Human leukocyte antigen-G expression after kidney transplantation is associated with a reduced incidence of rejection

Abstract HLA-G is a non-classic Human Leukocyte Antigen (HLA-G) Class I of low polymorphism and restricted tissue distribution that displays tolerogenic functions. In heart transplantation and in combined liver/renal allograft transplantation, the expression of HLA-G has been associated with a lower...

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Published in:	Transplant immunology Vol. 18; no. 4; pp. 361 - 367
Main Authors:	Crispim, J.C.O, Duarte, R.A, Soares, C.P, Costa, R, Silva, J.S, Mendes-Júnior, C.T, Wastowski, I.J, Faggioni, L.P, Saber, L.T, Donadi, E.A
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 01-02-2008
Subjects:	Adolescent Adult Aged Allergy and Immunology Cross-Sectional Studies Female Graft Rejection - blood Graft Rejection - epidemiology Graft Rejection - immunology Graft Rejection - prevention & control Histocompatibility Antigens Class I - biosynthesis Histocompatibility Antigens Class I - blood Histocompatibility Antigens Class I - genetics HLA Antigens - biosynthesis HLA Antigens - blood HLA Antigens - genetics HLA-G HLA-G Antigens Humans Incidence kidney allograft Kidney Transplantation - immunology Male Middle Aged Prospective Studies Rejection Rejection kidney allograft HLA-G
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Summary:	Abstract HLA-G is a non-classic Human Leukocyte Antigen (HLA-G) Class I of low polymorphism and restricted tissue distribution that displays tolerogenic functions. In heart transplantation and in combined liver/renal allograft transplantation, the expression of HLA-G has been associated with a lower incidence of acute graft rejection episodes and absence of chronic dysfunction. Since the expression of HLA-G in renal biopsies has been investigated only in few patients who received a combined kidney and liver transplant, in this study we performed a cross-sectional study, systematically comparing the expression of HLA-G in post-transplanted renal grafts, stratifying patients according to the presence or absence of rejection. Patients and Methods Seventy-three renal specimens (10 with acute rejection and 13 with chronic allograft nephropathy, and 50 with no signs of rejection) were immunohistochemically evaluated for HLA-G expression. Results In the group as a whole, HLA-G molecules were detected in 40 cases (54.8%). Among specimens that presented HLA-G expression, 2 out of 40 (5%) exhibited acute rejection, 2 (5%) exhibited chronic allograft nephropathy, and the remaining 36 (90%) exhibited no signs of rejection. The comparison between patients with rejection and those without rejection showed that the expression of HLA-G was significantly increased in specimens exhibiting no signs of rejection ( p < 0.0001). Considering only patients with acute rejection, 8 out of 10 patients showed no HLA-G expression in their kidney biopsies when compared to patients exhibiting no signs of rejection and absence of HLA-G was observed in 14 out of 50 (p = 0.0032). Similarly, considering only patients with chronic allograft nephropathy, absence of HLA-G expression was observed in 11 out of 13 specimens, whereas in patients without rejection absence of HLA-G was observed in 14 out of 50 ( p = 0.003). Therapy with tacrolimus was significantly associated with the expression of HLA-G and a better graft prognosis. Conclusions Our results suggest that HLA-G expression in the kidney allograft and the use of tacrolimus are associated with a lower frequency of acute renal rejection and chronic allograft nephropathy.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0966-3274 1878-5492
DOI:	10.1016/j.trim.2007.10.010