Novel aspects of epitope matching and practical application in kidney transplantation

Wai H. Lim, Germaine Wong, Sebastiaan Heidt, Frans H.J. Claas

Research output: Contribution to journalShort survey

7 Citations (Scopus)

Abstract

This review describes the recent developments in the applicability and clinical significance of epitope matching in kidney transplantation. As incremental human leukocyte antigen (HLA) mismatches are associated with increased risk of rejection and allograft loss, HLA-matching remains one of the standard immunological triage tests to determine transplant suitability. Advancements in tissue-typing techniques have led to innovative concepts of HLA-matching at the epitope level. Epitopes are configurations of polymorphic amino acid residues that are recognized by B cells, and antibodies reactive with these epitopes lead to rejection and/or premature allograft loss. Even though there is substantial advancement in the characterization and understanding of epitopes, evidence supporting the added clinical benefit of epitope matching over traditional antigen matching and the ability to identify clinically relevant immunogenic epitopes remains poorly defined. We present an overview of the evidence surrounding the immunogenicity of mismatched donor epitopes and the applicability of HLA epitope matching in kidney transplantation. A better understanding of the immunogenicity and structural characteristics of HLA epitopes will guide clinicians to integrate epitope matching as an important parameter for donor selection in kidney transplantation.

Original languageEnglish
Pages (from-to)375-389
Number of pages15
JournalKidney International
Volume93
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Fingerprint

Kidney Transplantation
Epitopes
HLA Antigens
Allografts
Donor Selection
Histocompatibility Testing
Immunologic Tests
Triage
B-Lymphocytes
Transplants
Antigens
Amino Acids
Antibodies

Cite this

Lim, Wai H. ; Wong, Germaine ; Heidt, Sebastiaan ; Claas, Frans H.J. / Novel aspects of epitope matching and practical application in kidney transplantation. In: Kidney International. 2018 ; Vol. 93, No. 2. pp. 375-389.
@article{31187e8d9d3641fd9daba2c52a6162a8,
title = "Novel aspects of epitope matching and practical application in kidney transplantation",
abstract = "This review describes the recent developments in the applicability and clinical significance of epitope matching in kidney transplantation. As incremental human leukocyte antigen (HLA) mismatches are associated with increased risk of rejection and allograft loss, HLA-matching remains one of the standard immunological triage tests to determine transplant suitability. Advancements in tissue-typing techniques have led to innovative concepts of HLA-matching at the epitope level. Epitopes are configurations of polymorphic amino acid residues that are recognized by B cells, and antibodies reactive with these epitopes lead to rejection and/or premature allograft loss. Even though there is substantial advancement in the characterization and understanding of epitopes, evidence supporting the added clinical benefit of epitope matching over traditional antigen matching and the ability to identify clinically relevant immunogenic epitopes remains poorly defined. We present an overview of the evidence surrounding the immunogenicity of mismatched donor epitopes and the applicability of HLA epitope matching in kidney transplantation. A better understanding of the immunogenicity and structural characteristics of HLA epitopes will guide clinicians to integrate epitope matching as an important parameter for donor selection in kidney transplantation.",
keywords = "acute rejection, chronic kidney disease, epitope, histocompatibility, kidney transplantation, tissue typin",
author = "Lim, {Wai H.} and Germaine Wong and Sebastiaan Heidt and Claas, {Frans H.J.}",
year = "2018",
month = "2",
day = "1",
doi = "10.1016/j.kint.2017.08.008",
language = "English",
volume = "93",
pages = "375--389",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Academic Press",
number = "2",

}

Novel aspects of epitope matching and practical application in kidney transplantation. / Lim, Wai H.; Wong, Germaine; Heidt, Sebastiaan; Claas, Frans H.J.

In: Kidney International, Vol. 93, No. 2, 01.02.2018, p. 375-389.

Research output: Contribution to journalShort survey

TY - JOUR

T1 - Novel aspects of epitope matching and practical application in kidney transplantation

AU - Lim, Wai H.

AU - Wong, Germaine

AU - Heidt, Sebastiaan

AU - Claas, Frans H.J.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - This review describes the recent developments in the applicability and clinical significance of epitope matching in kidney transplantation. As incremental human leukocyte antigen (HLA) mismatches are associated with increased risk of rejection and allograft loss, HLA-matching remains one of the standard immunological triage tests to determine transplant suitability. Advancements in tissue-typing techniques have led to innovative concepts of HLA-matching at the epitope level. Epitopes are configurations of polymorphic amino acid residues that are recognized by B cells, and antibodies reactive with these epitopes lead to rejection and/or premature allograft loss. Even though there is substantial advancement in the characterization and understanding of epitopes, evidence supporting the added clinical benefit of epitope matching over traditional antigen matching and the ability to identify clinically relevant immunogenic epitopes remains poorly defined. We present an overview of the evidence surrounding the immunogenicity of mismatched donor epitopes and the applicability of HLA epitope matching in kidney transplantation. A better understanding of the immunogenicity and structural characteristics of HLA epitopes will guide clinicians to integrate epitope matching as an important parameter for donor selection in kidney transplantation.

AB - This review describes the recent developments in the applicability and clinical significance of epitope matching in kidney transplantation. As incremental human leukocyte antigen (HLA) mismatches are associated with increased risk of rejection and allograft loss, HLA-matching remains one of the standard immunological triage tests to determine transplant suitability. Advancements in tissue-typing techniques have led to innovative concepts of HLA-matching at the epitope level. Epitopes are configurations of polymorphic amino acid residues that are recognized by B cells, and antibodies reactive with these epitopes lead to rejection and/or premature allograft loss. Even though there is substantial advancement in the characterization and understanding of epitopes, evidence supporting the added clinical benefit of epitope matching over traditional antigen matching and the ability to identify clinically relevant immunogenic epitopes remains poorly defined. We present an overview of the evidence surrounding the immunogenicity of mismatched donor epitopes and the applicability of HLA epitope matching in kidney transplantation. A better understanding of the immunogenicity and structural characteristics of HLA epitopes will guide clinicians to integrate epitope matching as an important parameter for donor selection in kidney transplantation.

KW - acute rejection

KW - chronic kidney disease

KW - epitope

KW - histocompatibility

KW - kidney transplantation

KW - tissue typin

UR - http://www.scopus.com/inward/record.url?scp=85031733462&partnerID=8YFLogxK

U2 - 10.1016/j.kint.2017.08.008

DO - 10.1016/j.kint.2017.08.008

M3 - Short survey

VL - 93

SP - 375

EP - 389

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 2

ER -