PMID- 23622661
OWN - NLM
STAT- MEDLINE
DCOM- 20131028
LR  - 20130429
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 45
IP  - 3
DP  - 2013 Apr
TI  - Case report: binding of a clinically relevant human leukocyte 
      antigen-DQalpha-specific antibody in a kidney graft recipient is inhibited by 
      donor-type human leukocyte antigen-DQbeta chain.
PG  - 1209-12
LID - S0041-1345(12)01182-7 [pii]
LID - 10.1016/j.transproceed.2012.10.006 [doi]
AB  - In this case report, we have found what may be an immunization with 
      donor-specific human leukocyte antigen (HLA)-DQalpha in combination with 
      recipient-specific HLA-DQbeta. A renal allograft recipient who did not comply with 
      immunosuppressive therapy during pregnancy had graft failure 23 months 
      posttransplantation with biopsy-proven humoral and cellular rejection. Sera were 
      tested in a Luminex-based single-antigen bead assay. We compared Luminex 
      reactivity with the degree of eplet mismatching between the recipient's own 
      HLA-DQ chains and the HLA-DQ chains bound to the Luminex beads. Eplet 
      calculations were done with the HLAMatchmaker. HLA-DQ similarities were compared 
      further by dissimilarity scoring in HistoCheck. We observed that Luminex beads 
      with donor-type HLA-DQalpha and HLA-DQbeta bound less antibody than beads with 
      donor-type HLA-DQalpha combined with recipient HLA-DQbeta. In HLAMatchmaker, we 
      identified all eplet mismatches between donor and recipient HLA-DQ. Next, we 
      counted how many of these eplets were represented on the various Luminex beads. 
      We found that antibody binding to the bead increased with the number of such 
      mismatches for HLA-DQalpha. Surprisingly, antibody binding decreased as the number of 
      eplet mismatches for HLA-DQbeta increased, from a mean fluorescence intensity (MFI) 
      value of 18,800 for no mismatched eplets to approximately 10,000 for 12 
      mismatched eplets. These findings were confirmed by comparing antibody binding 
      with the structural dissimilarity score between the recipient HLA-DQ type and the 
      HLA-DQ bound to the Luminex beads. In this patient, clinically relevant 
      antibodies bound strongly to donor-like HLA-DQalpha chains when combined with 
      recipient-like HLA-DQbeta. HLA-DQbeta chains more similar to those of the donor reduced 
      the binding of donor- specific HLA-DQalpha antibody.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - Mikkelsen, S
AU  - Mikkelsen S
AD  - Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark. 
      susanmikkelsen@live.dk
FAU - Korsholm, T
AU  - Korsholm T
FAU - Iburg, A
AU  - Iburg A
FAU - Petersen, M S
AU  - Petersen MS
FAU - Moller, B K
AU  - Moller BK
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Autoantibodies)
RN  - 0 (HLA-DQ alpha-Chains)
RN  - 0 (HLA-DQ beta-Chains)
RN  - 0 (HLA-DQA1 antigen)
RN  - 0 (HLA-DQbeta antigen)
SB  - IM
MH  - Adult
MH  - Autoantibodies/*immunology
MH  - Female
MH  - HLA-DQ alpha-Chains/*immunology
MH  - HLA-DQ beta-Chains/*immunology
MH  - Humans
MH  - Kidney Transplantation/*immunology
MH  - *Tissue Donors
EDAT- 2013/04/30 06:00
MHDA- 2013/10/29 06:00
CRDT- 2013/04/30 06:00
PHST- 2013/04/30 06:00 [entrez]
PHST- 2013/04/30 06:00 [pubmed]
PHST- 2013/10/29 06:00 [medline]
AID - S0041-1345(12)01182-7 [pii]
AID - 10.1016/j.transproceed.2012.10.006 [doi]
PST - ppublish
SO  - Transplant Proc. 2013 Apr;45(3):1209-12. doi: 10.1016/j.transproceed.2012.10.006.