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. 2021 Jan 22;10(3):422.
doi: 10.3390/jcm10030422.

Endothelin A Receptors Expressed in Glomeruli of Renal Transplant Patients May Be Associated with Antibody-Mediated Rejection

Katarzyna Nowańska  1 , Mirosław Banasik  1 , Piotr Donizy  2 , Katarzyna Kościelska-Kasprzak  3 , Sławomir Zmonarski  1 , Krzysztof Letachowicz  1 , Dorota Kamińska  1 , Oktawia Mazanowska  1 , Hanna Augustyniak-Bartosik  1 , Andrzej Tukiendorf  4 , Anna Chudiak  5 , Tomasz Dawiskiba  6 , Agnieszka Hałoń  2 , Magdalena Krajewska  1
Affiliations

Endothelin A Receptors Expressed in Glomeruli of Renal Transplant Patients May Be Associated with Antibody-Mediated Rejection

Katarzyna Nowańska et al. J Clin Med. .

Abstract

Background: Non-human leukocyte antigen (HLA) anti-endothelin A receptor antibodies are presented as being potentially important, but the expression of the endothelin A receptor in glomeruli (ETA receptor (g+)) has not yet been described. We decided to evaluate the presence and relevance of the ETA receptor in for-cause renal transplant biopsies. The aim of our study was to evaluate the immunoreactivity of the ETA receptor and its significance in patients who underwent a renal transplant biopsy due to the deterioration of transplant function, with detailed characterization of staining in glomeruli.

Methods: The immunohistochemical expression of ETA receptor (ETAR) was analyzed in renal transplant biopsies. Microscopic evaluation was performed on paraffin sections in glomeruli. The analysis was performed using a two-step scale (0: lack of ETAR expression; 1: the presence of ETAR expression-mild to moderate immunoreactivity).

Results: We analyzed 149 patients who underwent renal allograft biopsy after renal transplantation. Positive staining of ETA receptors in glomeruli (ETA receptor (g+)) was noticed in 13/149 (8.7%) patients. Five of these 13 (38.5%) patients with ETA receptor (g+) developed antibody-mediated rejection (AMR), while 13 of the remaining 136 (9.5%) ETA receptor (g-) patients developed AMR (p = 0.0022). Graft loss was noticed in all but one ETA receptor (g+) patient with AMR (4/5; 80%), but only in 2/13 (15%) ETA receptor (g-) patients with AMR (p = 0.009) during the first year after biopsy.

Conclusions: The expression of endothelin A receptors in glomeruli seems to be a potentially important feature in the diagnosis of damage during antibody-mediated rejection. It may help to identify patients at a higher risk of allograft rejection and injury.

Keywords: allograft injury; antibody-mediated rejection; endothelin A receptors; non-HLA antibodies.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Lack of endothelin A receptor (ETAR) expression in the tubular epithelium, glomeruli, and interstitium (200×, hematoxylin). (B) Mild to moderate expression of ETAR in glomeruli with mild to moderate reactivity in the tubular epithelium. Note the focal enhanced immunoreactivity of ETAR in the kidney interstitium (200×, hematoxylin). (C) Mild to moderate immunoreactivity in a glomerulus with high ETAR expression in the tubular epithelium (200×, hematoxylin).
See this image and copyright information in PMC

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