell IgG is an important contributor to and predictor of late graft rejection. Kaplan-Meier survival analysis revealed that patients with high pre-transplant IgG and post-transplant reactivity to apoptotic cells had a significantly increased rate of late graft loss that was apparent after approximately 1 year post-transplant. This association between pre-transplant IgG reactivity to apoptotic cells and graft loss was still significant after excluding patients with high reactivity to HLA, and it was almost exclusively mediated by IgG1 and IgG3 with complement fixing and activating properties. The association between elevated levels of anti-apoptotic cell IgG antibodies and late transplant rejection forms a basis for diagnosing and treating patients at high risk of late transplant rejection.

主权项

1. A method for predicting transplant rejection in a pre-transplant subject or a subject who has had a transplant,
(a) obtaining a biological sample from the subject and a biological sample from a group of healthy control subjects; (b) isolating IgG antibodies from the subject and from at least three control samples; (c) contacting a test population of apoptotic cells with the subject IgG antibodies and contacting at least three control populations of apoptotic cells with the IgG antibodies from each of the control samples, for a time and under conditions that permit the antibodies to bind to the apoptotic cells; and (d) determining the amount of binding of the IgG antibodies to apoptotic cells in the test population and in the control populations, and if the amount of IgG antibody binding in the test population is higher than the median value+2 standard deviation of three control specimens, then determining that the subject is at a high risk of transplant rejection.