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Anti-Angiotensin II Type 1 Receptor and Anti-Endothelial Cell Antibodies: A Cross-Sectional Analysis of Pathological Findings in Allograft Biopsies.

Publication ,  Journal Article
Philogene, MC; Bagnasco, S; Kraus, ES; Montgomery, RA; Dragun, D; Leffell, MS; Zachary, AA; Jackson, AM
Published in: Transplantation
March 2017

BACKGROUND: This is a cross-sectional study designed to evaluate the histologic characteristics of graft injury in the presence of anti-angiotensin II type 1 receptor antibody (AT1R-Ab) and anti-endothelial cell antibody (AECA). METHODS: Non-HLA antibody testing was included in the posttransplant evaluation for 70 kidney recipients. Biopsies were performed for cause for 47 patients and as protocol for the remaining 23 patients. Biopsy-proven rejection was defined according to the Banff 2009-2013 criteria. AT1R-Ab was measured on an ELISA platform. Patients were divided into 3 groups based on AT1R-Ab levels (>17, 10-17, and <10 U/ml). AECA was evaluated using an endothelial cell crossmatch (ECXM) in patients whose HLA antibody level was insufficient to cause a positive flow cytometric crossmatch. RESULTS: AT1R-Ab levels were higher in patients diagnosed with antibody mediated rejection compared to those with no rejection (P = 0.004). Glomerulitis (g) and peritubular capillaritis (ptc) scores were independently correlated with increased AT1R-Ab concentrations in the presence or absence of HLA-DSA (P = 0.007 and 0.03 for g scores; p = 0.005 and 0.03 for ptc scores). Patients with a positive ECXM had higher AT1R-Ab levels compared to those with a negative ECXM (P = 0.005). Microcirculation inflammation (MCI = g + ptc score) was higher in patients with a positive ECXM and with AT1R-Ab >17 U/ml, although this did not reach statistical significance (P = 0.07). CONCLUSIONS: The data show an association between non-HLA antibodies detected in the ECXM and AT1R ELISA and microvascular injury observed in antibody mediated rejection.

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Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

March 2017

Volume

101

Issue

3

Start / End Page

608 / 615

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Receptor, Angiotensin, Type 1
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Kidney
  • Isoantibodies
  • Humans
  • Histocompatibility Testing
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Philogene, M. C., Bagnasco, S., Kraus, E. S., Montgomery, R. A., Dragun, D., Leffell, M. S., … Jackson, A. M. (2017). Anti-Angiotensin II Type 1 Receptor and Anti-Endothelial Cell Antibodies: A Cross-Sectional Analysis of Pathological Findings in Allograft Biopsies. Transplantation, 101(3), 608–615. https://doi.org/10.1097/TP.0000000000001231
Philogene, Mary Carmelle, Serena Bagnasco, Edward S. Kraus, Robert A. Montgomery, Duska Dragun, Mary S. Leffell, Andrea A. Zachary, and Annette M. Jackson. “Anti-Angiotensin II Type 1 Receptor and Anti-Endothelial Cell Antibodies: A Cross-Sectional Analysis of Pathological Findings in Allograft Biopsies.Transplantation 101, no. 3 (March 2017): 608–15. https://doi.org/10.1097/TP.0000000000001231.
Philogene MC, Bagnasco S, Kraus ES, Montgomery RA, Dragun D, Leffell MS, et al. Anti-Angiotensin II Type 1 Receptor and Anti-Endothelial Cell Antibodies: A Cross-Sectional Analysis of Pathological Findings in Allograft Biopsies. Transplantation. 2017 Mar;101(3):608–15.
Philogene, Mary Carmelle, et al. “Anti-Angiotensin II Type 1 Receptor and Anti-Endothelial Cell Antibodies: A Cross-Sectional Analysis of Pathological Findings in Allograft Biopsies.Transplantation, vol. 101, no. 3, Mar. 2017, pp. 608–15. Pubmed, doi:10.1097/TP.0000000000001231.
Philogene MC, Bagnasco S, Kraus ES, Montgomery RA, Dragun D, Leffell MS, Zachary AA, Jackson AM. Anti-Angiotensin II Type 1 Receptor and Anti-Endothelial Cell Antibodies: A Cross-Sectional Analysis of Pathological Findings in Allograft Biopsies. Transplantation. 2017 Mar;101(3):608–615.

Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

March 2017

Volume

101

Issue

3

Start / End Page

608 / 615

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Receptor, Angiotensin, Type 1
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Kidney
  • Isoantibodies
  • Humans
  • Histocompatibility Testing