Technical challenges and clinical relevance of single antigen bead C1q/C3d testing and IgG subclass analysis of human leukocyte antigen antibodies

Transpl Int. 2018 Nov;31(11):1189-1197. doi: 10.1111/tri.13327. Epub 2018 Aug 24.

Abstract

Luminex single antigen bead assays revolutionized human leukocyte antigen (HLA) antibody detection owing to their superior sensitivity compared to conventional methods. Nevertheless, the advent of higher sensitivity came at the expense of difficulty in clinical decision-making, since not all luminex detectable antibodies are clinically relevant. Therefore, new tools such as C1q/C3d assays and IgG subclass analysis emerged with the aim to discriminate the inert antibodies from the deleterious ones. Here, we provide an overview on the technical challenges related to these different HLA antibody detection systems and briefly refer to the recent literature regarding the clinical relevance of these assays, mainly in the field of kidney transplantation.

Keywords: antibody-mediated rejection; donor-specific antibody; kidney transplantation; luminex.

Publication types

  • Review

MeSH terms

  • Complement C1q / chemistry*
  • Complement C3d / chemistry*
  • Decision Support Systems, Clinical
  • Graft Rejection / immunology
  • HLA Antigens / chemistry*
  • Histocompatibility Testing / methods*
  • Humans
  • Immunoglobulin G / chemistry*
  • Isoantibodies / immunology
  • Kidney Transplantation
  • Postoperative Period
  • Prognosis
  • Protein Binding
  • Risk

Substances

  • HLA Antigens
  • Immunoglobulin G
  • Isoantibodies
  • Complement C1q
  • Complement C3d