Serum antibody activity to glomerular endothelial cells is a prospective indicator of renal allograft rejection

Abstract

Background. Vascular endothelial ells (ECs) are considered to be a primary target for injury in allograft rejection. However, the relationship between serum antibody activity to ECs and rejection episodes has not been extensively examined in renal transplantation. Methods. Twenty-two renal transplant recipients were included in this study. Serum levels of anti-endothelial cell antibody (AECA) were measured using a cellular enzyme-linked immunosorbent assay (ELISA) in which human umbilical vein endothelial cells (HUVEC), human glomerular endothelial cells (HGEC), and human dermal microvascular endothelial cells (MvE) were used as target cells. Serum samples were obtained just before transplantation and once a week during the immediate 1- to 3-month posttransplantation period. Results. There was a significant correlation between the the presence of AECA against HGEC and rejection episodes (P < 0.05). Patients with multiple episodes of rejection showed significantly higher frequencies of AECA than patients with a single episode of rejection (P < 0.001). It should be noted that patients suffering from multiple episodes of rejection had higher AECA titers than those without a rejection episode before transplantation. Conclusions. These findings imply that the HGEC-ELISA could be used as a prospective, informative test to identify patients at a high risk of acute rejection in renal transplantation.