Detection of anti-MICA*010 in plasma of kidney transplant patients with pathologically confirmed antibody-mediated rejection
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Abstract
The screening for major histocompatibility complex class I- chain related A (MICA) antibodies in pre- and post-kidney transplantation is crucial to minimize the risk of immunological complications and antibody-mediated kidney rejection (AMR). However, the conventional method for detecting anti-MICA antibodies does not include all relevant MICA, especially MICA*010, a predominant MICA allele in northeastern Thais (NETs). Moreover, a significant number of patients have been diagnosed with AMR despite the absence of detectable antibodies. We hypothesized that anti-MICA*010 might be responsible for rejection in such instances. The household recombinant MICA*010 protein was successfully produced by HEK293 T cells and purified by using a cobalt-based magnetic bead with the percent recovery of 88.994. The ELISA testing using purified MICA*010 proteins was performed on plasma samples from 122 patients who were pathologically confirmed with AMR. Our findings showed that 21 samples (17.21%) in AMR patients exhibited the presence of anti-MICA*010. The flow cytometry showed a concordant result with ELISA. Among these samples with anti-MICA*010, the co-existing anti-HLA antibody was observed in one sample. Furthermore, there were six patients (4.9%) with positive for ELISA were negative for both anti-HLA and other anti-MICA antibodies as identified by Lab Screening Mix (LSM) Luminex test suggesting the importance of anti-MCIA*010 detection. Although further research with the comprehensive evaluation regarding the involvement of anti-MICA*010 in the kidney rejection episode is still needed, the present study is the first to highlight the presence of this antibody, which could offer valuable information for antibody detection in the future.
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