Publications (2)7.03 Total impact
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Article: Anti-idiotypic antibodies specific for HLA in heart and kidney allograft recipients
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ABSTRACT: Chronic rejection is the major threat to both heart and renal allograft survival. We have explored the possibility that some patients with anti-donor HLA antibodies (Ab1) develop specific anti-idiotypic antibodies (Ab2) which suppress the production of Ab1, and subsequently, the progression of chronic rejection. analysis of Ab2 in sera obtained from Ab1 producers showed that 22% of heart and 18% of kidney recipients produced Ab2. The 4- and 5-year actuarial graft survivals in Ab2 producers were 100% and 83%, respectively, compared to 57% in patients who formed Ab1 but not Ab2 (p<0.004). Patients carrying the DR2 alleles, DRB1*1501,*1502 or*1601 were at a lower risk of producing anti-donor HLA antibodies.Immunologic Research 04/1993; 12(1):1-11. · 3.03 Impact Factor -
Article: Soluble Hla Antigens, Anti-Hla Antibodies, and Antiidiotypic Antibodies in the Circulation of Renal Transplant Recipients
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ABSTRACT: Chronic rejection represents the major threat to long-term survival of organ allografts. It is presumed that this form of rejection is mediated by antibodies against mismatched HLA antigens of the graft. The presence and specificity of anti-HLA-antibodies in posttransplantation sera are, however, difficult to document. We have explored the possibility that anti-HLA antibodies form immune complexes with soluble HLA antigens released from the injured graft and/or that they are blocked by antiidiotypic, anti-anti-HLA-antibodies. Our data demonstrate that the long-term survival of renal allografts is significantly lower in patients who develop anti-HLA-antibodies following transplantation than in patients who do not form antibodies. Following depletion of soluble HLA antigens by magnetic immunoaffinity, we could identify anti-HLA-antibodies in 57% of the sera obtained from patients undergoing chronic rejection of kidney allografts, comared with 41% prior to antigen depletion. In patients tolerating the grafts for 4 years or more, the corresponding frequencies of antibody-positive sear was 2% and 5% prior and following depletion of HLA antigens. The presence of HLA-antibody immune complexes in patients' sear was positively associated with chronic humoral rejection (P < 0.0001). Patients who tolrated the graft in spite of having developed antibodies against one of its mismatched HLA antigens show specific antiidiotypic (anit-anit-HLA-antibodies). Such antiidiotypic antibodies were not found in sear from patients with chronic rejection (P = 0.005). This indicates that anitiidiotypic antibodies may delay the progression of chronic humoral rejection. (C) Williams & Wilkins 1991. All Rights Reserved.Transplantation 02/1991; 51(3). · 4.00 Impact Factor
