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Association of donor-specific anti-MHC class I-related chain A (MICA) antibodies with renal allograft outcome

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Authors
이누리
Advisor
송은영
Major
의과대학 의학과
Issue Date
2018-02
Publisher
서울대학교 대학원
Keywords
anti-MHC class I-related chain A (MICA) antibodiesgraft rejectionrenal transplantation
Description
학위논문 (석사)-- 서울대학교 대학원 : 의과대학 의학과, 2018. 2. 송은영.
Abstract
Background. Association of anti-MHC class I-related chain A (MICA) with kidney allograft rejection was suggested. However, associations of donor-MICA specific antibodies (dsMICA) and strength of dsMICA with allograft outcome were not elucidated yet.
Methods. From November 2009 to June 2016, 125 remaining sera from renal transplantation recipients with no HLA antibody and biopsy-proven acute rejection (AR) (n = 13), AR + Interstitial Fibrosis and Tubular Atrophy (IFTA) (n = 13), IFTA only (n = 12), IFTA + borderline change (n = 15), borderline change only (n = 18) and normal biopsy (n = 54) were screened for MICA antibody. MICA antibody identification was performed with LABScreen MICA (One Lambda, USA) on sera with positive MICA screening. Patients with positive MICA screening with available residual donor DNA for MICA genotyping (n = 12) were also analyzed for dsMICA.
Results. Among 125 sera, 19 were positive for MICA antibody (15.2%). dsMICA was positive on 5 out of 12 sera analyzed (41.7%). Neither MICA antibodies nor dsMICA was associated with acute rejection (AR). However, IFTA was significantly associated with MICA positivity (OR = 3.84
95% CI = 1.34 – 9.98, P = 0.009). The MFI value of dsMICA was significantly higher in patients with IFTA II or III (n = 3, median ± SE, 21919.0 ± 2581.0) compared to patients without IFTA II or III (n = 9, median ± SE, 500.0 ± 155.8) (P = 0.009).
Conclusion. MICA was associated with IFTA in patients without HLA antibody. The association of strength of dsMICA with IFTA severity was suspected. MICA or dsMICA was not associated with acute rejection in patients without HLA antibody. The MICA antibody is useful as a predictor of chronic renal damage and as a useful indicator for future treatment strategy.
Language
English
URI
https://hdl.handle.net/10371/142315
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Theses (Master's Degree_의학과)
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