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Pathogenesis of non-HLA antibodies in solid organ transplantation: Where do we stand?

Abstract : Antibody-mediated rejection (ABMR) is associated with poor transplant outcome. Pathogenic alloantibodies are usually directed against human leukocyte antigens (HLAs). Histological findings suggestive of ABMR usually demonstrate an anti-HLA donor-specific antibody (DSA)-mediated injury, while a small subset of patients develop acute dysfunction with histological lesions suggestive of ABMR in the absence of anti-HLA DSAs. Although this non-HLA ABMR is not well recognized by current diagnostic classifications,itisassociated withgraftdysfunctionandallograft loss. These clinicaldescriptions suggest apathogenic role for non-HLA anti-endothelial cell antibodies. Diverse antigenic targets have been described during the last decade. This review discusses recent findings in the field and addresses the clinical relevance of anti-endothelial cell antibodies (AECAs).
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Marianne Delville, Béatrice Charreau, Marion Rabant, Christophe Legendre, Dany Anglicheau. Pathogenesis of non-HLA antibodies in solid organ transplantation: Where do we stand?. Human Immunology, Elsevier, 2016, 77 (11), pp.1055-1062. ⟨10.1016/j.humimm.2016.05.021⟩. ⟨inserm-02150119⟩



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