Chronic humoral rejection mediated by anti-HLA-DP alloantibodies: Insights into the role of epitope sharing in donor-specific and non-donor specific alloantibodies generation

• Published in: Transplant immunology Vol. 20; no. 4; pp. 209 - 211
• Main Authors: Thaunat, Olivier, Hanf, William, Dubois, Valérie, McGregor, Brigitte, Perrat, Gisèle, Chauvet, Cécile, Touraine, Jean-Louis, Morelon, Emmanuel
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2009; Elsevier
• Subjects: Adult; Allergy and Immunology; Alloantibodies; Anemia, Hemolytic; Anti-Glomerular Basement Membrane Disease - immunology; Anti-Glomerular Basement Membrane Disease - pathology; Anti-Glomerular Basement Membrane Disease - physiopathology; Anti-Glomerular Basement Membrane Disease - therapy; Antibody Formation; Antibody-Dependent Cell Cytotoxicity; Chronic antibody-mediated rejection; Epitopes; Female; Graft Rejection - immunology; Graft Rejection - pathology; HLA-DP; HLA-DP Antigens - immunology; Humans; Immunodominant Epitopes; Immunologic Memory; Isoantibodies - immunology; Isoantibodies - metabolism; Kidney Transplantation; Life Sciences; Non-donor specific antibodies; Pregnancy; Renal Insufficiency - immunology; Renal Insufficiency - pathology; Renal Insufficiency - therapy; Sequence Homology; Alloantibodies; Chronic antibody-mediated rejection; HLA-DP; Non-donor specific antibodies
• ISSN: 0966-3274; 1878-5492
• DOI: 10.1016/j.trim.2008.12.006

Abstract We report the case of a renal transplanted patient, in whom the detection of a unique anti HLA-DP antibody response preceded the development of chronic humoral rejection. In addition to donor-specific anti-DP alloantibodies, the patient displayed reactions against several non-donor-specific DP antigens (NDSA). Interestingly, we found that all the DP molecules recognized by the alloantibodies displayed the same amino-acid sequence suggesting that epitope sharing between unrelated HLA molecules was the mechanism underlying NDSA generation. This case highlights the pathogenicity of anti-DP alloantibodies and suggests that it could be more meaningful to match the epitopes than the HLA antigens for the prevention of rejection.