PMID- 25095537
OWN - NLM
STAT- MEDLINE
DCOM- 20140909
LR  - 20140806
IS  - 0890-9016 (Print)
IS  - 0890-9016 (Linking)
DP  - 2013
TI  - Immunoglobulin G subclass analysis of HLA donor specific antibodies in heart and 
      renal transplant recipients.
PG  - 413-22
AB  - Immunoglobulin G (IgG) subclasses IgG1 (G1) and lgG3 (G3) can induce complement 
      dependent cytotoxicity (CDC) and bind to Fc receptors (FcR), which induces 
      phagocytosis and antibody dependent cellular cytotoxicity. In contrast, IgG2 has 
      low CDC activity, lgG4 (G4) has no CDC activity, and neither binds high affinity 
      FcR. Seven transplant recipients were analyzed for G1- G4 human leukocyte antigen 
      (HLA) donor-specific antibodies (DSAs); six had active rejection and one had 
      stable function. Patients with rejection had equal numbers of DSAs, which were G1 
      and G3, but no G4. The predominant DSAs were directed against HLA Class II 
      proteins. Even with successful anti-rejection therapy, DSA persisted, albeit in 
      several instances with lowered levels. Our findings are consistent with the 
      presence of CDC-inducing G1 and G3 subclass DSAs during rejection. One heart 
      transplant recipient followed for over 42 months had consistent, continuous G4 
      HLA DSA and stable function. We hypothesize that the presence of G4 DSA in the 
      heart transplant recipient is akin to the allergen specific G4 that has been 
      found in allergic desensitization tolerance, controlled by regulatory T-cells, 
      and that manipulating G4 class switching through HLA antigen desensitzation could 
      produce a tolerant state.
FAU - Cicciarelli, James C
AU  - Cicciarelli JC
FAU - Kasahara, Noriyuki
AU  - Kasahara N
FAU - Lemp, Nathan A
AU  - Lemp NA
FAU - Adamson, Robert
AU  - Adamson R
FAU - Dembitsky, Walter
AU  - Dembitsky W
FAU - Browne, Barry
AU  - Browne B
FAU - Steinberg, Steven
AU  - Steinberg S
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Clin Transpl
JT  - Clinical transplants
JID - 8812419
RN  - 0 (HLA Antigens)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Antibody Specificity
MH  - Female
MH  - Graft Rejection/epidemiology/*immunology
MH  - Graft Survival/immunology
MH  - HLA Antigens/*immunology
MH  - Heart Transplantation/*adverse effects
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunoglobulin Class Switching/immunology
MH  - Immunoglobulin G/blood/*immunology
MH  - Isoantibodies/blood/*immunology
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Risk Factors
MH  - Seroepidemiologic Studies
MH  - Tissue Donors
EDAT- 2013/01/01 00:00
MHDA- 2014/09/10 06:00
CRDT- 2014/08/07 06:00
PHST- 2014/08/07 06:00 [entrez]
PHST- 2013/01/01 00:00 [pubmed]
PHST- 2014/09/10 06:00 [medline]
PST - ppublish
SO  - Clin Transpl. 2013:413-22.