2021
DOI: 10.1111/ctr.14406
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Impact of SIRPα polymorphism on transplant outcomes in HLA‐identical living donor kidney transplantation

Abstract: Signal-regulatory protein α (SIRPα), a polymorphic inhibitory membrane-bound receptor, and its ligand CD47 have recently been implicated in the modulation of innate immune allorecognition in murine models.Here, we investigate the potential impact of SIRPα donor-recipient mismatches on graft outcomes in human kidney transplantation. To eliminate the specific role of HLAmatching in alloresponse, we genotyped the two most common variants of SIRPα in a cohort of 55 HLA-identical, biologically-related, donor-recipi… Show more

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Cited by 7 publications
(4 citation statements)
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“…SIRPα plays a crucial role as an inhibitory receptor for CD47 and is a key component of the “do-not-eat-me” signaling pathway, with potential implications in transplantation ( Garcia-Sanchez et al 2021 ). Similar to the HLA genes, the sequences encoding the extracellular domain of SIRPα exhibit the strongest signal.…”
Section: Discussionmentioning
confidence: 99%
“…SIRPα plays a crucial role as an inhibitory receptor for CD47 and is a key component of the “do-not-eat-me” signaling pathway, with potential implications in transplantation ( Garcia-Sanchez et al 2021 ). Similar to the HLA genes, the sequences encoding the extracellular domain of SIRPα exhibit the strongest signal.…”
Section: Discussionmentioning
confidence: 99%
“…Tennessen et al also observed selection around SIRPA , though they did not identify nearly as strong of a signal–likely due to a combination of different sequencing platforms, sample sources, and methodology. SIRPα acts as an inhibitory receptor for CD47 and is a key component of the “do-not-eat-me” signaling pathway and may have implications in transplantations 47 . Similar to the HLA genes, the strongest signal appears in sequences coding for the extracellular domain of SIRPα 48 .…”
Section: Discussionmentioning
confidence: 99%
“…In a small cohort of HLA-identical living donor kidney transplantation, they found a trend toward more graft failure, interstitial inflammation, and significant changes in peritubular capillaritis in the SIRPα-mismatched group. 29 Initial data from 375 patients suggest that donor-recipient SIRPα mismatches that modulate innate alloimmune responses are associated with increased acute rejection, premature interstitial fibrosis, tubular atrophy, and increased graft loss and are therefore important determinants of transplant success. 86 The negative effect on graft outcomes was found to be independent of HLA mismatch.…”
Section: Role Of Innate Alr In Clinical Transplantationmentioning
confidence: 99%
“… 24 Orthologs of both mouse PIR-A and CD47 have been identified in humans and they bind HLA molecules and human SIRPα, respectively, suggesting that innate recognition of allogeneic nonself could initiate alloimmune responses in humans as well. 28 , 29 Both classes of receptors are expressed on monocytes, and the engagement of these receptors by nonself MHC-I or SIRPα, respectively, causes differentiation of recipient monocytes into mature DC fully capable of activating the T cells responsible for rejection. It remains likely however that nonallogeneic factors such as PAMP or DAMP released during tissue damage or the intestinal microbiota potentiate monocyte maturation and APC activation at the time of transplantation via classical pattern recognition receptor.…”
Section: Introductionmentioning
confidence: 99%