Soluble HLA Class Research Articles

Increased Soluble Serum HLA Class I Antigens in Patients with Lymphoma

ABSTRACT: sHLA are soluble forms of class I histocompatibility antigens detected in human serum and cerebrospinal fluid. These molecules are secreted by B and T lymphocytes and the secretion increases dramatically upon mitogenic activation of these cells. sHLA was quantified by an ELISA sandwich method in sera from healthy blood donors, and from patients with Non Hodgkin’s Lymphoma (NHL) and Hodgkin’s Disease (HD) both at diagnosis and at remission. Pretreatment sHLA serum levels in NHL and in HD were compared with the values found in controls. sHLA levels are increased in patients with NHL (low grade: 6.68 ± 1.80; high grade: 2.65 ± 0.53 μg/ml X ± S.E.) and HD (6.44 ± 0.98) at diagnosis and in relapses when compared with controls (0.89 ± 0.08). This increment is statistically significant (low grade NHL: p = 0.0038; high grade NHL: p = 0.0049 and HD: p = 0.0005 versus control group). No statistical differences between titers of sHLA after complete remission and sHLA in the control group were found. The high levels of sHLA detected in patients with lymphoma are mainly due to low molecular weight HLA molecules (55 KD) (60–75% of the HLA present in serum in the control group and 75–100% in serum of patients with lymphoma).

Elevated serum HLA class I levels coincide with acute and chronic graft-versus-host disease.

The ability to predict the likely occurrence of graft-versus-host-disease (GVHD) after BMT would be extremely valuable. We performed a retrospective study on the correlation between soluble HLA class I (sHLA-I) levels and GVHD in the sera of 34 patients receiving an allogeneic BMT and in the sera of 12 patients receiving an autologous BMT. sHLA-I levels measured pre- and at different times post-BMT were correlated with the occurrence of post-BMT complications, ie acute graft-versus-host disease (aGVHD), chronic graft-versus-host disease (cGVHD), infections and relapse. No changes in sHLA-I levels (delta sHLA-I) occurred in autologous and allogeneic BMT patients without GVHD. In contrast, sHLA-I reached high levels in patients suffering from GVHD. Increased sHLA-I levels correlated strongly with episodes of both acute and chronic GVHD (P = 0.004 and P = 0.005, respectively). Also during relapse increased sHLA-I levels were found (P = 0.032). During infections sHLA-I levels increased, although not significantly. Kinetic studies gave no evidence that the increase in sHLA-I levels preceded the clinical occurrence of aGVHD or of cGVHD. A slight, but significant correlation was found between total blood bilirubin levels and sHLA-I levels in patients suffering from GVHD (P = 0.037), indicating the contribution of the liver as a source of sHLA-I. We conclude that measurements of sHLA-I levels do not function as a predictive parameter for GVHD, but can be valuable for the monitoring of GVHD after BMT.

Reactivity of Twenty-two Cytotoxic Human Monoclonal HLA Antibodies Towards Soluble HLA Class I in an Enzyme-Linked Immunosorbent Assay (PRA-STAT®)

ABSTRACT: An ELISA, PRA-STAT®was recently introduced for the detection of HLA class I specific antibodies of IgG isotype in patients’ sera. We studied the antigenicity of the soluble HLA (sHLA) preparations that are used in this ELISA as the detection matrix, with the aid of a panel of complement binding human HLA monoclonal antibodies (HuMAbs). A total of 22 HuMAbs, including both IgG and IgM were used. CDC and PRA-STAT ELISA were in complete agreement on 9 of the mAbs tested, with 16 HLA-A and 16 HLA-B locus antigens or their splits identified identically on CDC and PRA-STAT. In 7 of the remaining 13 HuMAbs, there was a difference of one antigen in the specificity pattern of the two techniques: three times a specificity call not made by CDC, and four times a call not made by PRA-STAT. For the remaining 6 HuMAbs the differences involve 2 antigens (4 HuMAbs), and 3 or 4 antigens (1 HuMAb each). This study shows the validity of PRA-STAT for detection of HLA-class I antibodies, irrespective of isotype, in serum. The immunological integrity of the sHLA preparations used in PRA-STAT is also confirmed, albeit with some slight discrepancies in antibody specificity seen between PRA-STAT and CDC.

Soluble HLA Class I Antigens in Patients with Type I Diabetes and Their Family Members

Our objective was to study a possible contribution of MHC genes to S-HLA-I secretion in patients with Type I diabetes. Quantitatively, we used a highly sensitive enzyme-linked immunoassay to measure S-HLA-I in the serum of a total of 39 patients with Type I diabetes, as well as 36 kinships of 12 diabetic patients and 82 normal individuals with known HLA-phenotypes. S-HLA-I levels were abnormally elevated in patients or their non-diabetic relatives compared to normal controls ( p < 0.0009). No complete HLA-haplotype had been identified to be correlated with high or low S-HLA-I secretion. Only the HLA-A23 or A24 (splits of HLA-A9) positive individuals sera were found to contain high S-HLA-I concentrations in all populations studied. The difference in S-HLA-I levels of HLA-A24 patients ( n = 4) or their HLA-A24 positive non-diabetic relatives ( n = 10) to the group of HLA-A24 normal controls ( n = 15) was statistically highly significant ( p < 0.0005 and p < 0.0009, respectively). The results suggests that HLA-A24 may confer additional independent risk for the disease expression in male children but not in female siblings. Nevertheless, the data implies that the patients or their non-diabetic relatives carrying the HLA-A24 have increased risk of developing ICA associated with high S-HLA-I levels compared to HLA-A24 negative probands or their kinships with low levels of S-HLA-I. This effect occurred irrespective to other diabetes related HLA-DR alleles. In summary, the results show a pronounced genetic heterogeneity of Type I diabetes with MHC control of the expression of S-HLA-I and possible involvement of hormonal factors that might potentiate a specific synthesis of S-HLA-I. The findings have implications for identifying individuals with a possible risk for developing the disease.

Serum concentrations of soluble HLA-class I and CD8 forms in patients with viral hepatic disorders.

Soluble HLA-class I and CD8 molecules were determined by sandwich ELISA in patients with viral-induced hepatic disorders. As a whole, the patients with hepatic disorders (acute hepatitis: AH; chronic hepatitis: CH; liver cirrhosis: LC; hepatocellular carcinoma: HCC) showed higher sHLA-class I and sCD8 levels than normal controls (P < 0.001). AH patients had the highest sHLA-class I levels (mean, 3513 +/- 2112 ng/ml), followed by CH (2896 +/- 1290 ng/ml), LC (2293 +/- 1266 ng/ml), and HCC (2221 +/- 1212 ng/ml) sCD8 levels wer highest in AH, followed by HCC, LC, and CH, in that order. Among histologically defined C virus-positive patients, sHLA-I levels were higher in those with chronic active hepatitis (CAH) 2A (3802 +/- 1124 ng/ml) than in those with chronic persistent hepatitis (CPH; 2200 +/- 711 ng/ml; P < 0.01), the levels then decreased as the disease progressed (CAH2B, 3564 +/- 1783 ng/ml, LC, 2376 +/- 1265 ng/ml). In contrast, sCD8 values showed little difference among the disorders. sHLA-class I levels showed a positive correlation with sCD8 values both in whole patients and in patients with AH (P < 0.01), but no correlation was shown, in any patients, with biochemical parameters such as GPT and GOT. These findings, taken together, suggest that hepatic destruction is not the only cause of sHLA-class I production, but that sHLA-class I levels, together with sCD8 levels, may reflect immunological activity in hepatic disorders.

Soluble HLA Class I and Class II Molecule Levels in Serum and Cerebrospinal Fluid of Multiple Sclerosis Patients

Increased concentrations of soluble HLA class I and class II molecules (sHLA-I and sHLA-II) have been observed in infectious, inflammatory, and autoimmune diseases. Because autoimmune mechanisms are considered to play a role in the pathogenesis of multiple sclerosis (MS), we decided to dose sHLA-I and sHLA-II in serum and cerebrospinal fluid (CSF) of MS patients comparing their concentrations with those observed in serum and CSF of patients with other neurologic diseases (OND) without evidence of neuroradiologic involvement of central nervous system (CNS) and in serum of healthy donors. The serum concentrations of sHLA-I were higher in both MS and OND patients than in healthy donors ( P < 0.05) whereas sHLA-II serum concentrations were lower in MS patients than in both OND patients and healthy donors ( P < 0.01). Detectable amounts of sHLA-II were observed in the CSF of 45% of MS patients and in CSF of only 6% of OND patients ( P < 0.001). In MS patients a significant correlation between sHLA-I serum and CSF concentrations was observed ( P < 0.01), whereas sHLA-II serum and CSF levels did not correlate. In conclusion, alterations of sHLA-I and sHLA-II serum and CSF concentrations are present in MS patients and could be involved in the induction of enhanced susceptibility to develop MS or in MS pathogenesis.

Soluble Histocompatibility Class I Antigens and β 2-Microglobulin in Pregnant Females and Cord Blood Samples

Pregnancy can be considered a successful transplantation of allogeneic paternal tissue to the mother. Soluble HLA class I serum levels have been found to increase during solid organ rejection episodes and during graft-versus-host disease after bone marrow transplantation. We wished to determine whether significant changes in sHLA class I and β 2-microglobulin light chain levels occurred during pregnancy, because these may reflect adaptive changes permitting the acceptance of the fetal graft. Serum samples were obtained from women at different stages of pregnancy and in the postpartum period. Cord blood samples and serum samples from nonpregnant female and male controls living in the same geographic area in Southern Chile were also studied. The levels of sHLA class I heterodimers were determined by an ELISA sandwich technique; β 2-microglobulin levels were measured by MEIA IMX-Abbott. There was a significant elevation of sHLA class I levels in the first 2 trimesters of pregnancy, followed by a significant drop below normal levels at the end of pregnancy, with normalization in the post-partum period. β 2-microglobulin levels did not change significantly during pregnancy and did not correlate with sHLA class I levels. In cord blood samples, sHLA class I levels were lower and β 2-microglobulin levels higher than those of adult controls and of mothers at the time of delivery. The variations in sHLA class I levels during pregnancy may reflect or contribute to immunoregulatory events related to the acceptance of the fetal graft.

Influence of anticoagulants on the level of soluble HLA class I and class II antigens measured in blood samples

Influence of anticoagulants on the level of soluble HLA class I and class II antigens measured in blood samples

The changes of serum soluble HLA-class I and CD8 concentrations during interferon treatment of chronic hepatitis C patients

Serum soluble HLA-class I and CD8 molecules were sequentially (pre, during, and post-therapy) measured by sandwich ELISA, in 20 interferon (IFN)-treated chronic hepatitis C (CHC) patients, who were judged as responders ( n = 8) or non-responders ( n = 12) with respect to the response to the therapy. Pretreatment levels of sHLA-I and sCD8 did not differ between responders and non-responders. Both values increased just after the start of therapy and peaked at 2–4 weeks. The IFN was discontinued at 24 weeks, when sHLA-I decreased to baseline levels in responders, whereas they remained at levels significantly higher than baseline levels even at 48 weeks in non-responders ( P < 0.01). sCD8 decreased significantly under than baseline levels at 48 weeks in responders ( P < 0.05), in contrast in non-responders, sCD8 did not decrease beyond baseline levels. In summary, serum levels of sHLA-I and sCD8 were elevated by the IFN treatment, and serial follow-up of these immunological parameters could provide additive information regarding the response to IFN therapy.

Soluble HLA class I in epithelial lining fluid of lung transplants: Associations with graft outcome

We hypothesized that the small amounts of donor HLA-A and HLA-B proteins detected in the serum during organ allograft rejection are indicative of higher local releases within the graft itself. We determined the concentrations of total HLA class I (HLA-I) and, in selected cases, specific donor and host HLA-A and HLA-B proteins, in the epithelial lining fluid (ELF) sampled by bronchoalveolar lavage (BAL) of lung transplant recipients (n = 37) and of normal controls (n = 25). We found that 1) HLA-I proteins were enriched in the lung ELF relative to other proteins; 2) the concentration of HLA-I in the ELF of well-functioning transplants was similar to that in normal lungs; 3) HLA-I proteins and total proteins were elevated in the ELF of patients who developed chronic rejection or refractory acute rejection; 4) the concentration of HLA-I was correlated with the percentage of neutrophils but not with the percentage of lymphocytes in the ELF of transplanted lungs; and 5) only the percentage of lymphocytes was elevated in the ELF of transplant patients with active CMV infections. Total HLA-I from the ELF was found to contain a mixture of both donor- and recipient-type HLA-A and HLA-B proteins and the donor-type HLA-A2 was found to be highly enriched in the ELF relative to serum.

The presence of posttransplant HLA-specific IgG antibodies detected by enzyme-linked immunosorbent assay correlates with specific rejection pathologies.

Posttransplant monitoring of anti-HLA antibodies with routine techniques gives unsatisfactory results due to a variety of technical limitations. We investigated how a new alternative technique correlates with posttransplant clinical events. A total of 313 nonselected serum samples from 136 patients were screened by an ELISA utilizing captured soluble HLA class I antigens. We observed the absence of anti-HLA antibody production in acute rejection cases responding to standard antirejection therapy. On the other hand, we showed a clear presence of these antibodies in acute rejection episodes not responding to standard therapy (P<0.0001) and in chronic rejection (P<0.001). We conclude that routine posttransplant monitoring by ELISA offers early risk assessment that is crucial for proper immunosuppression and for antirejection therapy choice.

Soluble HLA class i antigens in pediatric patients with renal transplants from related living donors without acute rejection and treated with triple therapy

All HLA class I Ag—expressing cells may be the source of serum Ag sHLA I. T and B lymphocytes secrete considerable amounts of Ag sHLA I in a variety of in vitro and in vivo activation systems. The purpose of this study was to evaluate the level of Ag sHLA I in serum of children with kidney transplants from related living donors without acute rejection and with triple therapy. We studied 25 patients (2–21 years) with first kidney transplant, 19 individuals (10–20 years) undergoing hemodialysis without transplant, and 25 normal children (4–21 years). The levels of Ag sHLA in transplant patients was 0.2–3.2 μg/ml ( x ̄ = 1.04 ). The hemodialyzed patients was 0.48-4.5 μg/ml ( x ̄ = 2.09 ), and the normal control was 0.30-4.38 μg/ml ( x ̄ = 2.04 ). A statistically significant reduction was observed in transplant patients compared to normal control and hemodialyzed patients ( p < 0.05 in both cases), whereas between normal and hemodialyzed patients no significant difference was seen ( p $ ̆ 0.05 ). The reduced levels of Ag sHLA I in blood could be an expression of adequate immunosuppressive treatment. Human Immunology 50, 135–139 (1996)

Soluble HLA class I molecules induce apoptosis in alloreactive cytotoxic T lymphocytes.

Soluble HLA class I molecules (sHLAs) have been identified in the serum of patients with inflammatory diseases, allografts and autoimmune diseases and in serum of healthy individuals. The biological significance of these molecules, particularly after allogeneic organ transplantation, has been enigmatic. Here we show that primary alloreactive CD8+ T cells interact with sHLA and undergo apoptosis in the absence of a second signal. Ligation of CD28 rescued T cells from death, implying that sHLAs induce apoptosis through selective stimulation of the T-cell receptor. CD95-L was upregulated after cytotoxic T lymphocytes were incubated with sHLAs, and cell death was blocked by a neutralizing anti-CD95-L antibody, suggesting that sHLAs induce endogenous mutual killing of activated T cells. These results provide a molecular basis for the capacity of sHLAs to downregulate T-cell responses, which may be especially relevant to organ transplantation.

Influence of anticoagulants on the level of soluble HLA class I and class II antigens measured in blood samples.

The existence of soluble forms of HLA class I and class II antigens in human serum is well established and altered concentrations of these serum proteins have been described to be associated with various diseases. Since soluble HLA antigens (sHLA) can be measured both in serum and plasma samples, we investigated whether anticoagulant treatment influences the determined levels of soluble HLA class I (sHLA-I) or soluble HLA-DR (sHLA-DR). Analyzing paired samples of serum and plasma of 40 healthy individuals we found significantly lower serum levels of sHLA-DR (0.31 +/- 0.15 ng/ml) compared to EDTA plasma levels (0.58 +/- 0.20 ng/ml). By contrast, serum levels of sHLA-I (0.89 +/- 0.74 micrograms/ml) were only slightly lower than EDTA plasma values (0.95 +/- 0.86 micrograms/ml), a situation similar to that of sIL-2R and sCD4 levels. Further experiments intended to clarify the reasons of the reduced sHLA-DR serum levels revealed that (i) the blood storage time before centrifugation did not influence the sHLA-DR level, (ii) treatment of serum with anticoagulant did not augment the measured sHLA-DR concentration, and (iii) the recovery of spiked sHLA-DR was significantly lower when added to native blood than to serum or anticoagulant-treated blood. These results suggest that sHLA-DR is partly removed by the process of blood clotting thus resulting in diminished sHLA-DR serum levels.

CORRELATION OF ELISA-DETECTED IgG AND IgA ANTI-HLA ANTIBODIES IN PRETRANSPLANT SERA WITH RENAL ALLOGRAFT REJECTION1

The present study compared the occurrence of rejection episodes during the first twelve posttransplant (Tx) months and the 1-, 2-, and 3-year graft survivals among recipients stratified by the percent panel reactive antibody (% PRA) of pre-Tx sera as detected using either an antihuman globulin determined PRA (AHG-% PRA) or an ELISA methodology detecting IgG reactive against soluble HLA class I antigens (% PRA-STAT). There was a significant correlation between AHG-PRA greater than or equal to 10% and a PRA-STAT greater than or equal to 10% (P<0.001). However, among 200 sera displaying an AHG-PRA greater than or equal to 10% (mean 57 +/- 2l%), only 69% (138/200) displayed a PRA-STAT greater than or equal to 10%. With further study the discrepant finding, of 62 sera that were AHG-PRA greater than or equal to 10% but PRA-STAT <10%, was due to the presence of IgM and/or IgG non-MHC reactivity. In contrast, among 293 sera displaying an AHG-PRA < 100% (mean 3 +/- 2%), 15% (43/293) displayed a PRA-STAT greater than or equal to 10%. There was no correlation between AHG-% PRA and rejection episodes occurring during the first twelve post Tx months. In contrast, however, there was a highly significant correlation between PRA-STAT greater than or equal to 10% and the occurrence of rejection episodes during the first twelve post-Tx months (P < 0.001). Patients with PRA-STAT greater than of equal to 10% experienced a 70% rejection frequency compared with the 35% rejection frequency for patients with PRA-STAT sera < 10% (P<0.001). A significant correlation was observed between the presence of IgG-1 and rejection (P<0.01) but not IgG-subclasses 2, 3, or 4. Of particular interest was the observation in 11 patients that the presence of ELISA-detected IgA anti-HLA class I antigen (ELISA-IgA PRA greater than or equal to 10%) was associated with a significantly reduced rejection risk compared with sera where only PRA-STAT greater than or equal to 10% was present (27% vs. 70% incidence of rejection episodes, P<0.01). Finally, patients displaying pretransplant PRA-STAT results < 10% experienced significantly improved l-, 2-, and 3- year graft survivals of 85% vs. 74%, 82% vs. 70% and 81% vs. 67%, respectively (P<0.01 for each time point), compared with patients displaying PRA-STAT results greater than or equal to 10%. These data suggest that the use of the ELISA methodology to detect IgG reactivity against soluble HLA class I antigens (PRA-STAT) may allow for the determination of a more clinically informative % PRA than the AHG-% PRA. Moreover, the presence of ELISA-detected IgA anti-HLA may act to inhibit rejection mechanisms associated with ELISA-detected IgG anti-HLA greater than or equal to 10%.

Macrophage Activation Factors in the Brains of AIDS Patients

HIV, soluble HLA class I (sHLA-I), quinolinic acid (QUIN), and the monokines IL-1&beta;, IL-6, and TNF-&#945; were measured by ELISA and PCR in brain tissue of 60 AIDS autopsies without evidence of CNS opportunistic infections. Individual cases showed good interrogational correlations for the factors measured. There was a positive correlation between concentrations of IL-1&beta; and IL-6. Brain viral burden correlated with intraparenchymal levels of sHLA-I, IL-1&beta;, and IL-6. Comparison of neuritic damage and levels of immune mediators implicates macrophage activation factors in the etiology of neurologic damage in AIDS.

P819 - Soluble HLA class I molecules induce apoptosis in human PHA-activated CD8+ T lymphocytes

P819 - Soluble HLA class I molecules induce apoptosis in human PHA-activated CD8+ T lymphocytes

P710 - Monitoring of soluble HLA class I (sHLA-I) molecular varia

P710 - Monitoring of soluble HLA class I (sHLA-I) molecular varia

Serum soluble HLA class I antigen levels in hemodialysis patients and following renal transplantation

Serum soluble HLA class I antigen levels in hemodialysis patients and following renal transplantation

Natural killer clones recognize specific soluble HLA class I molecules.

Enhancement of major histocompatibility complex (MHC) class I expression leads to protection from natural killer (NK) cell recognition in several systems. MHC class I gene products are released from the cell surface and can be found in sera as soluble forms. To investigate the possible immunoregulatory role of soluble HLA (sHLA) in NK cell-target recognition, several sHLA antigens were studied for their ability to induce NK cell cytotoxicity modulation. NK cell-target recognition was inhibited by the addition of sHLA during the cytotoxicity assay. Our results indicate that sHLA molecules can down-regulate NK killing at the effector level. Moreover, different NK clones are able to specifically recognize different sHLA antigens. Kp43 molecules seem to be involved in the NK recognition of sHLA-B7.