Protein microarrays identify antibodies to protein kinase Czeta that are associated with a greater risk of allograft loss in pediatric renal transplant recipients

Kidney Int. 2009 Dec;76(12):1277-83. doi: 10.1038/ki.2009.384. Epub 2009 Oct 7.

Abstract

Antibodies to human leukocyte antigens (HLAs) are a risk factor for acute renal allograft rejection and loss. The role of non-HLAs and their significance to allograft rejection have gained recent attention. Here, we applied protein microarray technology, with the capacity to simultaneously identify 5056 potential antigen targets, to assess non-HLA antibody formation in 15 pediatric renal transplant recipients during allograft rejection. Comparison of the pre- and post-transplant serum identified de novo antibodies to 229 non-HLA targets, 36 of which were present in multiple patients at allograft rejection. On the basis of its reactivity, protein kinase Czeta (PKCzeta) was selected for confirmatory testing and clinical study. Immunohistochemical analysis found PKCzeta both within the renal tissue and infiltrating lymphocytes at rejection. Patients who had an elevated anti-PKCzeta titer developed rejection, which was significantly more likely to result in graft loss. The absence of C4d deposition in patients with high anti-PKCzeta titers suggests that it is a marker of severe allograft injury rather than itself being pathogenic. Presumably, critical renal injury and inflammation associated with this rejection subtype lead to the immunological exposure of PKCzeta with resultant antibody formation. Prospective assessment of serum anti-PKCzeta levels at allograft rejection will be needed to confirm these results.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Adolescent
  • Child
  • Complement C4b / metabolism
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Graft Rejection / enzymology
  • Graft Rejection / etiology*
  • Graft Rejection / immunology*
  • Graft Rejection / pathology
  • Graft Survival / immunology
  • HLA Antigens
  • Humans
  • Immunohistochemistry
  • Isoantibodies / blood*
  • Isoantigens
  • Kidney / enzymology
  • Kidney / immunology
  • Kidney / pathology
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology*
  • Kidney Transplantation / pathology
  • Male
  • Peptide Fragments / metabolism
  • Protein Array Analysis
  • Protein Kinase C / immunology*
  • Protein Kinase C / metabolism
  • Risk Factors
  • Transplantation, Homologous

Substances

  • HLA Antigens
  • Isoantibodies
  • Isoantigens
  • Peptide Fragments
  • Complement C4b
  • complement C4d
  • protein kinase C zeta
  • Protein Kinase C