Association Between Panel Reactive Antibody and Antiendothelial Cell Antibody Positivity in Kidney Transplant Patients

Abstract

Objectives: Endothelium is the major tissue for hyperacute and acute rejection. Binding of antibody to endothelium activates several immunologic mechanisms. Antiendothelial cell antibodies are a group of nonhuman leukocyte antigen antibodies that may play a role in the induction of an immunologic reaction that triggers inflammation. The aim of this study was to investigate whether there was an association between antiendothelial cell antibody positivity and panel reactive antibody positivity in renal transplant patients.

Materials and Methods: In this study, we investigated the association between antiendothelial cell antibodies and panel reactive antibody Class I class II crossmatch positivity in patients, and compared these results with results from 100 healthy volunteers. All serum samples were analyzed by bead-based technology for calculated panel reactive antibody positivity; in addition, slides were used, each containing human umbilical vein endothelial cells and capillary-rich tissue for antiendothelial cell antibody positivity.

Results: Antiendothelial cell antibodies was positive in 48 of 89 patients (panel reactive antibody Class I class II negative), 22 of 35 patients (class l-positive), 25 of 39 patients (class II-positive), 26 of 40 (class I-class II positive), and 37 of 57 serologic and flow cytometry crossmatch-positive patients (P <= .016), and ultimately, in 122 of 205 patients and 25 of 100 volunteers (P <= .001). Antiendothelial cell antibody positivity was more frequent in panel reactive antibody-positive than negative patients and the control group.

Conclusions: Binding of antiendothelial cell antibodies to endothelial cells may activate complement by the classical pathway and cause up-regulation of adhesion molecules. This study questioned the antigenic specificity of antiendothelial cell antibodies. Our study results showed that antiendothelial cell antibodies may play an important role for graft destruction, independent of panel reactive antibody and crossmatch positivity.