Re-exposure to beta cell autoantigens in pancreatic allograft recipients with preexisting beta cell autoantibodies.

Abstract

Re-exposure to beta cell autoantigens and its relevance in the presence of donor-specific antibodies (DSA) in pancreatic allograft recipients is not well known. Thirty-three patients requiring a pancreas transplant were enrolled in an IRB approved study. They underwent prospective monitoring for DSA and beta cell autoantibody (BCAA) levels to GAD65, insulinoma-associated antigen 2 (IA-2), insulin (micro-IAA [mIAA]), and islet-specific zinc transporter isoform-8 (ZnT8). Twenty-five (75.7%) had pre-transplant BCAA. Twenty had a single antibody (mIAA n = 15, GAD65 n = 5); five had two or more BCAA (GAD65 + mIAA n = 2, GAD65 + mIAA+IA-2 n = 2, GA65 + mIAA+IA-2 + ZnT8 = 1). No changes in GAD65 (p > 0.29), IA-2 (>0.16), and ZnT8 (p > 0.07) were observed between pre-transplant and post-transplant at 6 or 12 months. A decrease in mIAA from pre- to post-6 months (p < 0.0001), 12 months (p < 0.0001), and from post-6 to post-12 months (p = 0.0002) was seen. No new BCAA was observed at one yr. Seven (21.0%) developed de novo DSA. The incidence of DSA was 24% in patients with BCAA vs. 25% in patients without BCAA (p = 0.69). Pancreatic allograft function of patients with vs. without BCAA, and with and without BCAA + DSA was comparable until last follow-up (three yr). Re-exposure to beta cell autoantigens by pancreas transplant may not lead to increased levels or development of new BCAA or pancreatic allograft dysfunction.

• Authors: Muhammad Ahmad Mujtaba, Jonathan Fridell, Benita Book, Sara Faiz, Asif Sharfuddin, Eric Wiebke, Mark Rigby, Tim Taber
• Journal: Clinical transplantation (Clin Transplant) Vol. 29 Issue 11 Pg. 991-6 (Nov 2015) ISSN: 1399-0012 [Electronic] Denmark
• PMID: 26289931 (Publication Type: Journal Article)
• Copyright: © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Autoantibodies
• Autoantigens

Topics

• Allografts
• Autoantibodies (blood, immunology)
• Autoantigens (immunology)
• Diabetes Mellitus, Type 1 (blood, immunology, surgery)
• Female
• Follow-Up Studies
• Humans
• Islets of Langerhans (immunology)
• Male
• Middle Aged
• Pancreas Transplantation
• Prognosis
• Prospective Studies