移植肾抗体介导的排斥反应:Banff诊断标准更新
|
摘要
近20年来对移植肾抗体介导的排斥反应(ABMR)认识逐渐深入。2001年和2007年的Banff会议,最早制订了急性和慢性活动性ABMR的诊断标准,由组织学(微血管炎症和移植肾肾小球病)、免疫病理(管周毛细血管C4d沉积)和血清学[循环中检出供者特异性抗体(DSA)]三方面的依据,构成ABMR的确定性诊断。Banff 2013诊断标准提出了较大更新,引入了C4d阴性的ABMR,并将动脉内膜炎列入ABMR可能的潜在表现,同时修订了肾小球炎和移植肾肾小球病的定义,从而提高了观察者之间的一致性,促进了临床、分子和血清学诊断的联系。Banff 2017会议,对诊断标准又有了更新,将C4d和分子分类器明确为DSA的替代性标志物。本文就近20年来ABMR Banff诊断标准的更新做一概述。
During the past two decades,there has developed an increasing awareness of antibody-mediated rejection(ABMR).The original Banff schema for diagnosis of acute and chronic active ABMR in renal allografts was formulated at the 2001 and 2007 Banff Conferences,and required histologic(microvascular inflammation and transplant glomerulopathy),immunohistologic(C4 d in peritubular capillaries),and serologic [circulating donor-specific antibodies(DSA)] evidence for a definitive diagnosis.This schema was updated at the 2013 Banff Conference,recognizing C4 d-negative ABMR,intimal arteritis as a potential manifestation of ABMR,and revising definitions and thresholds for glomerulitis and transplant glomerulopathy.At the 2017 Banff Conference,new modifications were made,accepting C4 d and thoroughly validated molecular classifiers as surrogate markers for DSA.
During the past two decades,there has developed an increasing awareness of antibody-mediated rejection(ABMR).The original Banff schema for diagnosis of acute and chronic active ABMR in renal allografts was formulated at the 2001 and 2007 Banff Conferences,and required histologic(microvascular inflammation and transplant glomerulopathy),immunohistologic(C4 d in peritubular capillaries),and serologic [circulating donor-specific antibodies(DSA)] evidence for a definitive diagnosis.This schema was updated at the 2013 Banff Conference,recognizing C4 d-negative ABMR,intimal arteritis as a potential manifestation of ABMR,and revising definitions and thresholds for glomerulitis and transplant glomerulopathy.At the 2017 Banff Conference,new modifications were made,accepting C4 d and thoroughly validated molecular classifiers as surrogate markers for DSA.
引文
1 Colvin RB.Antibody-mediated renal allograft rejection:diagnosis and pathogenesis.J Am Soc Nephrol,2007,18(4):1046-1056.
2 Einecke G,Sis B,Reeve J,et al.Antibody-mediated microcirculation injury is the major cause of late kidney transplant failure.Am J Transplant,2009,9(11):2520-2531.
3 United States Renal Data System(USRDS).USRDS 2012 annual data report:atlas of chronic kidney disease and endstage renal disease in the United States.Bethesda,MD:National Institutes of Health,National Institute of Diabetes and Digestive and Kidney Diseases;2012.
4 Jeannet M,Pinn VW,Russell PS,et al.Humoral antibodies in renal allotransplanta-tion in man.N Engl J Med,1970,282(3):111-117.
5 Terasaki PI,Ozawa M,Castro R.Four-year follow-up of a prospective trial of HLA and MICA antibodies on kidney graft survival.Am J Transplant,2007(2);7:408-415.
6 Worthington JE,Martin S,Al-Husseini DM,et al.Posttransplantation produc-tion of donor HLA-specific antibodies as a predictor of renal transplant outcome.Transplantation,2003,75(7):1034-1040.
7 Feucht HE,Felber E,Gokel MJ,et al.Vascular deposition of complement-split products in kidney allografts with cell-mediated rejection.Clin Exp Immunol,1991,86(3):464-470.
8 Halloran PF,Schlaut J,Solez K,et al.The significance of the anti-class I antibody response.II.Clinical and pathologic features of renal transplants with anti-class I-like antibody.Transplantation,1992,53(3):550-555.
9 Solez K,Colvin RB,Racusen LC,et al.Banff 07 classification of renal allograft pathology:updates and future directions.Am J Transplant,2008,8(4):753-760.
10 Sis B,Jhangri GS,Bunnag S,et al.Endothelial gene expression in kidney transplants with alloantibody indicates antibody-mediated damage despite lack of C4d staining.Am J Transplant,2009,9(10):2312-2323.
11 Haas M,Mirocha J.Early ultrastructural changes in renal allografts:correlation with antibody-mediated rejection and transplant glomerulopathy.Am J Transplant,2011,11(10):2123-2131.
12 Haas M,Sis B,Racusen LC,et al.Banff 2013 meeting report:inclusion of C4d-negative antibody-mediated rejection and antibody-associated arterial lesions.Am J Transplant,2014,14(2):272-283.
13 Haas M.The revised (2013) Banff classification for antibody-mediated rejection of renal allografts:update,difficulties,and future considerations.Am J Transplant,2016,16(5):1352-1357.
14 Loupy A,Haas M,Solez K,et al.The Banff 2015 kidney meeting report:current challenges in rejection classification and prospects for adopting molecular pathology.Am J Transplant,2017,17(1):28-41.
15 Aubert O,Loupy A,Hidalgo L,et al.Antibody-mediated rejection due to preexisting versus de novo donor-specific antibodies in kidney allograft recipients.J Am Soc Nephrol,2017,28(6):1912-1923.
16 Haas M,Mirocha J,Reinsmoen N,et al.Antibody-mediated rejection of renal allografts due to persistent/recurrent versus de novo donor-specific antibodies:comparison of pathologic features and graft outcomes.Kidney Int,2017,91(3):729-737.
17 DeSerres S,Noel R,Cote I,et al.2013 Banff criteria for chronic active antibody-mediated rejection:assessment in a real-life setting.Am J Transplant,2016,16(5):1516-1525.
18 Gupta A,O'Broin P,Bao Y,et al.Clinical and molecular significance of microvascular inflammation in transplant kidney biopsies.Kidney Int,2016,89(1):217-225.
19 Sellarés J,Reeve J,Loupy A,et al.Molecular diagnosis of antibody-mediated rejection in human kidney transplants.Am J Transplant,2013,13(4):971-983.
20 Haas M,Loupy A,Lefaucheur C,et al.The Banff 2017 kidney meeting report:revised diagnostic criteria for chronic active T cell-mediated rejection,antibody-mediated rejection,and prospects for integrative endpoints for next generation clinical trials.Am J Transplant,2018,18(2):293-307.
21 B?hmig GA,Exner M,Habicht A,et al.Capillary C4d deposition in kidney allografts:a specific marker of alloantibody-dependent graft injury.J Am Soc Nephrol,2002,13(4):1091-1099.
22 Haas M,Ratner LE,Montgomery RA.C4d staining of perioperative renal transplant biopsies.Transplantation,2002,74(5):711-717.
23 Gaston RS,Cecka JM,Kasiske BL,et al.Evidence for antibody-mediated injury as a major determinant of late kidney allograft failure.Transplantation,2010,90(1):68-74.
24 Lesage J,No?l R,Lapointe I,C?té I,et al.Donor-specific antibodies,C4d and their relationship with the prognosis of transplant glomerulopathy.Transplantation,2015,99(1):69-76.
25 Halloran PF,Reeve J,Akalin E,et al.Real time central assessment of kidney transplant indication biopsies by microarrays:the INTERCOMEX study.Am J Transplant,2017,17(11):2851-2862.
26 Loupy A,Lefaucheur C,Vernery D,et al.Molecular microscope strategy to improve risk stratification in early antibody-mediated kidney allograft rejection.J Am Soc Nephrol,2014,25(10):2267-2277.
27 Halloran PF,Venner JM,Famulski KS.Comprehensive analysis of transcript changes associated with allograft rejection:combining universal and selective features.Am J Transplant,2017,17(7):1754-1769.
28 Hidalgo LG,Sis B,Sellares J,et al.NK cell transcripts and NK cells in kidney biopsies from patients with donor-specific antibodies:evidence for NK cell involvement in antibody-mediated rejection.Am J Transplant,2010,10(8):1812-1822.
2 Einecke G,Sis B,Reeve J,et al.Antibody-mediated microcirculation injury is the major cause of late kidney transplant failure.Am J Transplant,2009,9(11):2520-2531.
3 United States Renal Data System(USRDS).USRDS 2012 annual data report:atlas of chronic kidney disease and endstage renal disease in the United States.Bethesda,MD:National Institutes of Health,National Institute of Diabetes and Digestive and Kidney Diseases;2012.
4 Jeannet M,Pinn VW,Russell PS,et al.Humoral antibodies in renal allotransplanta-tion in man.N Engl J Med,1970,282(3):111-117.
5 Terasaki PI,Ozawa M,Castro R.Four-year follow-up of a prospective trial of HLA and MICA antibodies on kidney graft survival.Am J Transplant,2007(2);7:408-415.
6 Worthington JE,Martin S,Al-Husseini DM,et al.Posttransplantation produc-tion of donor HLA-specific antibodies as a predictor of renal transplant outcome.Transplantation,2003,75(7):1034-1040.
7 Feucht HE,Felber E,Gokel MJ,et al.Vascular deposition of complement-split products in kidney allografts with cell-mediated rejection.Clin Exp Immunol,1991,86(3):464-470.
8 Halloran PF,Schlaut J,Solez K,et al.The significance of the anti-class I antibody response.II.Clinical and pathologic features of renal transplants with anti-class I-like antibody.Transplantation,1992,53(3):550-555.
9 Solez K,Colvin RB,Racusen LC,et al.Banff 07 classification of renal allograft pathology:updates and future directions.Am J Transplant,2008,8(4):753-760.
10 Sis B,Jhangri GS,Bunnag S,et al.Endothelial gene expression in kidney transplants with alloantibody indicates antibody-mediated damage despite lack of C4d staining.Am J Transplant,2009,9(10):2312-2323.
11 Haas M,Mirocha J.Early ultrastructural changes in renal allografts:correlation with antibody-mediated rejection and transplant glomerulopathy.Am J Transplant,2011,11(10):2123-2131.
12 Haas M,Sis B,Racusen LC,et al.Banff 2013 meeting report:inclusion of C4d-negative antibody-mediated rejection and antibody-associated arterial lesions.Am J Transplant,2014,14(2):272-283.
13 Haas M.The revised (2013) Banff classification for antibody-mediated rejection of renal allografts:update,difficulties,and future considerations.Am J Transplant,2016,16(5):1352-1357.
14 Loupy A,Haas M,Solez K,et al.The Banff 2015 kidney meeting report:current challenges in rejection classification and prospects for adopting molecular pathology.Am J Transplant,2017,17(1):28-41.
15 Aubert O,Loupy A,Hidalgo L,et al.Antibody-mediated rejection due to preexisting versus de novo donor-specific antibodies in kidney allograft recipients.J Am Soc Nephrol,2017,28(6):1912-1923.
16 Haas M,Mirocha J,Reinsmoen N,et al.Antibody-mediated rejection of renal allografts due to persistent/recurrent versus de novo donor-specific antibodies:comparison of pathologic features and graft outcomes.Kidney Int,2017,91(3):729-737.
17 DeSerres S,Noel R,Cote I,et al.2013 Banff criteria for chronic active antibody-mediated rejection:assessment in a real-life setting.Am J Transplant,2016,16(5):1516-1525.
18 Gupta A,O'Broin P,Bao Y,et al.Clinical and molecular significance of microvascular inflammation in transplant kidney biopsies.Kidney Int,2016,89(1):217-225.
19 Sellarés J,Reeve J,Loupy A,et al.Molecular diagnosis of antibody-mediated rejection in human kidney transplants.Am J Transplant,2013,13(4):971-983.
20 Haas M,Loupy A,Lefaucheur C,et al.The Banff 2017 kidney meeting report:revised diagnostic criteria for chronic active T cell-mediated rejection,antibody-mediated rejection,and prospects for integrative endpoints for next generation clinical trials.Am J Transplant,2018,18(2):293-307.
21 B?hmig GA,Exner M,Habicht A,et al.Capillary C4d deposition in kidney allografts:a specific marker of alloantibody-dependent graft injury.J Am Soc Nephrol,2002,13(4):1091-1099.
22 Haas M,Ratner LE,Montgomery RA.C4d staining of perioperative renal transplant biopsies.Transplantation,2002,74(5):711-717.
23 Gaston RS,Cecka JM,Kasiske BL,et al.Evidence for antibody-mediated injury as a major determinant of late kidney allograft failure.Transplantation,2010,90(1):68-74.
24 Lesage J,No?l R,Lapointe I,C?té I,et al.Donor-specific antibodies,C4d and their relationship with the prognosis of transplant glomerulopathy.Transplantation,2015,99(1):69-76.
25 Halloran PF,Reeve J,Akalin E,et al.Real time central assessment of kidney transplant indication biopsies by microarrays:the INTERCOMEX study.Am J Transplant,2017,17(11):2851-2862.
26 Loupy A,Lefaucheur C,Vernery D,et al.Molecular microscope strategy to improve risk stratification in early antibody-mediated kidney allograft rejection.J Am Soc Nephrol,2014,25(10):2267-2277.
27 Halloran PF,Venner JM,Famulski KS.Comprehensive analysis of transcript changes associated with allograft rejection:combining universal and selective features.Am J Transplant,2017,17(7):1754-1769.
28 Hidalgo LG,Sis B,Sellares J,et al.NK cell transcripts and NK cells in kidney biopsies from patients with donor-specific antibodies:evidence for NK cell involvement in antibody-mediated rejection.Am J Transplant,2010,10(8):1812-1822.