BAFF and BAFF‐R Levels Are Associated With Risk of Long‐Term Kidney Graft Dysfunction and Development of Donor‐Specific Antibodies

• Published in: American journal of transplantation Vol. 12; no. 10; pp. 2754 - 2762
• Main Authors: Thibault‐Espitia, A., Foucher, Y., Danger, R., Migone, T., Pallier, A., Castagnet, S., G.‐Gueguen, C., Devys, A., C.‐Gautier, A., Giral, M., Soulillou, J.‐P., Brouard, S.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-10-2012; Wiley; Elsevier Limited
• Subjects: Antibody Formation; B-Cell Activating Factor - metabolism; B-Cell Activation Factor Receptor - metabolism; Biological and medical sciences; Dysfunction; Female; human; Humans; immunology; kidney; Kidney Transplantation; Male; Medical sciences; rejection; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue Donors; transplantation; Transplants & implants; Human; Kidney disease; Graft(material); Urinary system disease; Renal function; Antibody; Homograft; Risk; Transplantation; Homotransplantation; Long term; Kidney; B cell activating factor receptor; Rejection; Association; Immunology; Treatment; Urinary system; Dysfunction; Surgery; Risk factor; Development; Graft
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2012.04194.x

There are lines of evidence that B cells may play a role in transplantation. B cell activating factor, BAFF, is a homotrimer that has been shown to play a role in B cell survival, maturation and activation. To date, little is known of the role of BAFF and its receptors in transplantation. We analyzed the level of BAFF mRNA and its soluble protein, as well as transcripts coding for its receptors, BAFF‐R, TACI and BCMA, in the blood of 143 patients with stable kidney transplant function 5 years or more posttransplantation. Three endpoints were analyzed: the time to renal dysfunction, the time to appearance of anti‐HLA antibodies and the time to development of donor‐specific antibodies. We established threshold values for BAFF and BAFF‐R and showed that (1) stable patients with high BAFF‐R levels had a higher risk of developing graft dysfunction, (2) patients with lower levels of BAFF transcripts or a higher level of soluble BAFF had a significantly higher risk of developing donor‐specific antibodies. These data suggest that BAFF constitutes a risk factor for renal graft dysfunction and development of donor‐specific antibodies. They also suggest that agents targeting BAFF‐R interactions may offer new therapeutic opportunities in transplantation.
BAFF constitutes a risk factor for renal graft dysfunction and the development of donor‐specific antibodies.