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Review
. 2022 Jun 25;10(7):1506.
doi: 10.3390/biomedicines10071506.

Non-HLA Antibodies in Kidney Transplantation: Immunity and Genetic Insights

Bogdan Marian Sorohan  1   2 , Cătălin Baston  1   2 , Dorina Tacu  2 , Cristina Bucșa  2 , Corina Țincu  2 , Paula Vizireanu  2 , Ioanel Sinescu  1   2 , Ileana Constantinescu  1   3
Affiliations
Review

Non-HLA Antibodies in Kidney Transplantation: Immunity and Genetic Insights

Bogdan Marian Sorohan et al. Biomedicines. .

Abstract

The polymorphic human leukocyte antigen (HLA) system has been considered the main target for alloimmunity, but the non-HLA antibodies and autoimmunity have gained importance in kidney transplantation (KT). Apart from the endothelial injury, secondary self-antigen exposure and the presence of polymorphic alloantigens, respectively, auto- and allo- non-HLA antibodies shared common steps in their development, such as: antigen recognition via indirect pathway by recipient antigen presenting cells, autoreactive T cell activation, autoreactive B cell activation, T helper 17 cell differentiation, loss of self-tolerance and epitope spreading phenomena. Both alloimmunity and autoimmunity play a synergic role in the formation of non-HLA antibodies, and the emergence of transcriptomics and genome-wide evaluation techniques has led to important progress in understanding the mechanistic features. Among them, non-HLA mismatches between donors and recipients provide valuable information regarding the role of genetics in non-HLA antibody immunity and development.

Keywords: AT1R; ETAR; antibodies; antigen; genetic; immunity; kidney transplant; mismatch; non-HLA.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms of non-HLA antibodies formation; FSGS–focal segmental glomerular sclerosis; BK–BK virus; HLA–human leukocyte antigen; DAMPs–damaging molecular patterns; APC–antigen presenting cell.
Figure 2
Figure 2
Intrarenal distribution of angiotensin II type I receptor (AT1R).
See this image and copyright information in PMC

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