Immune Response to Kidney and Pancreas Self-Antigens Are Associated With Antibody Mediated Rejection in Simultaneous Kidney Pancreas Transplants
1Surgery, Washington Univ Sch of Med, St. Louis, MO
2Medicine, Washington Univ Sch of Med, St. Louis, MO.
Meeting: 2015 American Transplant Congress
Abstract number: A91
Keywords: Antibodies, Kidney/pancreas transplantation, Renal failure, Tissue-specific
Session Information
Session Name: Poster Session A: Kidney Antibody Mediated Rejection
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Background: Simultaneous kidney-pancreas transplantation (SKP Tx) is performed as treatment option for type-1 diabetes with end stage kidney diseases. Though allograft survival was improved with advanced surgical procedures and immune suppressive regimens, acute/chronic antibody (Ab) mediated rejection is a major risk factor for poor allograft function in SKP Tx. Goal of this study is to determine the role of immune responses to kidney (KSAg) and pancreas self-antigens (PSAg) in allograft rejection following SKP Tx.
Methods: Sera were collected from 30 SKP Tx recipients. Pre, post-transplant Abs to KSAgs (Collagen-IV (Col-IV), fibronectin (FN)) and PSAgs (insulin, islet cell, glutamic acid decarboxylase (GAD) and pancreatitis associated protein 1 (PAP-1) were measured by ELISA. Abs concentration was calculated using a standard curve from known concentrations of kidney and pancreas Abs. The sample was considered positive if the values above mean+2X standard deviation of healthy normal subjects. Antigen specific CD4+ T cells secreting cytokines were measured by ELISPOT.
Results: Biopsy-proven acute rejection episodes of the kidney and/or pancreas allografts occurred in 12/30 patients. 6/12 patients had combined kidney pancreas rejection, 2/12 had kidney-alone and 4/12 with pancreas-alone rejections. Pre, post-transplant serum Ab concentration of rejected groups was compared with 18 SPK Tx stable controls. Abs to KSAg and PSAg were significantly higher in post-transplant in SKP with rejection compared with stable controls. Elispot results showed increased frequency of IFNγ and IL-17 with reduction in IL-10 secreting cells in SKP Tx with rejection groups, while reduced IFNγ and IL-17 with increased in IL-10 secreting cells were observed in SKP Tx stable controls.
Abs | KP rejection (no=6) | Stable (no=18) | KP vs Stable (p-Value) |
---|---|---|---|
Col-IV | 108.66 | 69.41 | <0.011 |
FN | 129.47 | 94.16 | <0.021 |
K-alpha 1T | 153.11 | 79.4 | <0.017 |
PAP-1 | 71.49 | 37.54 | <0.020 |
GAD | 0.79 | 0.54 | <0.001 |
IAA | 1.15 | 0.58 | <0.020 |
ICA | 0.81 | 0.5 | <0.008 |
To cite this abstract in AMA style:
Gunasekaran M, Siddiq A, Shenoy S, Wellen J, Mohanakumar T. Immune Response to Kidney and Pancreas Self-Antigens Are Associated With Antibody Mediated Rejection in Simultaneous Kidney Pancreas Transplants [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/immune-response-to-kidney-and-pancreas-self-antigens-are-associated-with-antibody-mediated-rejection-in-simultaneous-kidney-pancreas-transplants/. Accessed October 3, 2024.« Back to 2015 American Transplant Congress