BLyS neutralization results in selective anti-HLA alloantibody depletion without successful desensitization.
Transpl Immunol
; 69: 101465, 2021 12.
Article
em En
| MEDLINE
| ID: mdl-34506905
ABSTRACT
Pre-existing anti-HLA allo-antibodies (allo-Abs) are a major barrier to successful kidney transplantation, resulting in an elevated risk for antibody-mediated rejection (AMR) and eventual graft loss. The cytokine B lymphocyte stimulator (BLyS) promotes B cell maturation and plasma cell survival; consequently, anti-BLyS therapy represents a potential therapeutic opportunity in diminishing pre-existing allo-Abs. Here we report that in our 1-year pilot trial, BLyS neutralization failed to reduce total anti-HLA allo-Ab levels in highly sensitized candidates awaiting kidney transplant in a clinically meaningful way. Additionally, we performed a post hoc analysis using sera from trial candidates which revealed selective depletion of anti-HLA class I and class II Abs in response to belimumab treatment, restricted to certain allele specificities and IgG subclasses. Altogether, we observed that BLyS blockade only results in selective depletion of anti-HLA Abs recognizing a few discrete HLA allele specificities.
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Base de dados:
MEDLINE
Assunto principal:
Transplante de Rim
/
Fator Ativador de Células B
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article