62-P: HLA-DQ C1q BINDING DONOR SPECIFIC ANTIBODY (qDSA) ASSOCIATED WITH THE DEVELOPMENT OF CARDIAC ALLOGRAFT VASCULOPATHY (CAV)

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• 作者：Chih-Hung Lai¹ ; Nancy L. Reinsmoen¹ ; Robin Masukawa¹ ; Geraldine Ong¹ ; Qi Wang¹ ; Mehrnoush Naim¹ ; Matthew Rafiei² ; Lily Stern² ; Jon A. Kobashigawa²
• 刊名：Human Immunology
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：73
• 期：supp_S
• 页码：88
• 全文大小：103 K

文摘

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Aim

After the first year of heart transplant (TX), CAV is the second most common cause of death, with malignancy being more common. Early detection of the CAV process may allow for therapeutic intervention aimed at interrupting or preventing the disease progression. This study is to determine if qDSA and Luminex single antigen (LSA) binding patterns can predict CAV diagnosis.

Methods

LABScreen^? single antigen and C1qScreen? kits (One Lambda, CanogaPark) were used for detecting HLA antibodies and qDSA.

Results

Sera from 9 patients (pts) with strong binding DSA (>10K MFI) post-TX were tested for C1q binding. 9 of 9 had anti-DQ DSA and of these 4 of 9 DQ antibodies bound C1q. CAV was diagnosed for 5 of 9 pts with HLA-DQ qDSA. The post-TX antibody profiles showed the average time to peak DQ DSA was 1,796 days. The average time to CAV diagnosis was 1,645 days. Fig. 1a shows the post-TX DSA profile for one of these pts. The DSAs DQ7, DQ8 and DR53 were detected at the time of AMR, peaked at day 1,074, decreased at day 1,239, and increased again at day 1,617. Fig. 1b shows the comparison of neat (L-IgG), 1:8 dilution (L-1:8) and C1q (L-C1q) at day 1,617 sample. At the 1:8 dilution, the pt¡¯s DSA DR51, DR53, DQ7 and DQ8 reached about the same MFI levels as undiluted sample. C1q test showed the same strong binding HLA specificities as the 1:8 dilution test. The anti-HLA-DQ DSA was detected 4 years prior to the diagnosis of CAV.