ArticleJournal of the American Society of Nephrology : JASN2019
Early Acute Microvascular Kidney Transplant Rejection in the Absence of Anti-HLA Antibodies Is Associated with Preformed IgG Antibodies against Diverse Glomerular Endothelial Cell Antigens.
Article in Journal of the American Society of Nephrology : JASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
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Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it, 108 citations in OpenAlex.
- Association between transplant glomerulopathy and graft outcomes following kidney transplantation: A meta-analysis.PloS one · 2020Pooled it
- Non-HLA Antibodies and Epitope Mismatches in Kidney Transplant Recipients With Histological Antibody-Mediated Rejection.Frontiers in immunology · 2021Trial
- Advances in HLA and Non-HLA Immune Profiling: Integrating Next-Generation Sequencing and Artificial Intelligence in Transplantation.Annals of laboratory medicine · 2026Review
- Dual inhibition of mTOR and calcineurin pathways mitigates missing self-induced NK cell-mediated microvascular rejection.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Anti-angiotensin II type 1 receptor autoantibodies of IgG3 subclass outperform total anti-AT1R IgG1-IgG4 levels in predicting transplanted kidney antibody-mediated rejection.Frontiers in immunology · 2026Article
- Antibody Polyreactivity: A Challenger of Immune Paradigms.Immunology · 2025Review
- Endothelial dysfunction in the kidney transplant population: Current evidence and management strategies.World journal of transplantation · 2025Review
- Impact of Immunosuppressive Drug Concentrations on Microvascular Inflammation, Negative Donor-Specific Antibodies, and C4d-Negative Status in Kidney Transplant Recipients.Clinical transplantation · 2025Article
- Angiotensin II type 1 receptor antibodies as a contributor to microvascular inflammation in kidney transplant recipients: insights from statistical and artificial intelligence based approaches.Frontiers in immunology · 2025Article
- Risk assessment of antibody-mediated damage based on the detection of HLA and non-HLA antibodies toward extracellular antigens before kidney transplantation.Frontiers in immunology · 2025Article
- Case Report: Failure of eculizumab to block complement to prevent relapse of anti-phospholipid syndrome in kidney transplant recipient.Frontiers in nephrology · 2025Article
- Comprehensive Characterization of Anti-HLA and Non-HLA Antibodies in Patients on Kidney Transplant Waiting List and Evaluation of Their Impact on Alloimmunization Risk and Dialysis Treatment.International journal of molecular sciences · 2024Article
- Natural killer cell-mediated innate microvascular rejection.Nature reviews. Nephrology · 2024Article
- Absence of IL-6 Receptor Blockade Effect on the Outcomes of Transplant Glomerulopathy in the Absence of Anti-HLA Donor-specific Antibodies.Transplantation direct · 2024Article
- Donor-derived cell-free DNA predicted allograft rejection and severe microvascular inflammation in kidney transplant recipients.Frontiers in immunology · 2024Observational
- Angiotensin II Type-1 Receptor Antibody in Solid Organ Transplantation - Is It Time to Test?Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
- Autoantibodies against DNA topoisomerase I promote renal allograft rejection by increasing alloreactive T cell responses.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2023Article
- Pathophysiology of Rejection in Kidney Transplantation.Journal of clinical medicine · 2023Review
- The Influence of Antibodies against Angiotensin II Type-1 Receptor on the Outcome of Kidney Transplantation: A Single-Center Retrospective Study.Journal of clinical medicine · 2023Article
- Prospective assessment of pre-existing andFrontiers in immunology · 2023Article
Corrections and comments
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Authors and funding
35 authors at 19 institutions in 4 countries.
Funding
Abstract
backgroundAlthough anti-HLA antibodies (Abs) cause most antibody-mediated rejections of renal allografts, non-anti-HLA Abs have also been postulated to contribute. A better understanding of such Abs in rejection is needed.
methodsWe conducted a nationwide study to identify kidney transplant recipients without anti-HLA donor-specific Abs who experienced acute graft dysfunction within 3 months after transplantation and showed evidence of microvascular injury, called acute microvascular rejection (AMVR). We developed a crossmatch assay to assess serum reactivity to human microvascular endothelial cells, and used a combination of transcriptomic and proteomic approaches to identify non-HLA Abs.
resultsWe identified a highly selected cohort of 38 patients with early acute AMVR. Biopsy specimens revealed intense microvascular inflammation and the presence of vasculitis (in 60.5%), interstitial hemorrhages (31.6%), or thrombotic microangiopathy (15.8%). Serum samples collected at the time of transplant showed that previously proposed anti-endothelial cell Abs-angiotensin type 1 receptor (AT1R), endothelin-1 type A and natural polyreactive Abs-did not increase significantly among patients with AMVR compared with a control group of stable kidney transplant recipients. However, 26% of the tested AMVR samples were positive for AT1R Abs when a threshold of 10 IU/ml was used. The crossmatch assay identified a common IgG response that was specifically directed against constitutively expressed antigens of microvascular glomerular cells in patients with AMVR. Transcriptomic and proteomic analyses identified new targets of non-HLA Abs, with little redundancy among individuals.
conclusionsOur findings indicate that preformed IgG Abs targeting non-HLA antigens expressed on glomerular endothelial cells are associated with early AMVR, and that
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