Technique For Detection Of Antibodies Research Articles

Clinical characteristics of patients with myelin oligodendrocyte glycoprotein antibodies.

The clinical landscape associated to myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) has undergone a remarkable transformation over the past two decades, primarily driven by advancements in antibody detection techniques that have enhanced both the specificity and sensitivity of assays, enabling the identification of novel clinical phenotypes. Recent pivotal research publications, comprehensive reviews from established research groups, and most notably the first proposed international criteria for MOG-Ab associated disease (MOGAD) have substantially enriched our understanding of the clinical features associated with MOG-Ab. This review presents a comprehensive overview of the clinical characteristics of patients with MOG-Ab, systematically examining each core clinical syndrome defined by the proposed international MOGAD criteria. We incorporated recent insights and discussed potential challenges in applying these criteria across diverse clinical scenarios. The proposed international MOGAD criteria provide a comprehensive, homogeneous, and specific framework for characterizing the clinical features of patients with MOG-Ab, encompassing both paediatric and adult populations. In the future, the widespread adoption of specific and reliable assays for MOG-Ab detection, complemented by the development of surrogate fluid and imaging markers, holds promise for better characterizing atypical presentations, only-cerebrospinal fluid positivity and the MOGAD "seronegative" situations.

A narrative review of identifying the culprit antibody in neuroimmune diseases: concept and clinical significance.

Neuroimmune disease is a group of autoimmune diseases that are directed against antigens of the nervous system. Autoantibody testing is of great significance in early diagnosis, clinical severity assessment, prognosis, and efficacy evaluation. With the discovery of new antibodies and the development of antibody detection techniques, multiple antibodies have been found to coexist in patients with neuroimmune diseases. In this narrative review, we aim to define the culprit antibody and discuss the correlation between culprit antibodies and the clinical phenotype of neuroimmune diseases. We searched Medline, Embase, Web of Science, and CNKI from inception to February 2021 to acquire references on the relationship between neuroimmune diseases and antibodies. Eligible articles were reviewed regarding the relationship between antibodies and phenotypes. By reviewing relevant references and discussion, we propose the concept of "culprit antibody", namely, the pathogenic antibody which has a corresponding causal relationship with one or more phenotypes during the course of a patient's neuroimmune disease. The proposal, significance, and relevant clinical research of culprit antibodies related to neuroimmune diseases are elaborated as the proposal of concept and determination points of casual relationship, association with clinical phenotypes and core phenotypes, the role in antibody overlapping syndrome in the same patient, and different stages. In the era of precision medicine, proposing the concept of culprit antibodies and clarifying relevant evidence chains are helpful for precise and effective immune intervention.

Polydopamine Nanoparticles-Based Three-Line Lateral Flow Immunoassay for COVID-19 Detection.

Currently, the global trend of several hundred thousand new confirmed COVID-19 patients per day has not abated significantly. Serological antibody detection has become an important tool for the self-screening of people. While the most commonly used colorimetric lateral flow immunoassay (LFIA) methods for the detection of COVID-19 antibodies are limited by low sensitivity and a lack of quantification ability. This leads to poor accuracy in the screening of early COVID-19 patients. Therefore, it is necessary to develop an accurate and sensitive autonomous antibody detection technique that will effectively reduce the COVID-19 infection rate. Here, we developed a three-line LFIA immunoassay based on polydopamine (PDA) nanoparticles for COVID-19 IgG and IgM antibodies detection to determine the degree of infection. The PDA-based three-line LFIA has a detection limit of 1.51 and 2.34 ng/mL for IgM and IgG, respectively. This assay reveals a good linearity for both IgM and IgG antibodies detection and is also able to achieve quantitative detection by measuring the optical density of test lines. In comparison, the commercial AuNP-based LFIA showed worse quantification results than the developed PDA-based LFIA for low-concentration COVID-19 antibody samples, making it difficult to distinguish between negative and positive samples. Therefore, the developed PDA-based three-line LFIA platform has the accurate quantitative capability and high sensitivity, which could be a powerful tool for the large-scale self-screening of people.

Protein A–Nanoluciferase fusion protein for generalized, sensitive detection of immunoglobulin G

Detection and quantification of antibodies, especially immunoglobulin G (IgG), is a cornerstone of ELISAs, many diagnostics, and the development of antibody-based drugs. Current state-of-the-art immunoassay techniques for antibody detection require species-specific secondary antibodies and carefully-controlled bioconjugations. Poor conjugation efficiency degrades assay performance and increases the risk of clinical false positives due to non-specific binding. We developed a generic, highly-sensitive platform for IgG quantification by fusing the IgG-Fc binding Z domain of Staphylococcal Protein A with the ultrabright bioluminescence reporter Nanoluc-luciferase (Nluc). We demonstrated the application of this fusion protein in a sandwich IgG detection immunoassay using surface-bound antigens to capture target IgG and protein A-Nanoluc fusion as the detector. We optimized the platform's sensitivity by incorporating multiple repeats of the Z domain into the fusion protein constructs. Using rabbit and mouse anti-SARS-CoV-2 Nucleoprotein IgGs as model analytes, we performed ELISAs in two different formats, either with SARS-CoV-2 Nucleoprotein as the capture antigen or with polyclonal chicken IgY as the capture antibody. Using standard laboratory equipment, the platform enabled the quantitation of antibody analytes at concentrations as low as 10 pg/mL (67 fM).

Improving immunoassay detection accuracy of anti-SARS-CoV-2 antibodies through dual modality validation

A novel test strategy is proposed with dual-modality detection techniques for COVID-19 antibody detection. The full-length S protein of SARS-CoV-2 was chemically immobilized on a glass surface to capture anti-SARS-CoV-2 IgG in patient serum and was detected through either Electrochemical Impedance Spectroscopy (EIS) or fluorescence imaging with labeled secondary antibodies. Gold nanoparticles conjugated with protein G were used as the probe and the bound GNP-G was detected through EIS measurements. Anti-human-IgG conjugated with the fluorescent tag Alexa Fluor 488 was used as the probe for fluorescence imaging. Clinical SARS-CoV-2 IgG positive serum and negative controls were used to validate both modalities. For fluorescence-based detection, a high sensitivity was noticed with a quantification range of 0.01–0.1 A.U.C. and a LOD of 0.004 A.U.C. This study demonstrates the possibility of utilizing different measurement techniques in conjunction for improved COVID-19 serology testing.

Comparison between immune-chromatography (ICT) and ELISA techniques for detection of anti-HAV antibodies among patients suspected to be infected with Hepatitis A virus (HAV)

Infection with Hepatitis A virus (HAV) is a significant cause of acute hepatitis, posing an important public health problem worldwide. This study aimed to compare the efficiency of the immune-chromatography test and the enzyme-linked immunosorbent assay (ELISA) in detecting infection with hepatitis A virus (HAV). For this purpose, 5 ml of blood was collected from 176 patients (92 males and 84 females) who attended the virology unit at Kirkuk General Hospital and the serological examination unit at the pediatric hospital, as well as private clinics in Kirkuk city for the presence of clinical signs or complaint directed towards infection doubt with hepatitis A virus (HAV), during the period between March 2020 and December 2021. The seropositive rate of anti –Hepatitis A immunoglobulin M antibody was 46(26.13%) of total patients of the study, while the ratio of the seronegative of HAV was 90(51.13%). The percentage of false-positive and false-negative results by immune-chromatography (ICT) was 34(19.38%) and 6(3.4%). These findings suggest that the fast test (ICT) is not a suitable screening test for detecting specific antibodies to the hepatitis A virus due to the high frequency of false-negative results caused by the test's low sensitivity and negative predictive value. This emphasizes employing ELISA or PCR methods to confirm hepatitis A virus diagnosis in public hospitals. Although ICTs are cheap, they alone are not useful in diagnosing and deciding treatment for patients infected with Hepatitis A virus, so it is recommended to use the ELISA test to confirm the diagnosis of infection and identify the Hepatitis A virus in public hospitals, healthcare units and blood transfusion centers. Keywords. Hepatitis A virus, Seroprevalence, immuno-chromatographic test, ELISA test, IgM

Epidemiology of neuromyelitis optica spectrum. New and old challenges

This epidemiological review on neuromyelitis optica spectrum disorder (NMOSD) focuses on describing the methodologies employed in studies conducted under the 2015 NMOSD criteria and the studies conducted in Spain and Latin America, as well as examining factors related to the prognosis of the disease. The methodology used in the studies varies essentially in the application of different diagnostic criteria, sources of records, antibody detection techniques and standardisation methods. However, in general terms, NMOSD is distributed worldwide with an incidence/prevalence that is higher in women than in men, and in Asian and African-American countries than in Western countries. The frequency increases in parallel to age, with a peak incidence/prevalence in the 40-59 age range. The Latin American population has particular epidemiological characteristics linked to its racial and genetic mix. Finally, epidemiological variables, such as belonging to the black race, being of older age at onset and being female, are associated with a worse functional prognosis. Epidemiological data on NMOSD vary from one study to another, largely due to discrepancies in the methodological designs. Although Latin American studies are scarce, the findings described are associated with their ethnic mix. The homogenisation of criteria and the use of similar diagnostic techniques and standardisation methods must be implemented for the correct study of the epidemiology of NMOSD.

Current Trends of SARS-CoV-2 and its New Variants Diagnostics in Different Body Fluids: Surface Antigen, Antibody, Nucleic Acid, and RNA Sequencing Detection Techniques

Current Trends of SARS-CoV-2 and its New Variants Diagnostics in Different Body Fluids: Surface Antigen, Antibody, Nucleic Acid, and RNA Sequencing Detection Techniques

Eplet mismatch imputation studies should include immunologic risk assessment

To the Editor: HLA eplet mismatch analysis represents the evolution from antigen-level match assessments and cell-based donor-specific antibody (DSA) identification to an integrated approach combining sophisticated molecular histocompatibility genotyping with solid phase antibody detection techniques. Analyzing eplet mismatches between donor–recipient pairs at each HLA locus and using eplet motifs in the interpretation of posttransplant antibody reactivity has garnered increasing attention in recent years. Seminal studies to date reveal a direct correlation between posttransplant outcomes and the degree of HLA-DR and/or HLA-DQ eplet mismatches, particularly when grouped into high or low eplet mismatch ranges.1Wiebe C Nickerson PW. Human leukocyte antigen molecular mismatch to risk stratify kidney transplant recipients.Current Opinion Organ Transplant. 2020; 25: 8-14Crossref PubMed Scopus (18) Google Scholar While this area of solid organ transplantation continues to develop, there is an anticipation that eplet mismatch analysis will eventually play a role in organ allocation. Two recent studies in AJT by Senev et al2Senev A Emonds MP Van Sandt V et al.Clinical importance of extended second field high-resolution HLA genotyping for kidney transplantation.Am J Transplant. 2020; 20: 3367-3378Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar and Engen et al3Engen RM Jedraszko AM Conciatori MA Tambur AR. Substituting imputation of HLA antigens for high-resolution HLA typing: Evaluation of a multiethnic population and implications for clinical decision making in transplantation.Am J Transplant. 2021; 21 (https://doi.org/10.1111/ajt.16070): 344-352Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar performed stringent analyses of the accuracy of imputing high-resolution typing based on the low-resolution HLA genotyping to identify eplet mismatches in donor–recipient pairs. Using slightly different methods, these groups found that imputation did not agree with high-resolution HLA genotyping in 8.7–18.8% of pairs for HLA-ABC eplets and 37–46.1% of pairs for HLA-DR and DQB1 eplets. The authors concluded that the overall imprecision of imputation was a major limitation to eplet mismatch analysis. However, we believe that the utility and potential application of imputation for determining HLA eplet mismatch burden was not fully addressed in the two studies. While we agree that imputation is not a perfect tool to define high-resolution HLA typing results, we maintain that imputation can nonetheless be a useful approach when high-resolution typing is unavailable. Multiple retrospective studies have correlated clinical outcomes, such as DSA formation and graft rejection, with numerical ranges of eplet mismatches that stratify donor–recipient pairs into high or low immunologic risk groups. As such, risk stratification does not necessarily depend on the correct identification of each individual eplet. For example, if imputation versus high-resolution genotyping increased the mismatch burden by four HLA-DR eplets, but did not change the immunologic risk stratification because the number of eplet mismatches remains below the low-risk cutoff of 10,4Wiebe C Kosmoliaptsis V Pochinco D et al.HLA-DR/DQ molecular mismatch: a prognostic biomarker for primary alloimmunity.Am J Transplant. 2019; 19: 1708-1719Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar then imputation would be useful. Supporting this presumption, Senev et al show in Figure 6 that in 88% of cases the imputed HLA-DR and -DQ eplet mismatch burden is within two eplets of agreement with high-resolution genotyping (Figure 6). Similarly, Engen et al report in Table 8 that in 85.4% of cases, the imputed total Class-I and Class-II eplet mismatch burden is within two eplets of high-resolution genotyping. While a direct analysis was not performed, those data strongly suggest that imputation would result in the correct eplet-based immunologic risk stratification in nearly all cases. In the future, as total eplet mismatch burden is superseded by analysis of the mismatch of specific immunogenic eplets, the need for high-resolution genotyping will grow.5McCaughan JA Battle RK Singh SKS et al.Identification of risk epitope mismatches associated with de novo donor-specific HLA antibody development in cardiothoracic transplantation.Am J Transplant. 2018; 18: 2924-2933Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar However, in the current era of eplet mismatch analysis, we believe that imputation is a reasonable approach for retrospective studies when high-resolution genotyping is not available. The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Anti-Cytosolic 5'-Nucleotidase 1A Autoantibodies Are Absent in Juvenile Dermatomyositis.

ObjectiveTo assess anti–cytosolic 5′‐nucleotidase 1A (anti–cN‐1A) autoantibodies in children with juvenile dermatomyositis (DM) and healthy controls, using 3 different methods of antibody detection, as well as verification of the results in an independent cohort.MethodsAnti–cN‐1A reactivity was assessed in 34 Dutch juvenile DM patients and 20 healthy juvenile controls using the following methods: a commercially available full‐length cN‐1A enzyme‐linked immunosorbent assay (ELISA), a synthetic peptide ELISA, and immunoblotting with a lysate from cN‐1A–expressing HEK 293 cells. Sera from juvenile DM patients with active disease and those with disease in remission were analyzed. An independent British cohort of 110 juvenile DM patients and 43 healthy juvenile controls was assessed using an in‐house full‐length cN‐1A ELISA.ResultsAnti–cN‐1A reactivity was not present in sera from juvenile DM patients or healthy controls when tested with the commercially available full‐length cN‐1A ELISA or by immunoblotting, in either active disease or disease in remission. Additionally, in the British juvenile DM cohort, anti–cN‐1A reactivity was not detected. Three Dutch juvenile DM patients had weakly positive results for 1 of 3 synthetic cN‐1A peptides measured by ELISA.ConclusionJuvenile DM patients and young healthy individuals did not show anti–cN‐1A reactivity as assessed by different antibody detection techniques.

Current Approaches to Desensitization in Solid Organ Transplantation.

Major advancements in the development of HLA antibody detection techniques and our understanding of the outcomes of solid organ transplant in the context of HLA antibody have occurred since the relevance of sensitization was first recognized nearly 50 years ago. Additionally, kidney paired donation programs (KPD) have become widespread, deceased donor allocation policies have changed, and several new therapeutic options have become available with promise to reduce HLA antibody. In this overview we aim to provide thoughtful guidance about when desensitization in kidney transplantation should be considered taking into account the outcomes of HLA incompatible transplantation. Novel therapeutics, desensitization endpoints, and strategies for future study will also be discussed. While most of our understanding about desensitization comes from studying kidney transplant candidates and recipients, many of the concepts discussed can be easily applied to desensitization in all of solid organ transplantation.

Protocolo de indicaciones e interpretación de pruebas alérgicas serológicas y cutáneas

In this update we define the latest in vivo and in vitro testing protocols (skin tests and Inmunoglobuline E antibody detection techniques) in the allergological diagnosis.

Evaluation of the efficiency of the various techniques used for screening of HIV in antenatal mothers to facilitate early initiation of treatment

The study has been conducted in pregnant women in the high risk category attending the antenatal O.P at M.N.R Hospital and medical college and Niloufer Hospital for a defined period. The screening tests for HIV used are Coombaids, (Dot Immunoassay), as per NACO guidelines & Fourth- Generation (double antigen/antibody Sandwich with solid micro wells pre-coated with Recombinant HIV-1gp41, HIV-1 Group O gp41, HIV-2 gp36, & amp; Monoclonal Anti p24 Antibodies. The individual sensitivity and specificity were evaluated and compared. The sera of all the women screened by COOMBAIDS were tested negative & out of all the negative samples one sample was tested positive by 4th generation ELISA. Hence, this study was carried out to evaluate the sensitivity and specificity of various techniques for Antibody detection and Antigen detection, and to determine the technique most suitable for early diagnosis of HIV infection.4 Keyword: Antenatal women, Specificity and Sensitivity.

PRE-TRANSPLANT HLA ANTIBODIES AND DELAYED GRAFT FUNCTION IN THE CURRENT ERA OF KIDNEY TRANSPLANTATION

Collaborative Transplant Study. Introduction: We reported previously that early adverse events in deceased donor kidney transplantation, such as delayed graft function (DGF) and rejection episodes, are associated with pre-transplant presence of HLA antibodies and that patients with adverse events show significantly impaired graft survival rates. In the meantime, the introduction of sensitive antibody detection techniques is expected to have diminished the involvement of overlooked HLA antibodies in DGF. On the other hand, DGF risk might have increased due to growing use of kidneys from elderly donors. The aim of the present multi-center study was to identify the immunological and non-immunological predictors of DGF and to determine its influence on outcome in the presence and absence of HLA antibodies in the new era of transplantation. Methods: 1,724 patients who received a deceased donor kidney transplant during 2008–2017 and on whom a pre-transplant serum sample and the information on immediate function within the first 24 hours after transplantation, dialysis during the first week, and biopsy-proven rejection during the first 3 months were available. Graft survival after day 7 during the first 3 years post-transplant was analyzed by multivariable Cox regression. Predictors of DGF and influence of DGF and pre-transplant HLA antibodies on biopsy-proven rejections during days 8–90 were determined by multivariable logistic regression. DGF was defined as either no graft function during the first 24 hours and/or dialysis during the first week. In 44% of cases, we were informed by the centers on the presence or absence of pre-transplant donor-specific antibodies (DSA) as determined by single antigen technique. Results and Discussion: Donor age ≥50 years, simultaneous presence of HLA class I and II antibodies pre-transplant, diabetes mellitus as original disease, cold ischemia time ≥18 hours, and time on dialysis >5 years were associated with an increased risk of DGF. DGF alone doubled the risk for all cause graft loss, more due to impaired death-censored graft than patient survival. In DGF patients, the risk of death-censored graft loss increased further if HLA antibodies (HR=4.75, P<0.001) or donor-specific HLA antibodies (DSA, HR=7.39, P<0.001) were present prior to transplantation. In the presence of HLA antibodies or DSA, the incidence of biopsy-proven rejections increased significantly in patients with as well as without DGF. Recipients without DGF and without biopsy-proven rejections during the first 3 months had the highest fraction of patients with good kidney function at year 1 post-transplant, whereas patients with both DGF and rejection showed the lowest rate of good kidney function. Our data indicate that, in the current era of transplantation, besides non-immunological factors, also the pre-transplant presence of HLA class I and II antibodies increase the risk of DGF. Conclusion: Patients with DGF require special attention, especially in the presence of HLA antibodies.

Prevalidation of an ELISA for Detection of a New Clinical Entity: Leishmania donovani-Induced Cutaneous Leishmaniasis.

Human leishmaniasis which is considered a neglected tropical parasitic disease presents in three main clinical forms (i.e., cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL)) that are mainly determined by its causative species. Leishmania donovani, the most virulent and visceralizing parasite, is increasingly reported to cause CL in many countries in the world. Although CL is generally not considered to evoke a humoral immune response except for a nonrobust and a variable response in minority of cases, VL is associated with a clear strong humoral response. However, humoral response in L. donovani-induced CL has not been well evaluated before. A suitable serology-based assay is an essential primary step in such a study. An indirect enzyme-linked immunosorbent assay (ELISA) based on Leishmania promastigote crude antigen (Ag) was designed and optimized in order to utilize in further serological studies on this new clinical entity. Optimization included quantification of crude Ag, checkerboard titration method for determination of optimal concentrations for coating Ag, human sera and secondary antibody (Ab) with suitable coating buffer, blocking buffer, and incubating temperatures. The selected coating buffer was 0.02 M phosphate buffer, pH 6.8, and the blocking buffer was 2% fetal bovine serum with 0.01 M phosphate-buffered saline. At least 1 μg of crude Ag was required for coating the ELISA plate, while 1 : 1000 serum was used as primary Ab. The optimized concentration of secondary Ab was 1 : 64000 which might be altered according to manufacturer recommendations. The assay specificity was pre-evaluated using sera (n = 20 from each category) from confirmed CL patients and controls (other skin diseases which mimic CL, other systemic diseases that mimic VL, nonendemic healthy controls, and endemic healthy controls). This procedure described an optimization procedure of an ELISA technique for detection of anti-Leishmania antibodies in patients with L. donovani caused CL.

Acute infectious myelopathies.

The patient who presents with an acute spinal cord syndrome with weakness/paralysis of the limbs presents a diagnostic. Two important syndromes are acute transverse myelitis (ATM) and acute flaccid paralysis (AFP). Both can be caused by a number of infectious and noninfectious causes. Since 2014 there have been outbreaks of acute flaccid myelitis (a subgroup of AFP) in the United States, with a national surveillance program underway. In addition, there have been increasing reports of ATM from new and emerging pathogens, and opportunistic infections in immunocompromised hosts. Infectious causes of ATM or AFP need to be ruled out first. There may be important clues to an infectious cause from epidemiologic risk factors, immune status, international travel, MRI, and laboratory findings. We summarize key features for the more common pathogens in this review. Advances in laboratory testing have improved the diagnostic yield from cerebrospinal fluid, including real-time polymerase chain reaction, metagenomic next-generation sequencing, and advanced antibody detection techniques. These tests still have limitations and require clinical correlation. We present a syndromic approach to infectious myelopathies, focusing on clinical patterns that help narrow the diagnostic possibilities.

Future direction of immunosuppressive treatment in organ transplantation

Since the first success of kidney transplantation in 1954, significant advances have been achieved in the field of organ transplantation. It was possible with the introduction of immunosuppressive drugs belonging to the class of calcineurin inhibitors (CNIs) such as cyclosporine and tacrolimus, the advances in surgical techniques and perioperative management, the monitoring and management infections, and the highly sensitive and specific antibody detection techniques. Despite recent progress, we currently encounter the limitation of better long-term transplant outcomes mainly because of paradoxical CNI toxicity and failure to control antibody or antibody-mediated rejections. The future direction of immunosuppression can be continued by optimizing immunosuppressive regimens with currently available immunosuppressants for better control of antibodies while avoiding CNI toxicity and by using biological therapeutics such as costimulation blockade agents that provide effective control of antibodies along with a reduction in usage or avoidance of CNIs and may develop as new immunosuppressants in the near future. Moreover, a tolerance induction through transplantation of donor hematopoietic stem cells or an infusion of regulatory cells using various sources of immune cells can also be a promising strategy as it can fundamentally escape from the complications of immunosuppressants. Over and above, it is important to note that the results of clinically applicable immunosuppressants from research in the non-human primate xenotransplantation model at the forefront of the future development of immunosuppressants can be a good opportunity to selectively apply to allo-transplants. No immunosuppressants can be risk-free, and therefore, all new immunosuppressants should be evaluated under the considerations for the risk/benefit ratio in various clinical conditions.

P185 Back up technique for detection of HLA antibodies is enhancing the reliability of HLA results in high risk patients

P185 Back up technique for detection of HLA antibodies is enhancing the reliability of HLA results in high risk patients

Anticorps non-HLA et transplantation d’organe : une vision critique

In solid organ transplantation, the deleterious effect of antibodies directed against donor HLA antigens, whether preformed or de novo, is well established. Anti-HLA antibodies have been associated not only with the risk of antibody-mediated rejection but also with late graft dysfunction and are now considered to be the leading cause of allograft loss after renal transplantation. In addition to HLA antibodies, the possible involvement of non-HLA antibodies targeting donor endothelial cells has long been the subject of intense research. The purpose of this review is to discuss current knowledge and remaining issues related to the involvement of non-HLA antibodies in solid organ transplantation. More specifically, the clinical data underlying the hypothesis of the role of non-HLA antibodies will be discussed, as well as the different techniques for antibody detection, their clinical relevance and their antigenic targets.

Renal transplantation from seropositive hepatitis C virus donors to seronegative recipients in Spain: a prospective study.

Hepatitis C virus (HCV) positive donors are identified in Spain by antibody detection (HCV-Ab) techniques while a HCV nuclear acid-testing (HCV-NAT) is not mandatory. Since it has been shown that HCV-Ab positive HCV-NAT negative donors do not universally transmit the infection, we designed a protocol based on the identification of viremia in HCV-Ab positive donors to start treatment if needed. HCV-Ab-positive donors were identified and we performed HCV-NAT immediately. Donors coinfected with HIV were excluded. Recipients with a low chance to receive a transplant, with no history of liver disease and who were negative for HCV-Ab were selected after informed consent was signed. Kidney recipients from HCV-NAT-positive donors received glecaprevir and pibrentasvir from 6 h before the transplant until 8 weeks after. Recipients from HCV-NAT-negative donors were not treated. Regular monitoring by HCV-NAT was performed to initiate antiviral treatment. We included 11 recipients from six deceased donors Four recipients received grafts from HCV-NAT-positive donors and seven patients received grafts from HCV-NAT-negative donors. None of our recipients exhibited HCV-NAT positivity during the minimum follow-up period of 6 months. Recipients from HCV-NAT-positive donors exhibited sustained virologic response at 12 weeks. One recipient from an HCV-NAT-negative donor lost his graft via a process thought to be unrelated to HCV. The remaining 10 patients had a stable functioning graft at the end of the follow-up period. Our preliminary data suggest that renal transplantation from HCV-Ab- positive donors to HCV-Ab negative recipients is safe when only the recipients of organs from HCV-NAT-positive donors are treated.