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

Muhammad Ahmad Mujtaba, Jonathan Fridell, Benita Book, Sara Faiz, Asif Sharfuddin, Eric Wiebke, Mark Rigby, Tim Taber

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)991-996
Number of pages6
JournalClinical Transplantation
Volume29
Issue number11
DOIs
StatePublished - Nov 1 2015

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Autoantigens
Autoantibodies
Allografts
Insulinoma
Tissue Donors
Antibodies
Transplants
Antigens
Protein Isoforms
Pancreas
Research Ethics Committees
Insulin
Incidence

Keywords

  • Autoantibodies
  • Autoimmunity
  • Donor specific antibodies
  • Pancreas transplant
  • Pancreatic allograft dysfunction

ASJC Scopus subject areas

  • Transplantation

Cite this

Re-exposure to beta cell autoantigens in pancreatic allograft recipients with preexisting beta cell autoantibodies. / Mujtaba, Muhammad Ahmad; Fridell, Jonathan; Book, Benita; Faiz, Sara; Sharfuddin, Asif; Wiebke, Eric; Rigby, Mark; Taber, Tim.

In: Clinical Transplantation, Vol. 29, No. 11, 01.11.2015, p. 991-996.

Research output: Contribution to journalArticle

Mujtaba, Muhammad Ahmad ; Fridell, Jonathan ; Book, Benita ; Faiz, Sara ; Sharfuddin, Asif ; Wiebke, Eric ; Rigby, Mark ; Taber, Tim. / Re-exposure to beta cell autoantigens in pancreatic allograft recipients with preexisting beta cell autoantibodies. In: Clinical Transplantation. 2015 ; Vol. 29, No. 11. pp. 991-996.
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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.",
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