Use of specific anti-HLA antibodies in clinical nephrology

Abstract

In order to optimize the regimen of pathogenetic therapy of glomerulonephritis with nephrotic syndrome we used transfusions of plasma containing specific anti-HLA antibodies against the patient's phenotype as a part of the treatment in the acute stages of disease. The method was theoretically based on the conception of autoimmune genesis of glomerular lesion as well as on the assumption that the highest expression of HLA-antigens are on the surface of activated immunocompetent cells. In previous experiments in vitro we demonstrated immunosuppressive activity of cytotoxic serum on lymphocytes in the absence of complement. Stable remission that was associated with the recovery of serum IgG/IgM balance and normalization of cellular immunity indices was achieved in 72% of 50 treated patients after 2-4 transfusions. Immunotherapeutic properties of anti-HLA antibodies were also confirmed with preliminary results of plasma transfusions in 5 kidney graft recipients. Posttransfusion reactions of a non-haemolytic type were slight and transient. The data presented allow us to conclude that our method may be useful in clinical cases associated with undesirable immune activation induced by both auto- and alloantigens.