Infectious pathogens may trigger specific allo-HLA reactivity via multiple mechanisms

D’Orsogna, Lloyd; Heuvel, H. van den; Kooten, Cees van; Heidt, Sebastiaan; Claas, Frans H.J.

doi:10.1007/s00251-017-0989-3

Cited by 54 publications

(56 citation statements)

References 97 publications

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“…However, these studies have not examined the role of infection as a risk factor for the development of DSA, yet infections are common complications after lung transplantation and have been linked to the development of CLAD . Emerging data support the paradigm that infections may augment or trigger alloimmune responses that promote rejection . Although various mechanisms have been proposed to explain this association, most of which involve analyzing T cell–mediated immune responses, a role for humoral immune activation, especially DSA, has not been defined.…”

Section: Introductionmentioning

confidence: 99%

Pseudomonas aeruginosa and acute rejection independently increase the risk of donor-specific antibodies after lung transplantation

Kulkarni

Tsui

Sunder

et al. 2020

American Journal of Transplantation

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Factors contributing to donor‐specific HLA antibody (DSA) development after lung transplantation have not been systematically evaluated. We hypothesized that the isolation of Pseudomonas aeruginosa in respiratory specimens would increase the risk of DSA development. Our objective was to determine the risk of DSA development associated with the isolation of Pseudomonas aeruginosa after lung transplantation. We conducted a single‐center retrospective cohort study of primary lung transplant recipients and examined risk factors for DSA development using Cox regression models. Of 460 recipients, 205 (45%) developed DSA; the majority developed Class II DSA (n = 175, 85%), and 145 of 205 (71%) developed DSA to HLA‐DQ alleles. Univariate time‐dependent analyses revealed that isolation of Pseudomonas from respiratory specimens, acute cellular rejection, and lymphocytic bronchiolitis are associated with an increased risk of DSA development. In multivariable analyses, Pseudomonas isolation, acute cellular rejection, and lymphocytic bronchiolitis remained independent risk factors for DSA development. Additionally, there was a direct association between the number of positive Pseudomonas cultures and the risk of DSA development. Our findings suggest that pro‐inflammatory events including acute cellular rejection, lymphocytic bronchiolitis, and Pseudomonas isolation after transplantation are associated with an increased risk of DSA development.

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Section: Introductionmentioning

confidence: 99%

Pseudomonas aeruginosa and acute rejection independently increase the risk of donor-specific antibodies after lung transplantation

Kulkarni

Tsui

Sunder

et al. 2020

American Journal of Transplantation

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“…Severe diarrhoea is a cause of systemic inflammation and may also lead to ischemic injury to grafts because of dehydration or volume depletion . Recently, growing evidence has indicated that production of DSA is attributable to increased alloreactivity by multiple types of infections, including Cytomegalovirus . In the present study, the infectious and non‐infectious diarrhoea groups showed an elevated risk of DSA, despite different classes of DSA and the dependence on the change in immunosuppressive regimen.…”

Section: Discussionmentioning

confidence: 48%

Effect of severe diarrhoea on kidney transplant outcomes

Kim

et al. 2019

Nephrology

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Aim In addition to immunological complications, non‐immunological events should be considered following kidney transplantation. Among them, diarrhoea is the most common gastrointestinal complication, but its effect on transplant outcomes remains unclear. Methods This retrospective study enrolled patients who underwent kidney transplantation between May 1993 and December 2017. Patients with diarrhoea as the chief complaint at admission were defined as the diarrhoea group. Transplant outcomes were compared between the diarrhoea and non‐diarrhoea groups. Results Among a total of 1704 kidney recipients, severe diarrhoea that required hospitalization was identified in 84 (4.9%) patients. Patients with diarrhoea showed higher risks of graft failure (adjusted hazard ratio, 4.77 (2.98–7.64)) and all‐cause mortality (adjusted hazard ratio, 7.17 (4.09–12.58)) than did patients without diarrhoea. The risk of de novo donor‐specific antibody was also elevated in the diarrhoea group, although there was no change in the risk of biopsy‐proven rejection. In subgroup analysis, the aetiology of diarrhoea, as well as a change in immunosuppressant following diarrhoea, showed no significant differences in graft survival. However, incomplete recovery from concurrent acute kidney injury was significantly associated with graft loss. Conclusion Diarrhoea is related to poor graft and patients’ outcomes in kidney recipients. An effort to recover from concurrent acute kidney injury is important for improved graft survival.

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“…Antibodies have been shown to protect from heterologous virus challenge [15]. On the other hand, antibodies induced by viral infection contribute to autoimmune disease [11] and possibly play a role in alloreactivity [16]. Evidence suggests that T cell receptor (TCR) cross-reactivity is common between respiratory viruses [17,18,19,20], but it has also been shown between unrelated viruses [21,22,23] and even between viruses and other microbial species [23].…”

Section: Heterologous Immunitymentioning

confidence: 99%

“…A narrowed T cell response may lead to escape variants and has been shown to be associated with severe disease progression [27,28]. Furthermore, virus-mediated TCR cross-reactivity has also been shown to involve allo- [16] as well as autoantigens [11,29]. Cross-reactive CD8 + T cells contributed to transplant rejection in many [16], although not all cases [30].…”

Section: Heterologous Immunitymentioning

confidence: 99%

Respiratory virus-induced heterologous immunity

2018

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Purpose: To provide current knowledge on respiratory virus-induced heterologous immunity (HI) with a focus on humoral and cellular cross-reactivity. Adaptive heterologous immune responses have broad implications on infection, autoimmunity, allergy and transplant immunology. A better understanding of the mechanisms involved might ultimately open up possibilities for disease prevention, for example by vaccination. Methods: A structured literature search was performed using Medline and PubMed to provide an overview of the current knowledge on respiratoryvirus induced adaptive HI. Results: In HI the immune response towards one antigen results in an alteration of the immune response towards a second antigen. We provide an overview of respiratory virus-induced HI, including viruses such as respiratory syncytial virus (RSV), rhinovirus (RV), coronavirus (CoV) and in uenza virus (IV). We discuss T cell receptor (TCR) and humoral cross-reactivity as mechanisms of HI involving those respiratory viruses. Topics covered include HI between respiratory viruses as well as between respiratory viruses and other pathogens. Newly developed vaccines, which have the potential Cite this as Pusch E, Renz H, Skevaki C. Respiratory virus-induced heterologous immunity -Part of the problem or part of the solution? Allergo J Int 2018; 27:79-96

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Infectious pathogens may trigger specific allo-HLA reactivity via multiple mechanisms

Cited by 54 publications

References 97 publications

Pseudomonas aeruginosa and acute rejection independently increase the risk of donor-specific antibodies after lung transplantation

Pseudomonas aeruginosa and acute rejection independently increase the risk of donor-specific antibodies after lung transplantation

Effect of severe diarrhoea on kidney transplant outcomes

Respiratory virus-induced heterologous immunity

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