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From the Departments of Nephrology* andImmunohematology and Blood Transfusion,
Leiden University Medical Center, Leiden, The Netherlands; and theDepartment of Pathology and LaboratoryMedicine,
University of Calgary, Calgary,Alberta, Canada
Chronic rejection is the leading cause of late renal transplant
failure. Various structural lesions are observed in grafts undergoing
chronic rejection including glomerular basement membrane (GBM)
duplications. The well-established Fisher (F344) to Lewis (LEW) rat
renal transplant model for chronic rejection was used to assess the
presence and role of the humoral immune response against graft antigens
during chronic rejection. LEW recipients of F344 allografts develop
transplant glomerulopathy and produce IgG1 antibodies directed against
F344 GBM preparations that are detectable 3 weeks after
transplantation. Glomerular IgG1 deposition was observed that in
vitro co-localized with a rabbit anti-rat GBM antiserum in
rejecting F344 grafts; elution experiments of isolated glomeruli
yielded IgG1 antibodies reactive in vitro with F344
GBM, but not LEW GBM. Prevention of acute rejection by
transient treatment of the recipients with cyclosporin A completely
abrogated the production of anti-GBM antibodies. Using proteomic
techniques we identified the antigens recognized by the LEW
posttransplant sera as being the heparan sulfate proteoglycan perlecan
and the
1 chain of collagen type VI in association with the
5
chain of collagen type IV. In conclusion, LEW recipients of
F344 kidney grafts produce IgG1 antibodies against donor type perlecan
and
1(VI)/
5(IV) collagen and develop transplant glomerulopathy.
These data implicate an important role for the humoral immune response
in the development of glomerulopathy during chronic
rejection.
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