Antibody response may lead to narrowed arteries and organ rejection

April 14, 2011

Kidney transplant recipients who develop antibodies in response to receiving new organs can develop accelerated arteriosclerosis, or narrowing of the arteries that supply blood to the kidney, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results indicate that arteriosclerosis resulting from such donor-specific antibodies may play an important role in organ rejection following transplantation.

Antibody-mediated transplant rejection—a process that occurs when a transplant recipient mounts antibodies against a new organ—can contribute to declining function and ultimately loss of transplanted kidneys. To study the effects of antibody-mediated , Gary Hill, MD (Hôpital Européen Georges Pompidou, APHP, in Paris, France), Alexandre Loupy, MD, PhD (Hôpital Necker, APHP in Paris, France), and their colleagues examined kidney biopsies from 40 transplant patients who mounted antibodies directed against their transplanted kidney and 59 patients who did not.

The investigators found that narrowing of the arteries significantly progressed between three and 12 months after transplant in the antibody-positive patients but not in the antibody-negative patients. In those patients who did not develop antibodies, narrowing of the arteries progressed at approximately one third the rate of patients who did develop .

In the antibody-positive patients, narrowing of the arteries in the transplanted kidneys was much worse than expected based on the donor's age and translated to approximately 28 years of "aging" in the first year after transplantation. "This accelerated arteriosclerosis can now be seen to form part of the rejection process, and it will probably be found to contribute to the ultimate decline of kidney function," said Dr. Hill.

The study's results should spark considerable interest in the importance of arteriosclerosis following kidney transplantation. "Acceleration of arteriosclerosis was a totally unexpected finding, an important one since it broadens our thinking about what constitutes rejection," said Dr. Hill.

More information: The article entitled, "Donor-Specific Antibodies Accelerate Arteriosclerosis after Kidney Transplantation," will appear online on April 14, 2011, doi 10.1681/ASN.2010070777

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3 / 5 (1) Apr 15, 2011
Vitamin C plays a vital role in clearing cholesterol from the arteries. It also plays a big role in the immune system.

Hence, if it gets used up in the anti-body activities, not much is left for clearing out arteries. It stands to reason that the body would choose to use the vitamin C in the anti-body activities instead of clearing out arteries since the immune system would be given priority at that stage. This then would lead to narrowed arteries. I'm surprised the researchers didn't investigate this from the start.

This is similar to the use of calcium in protein metabolism [and cortisol activities] taking precedence over storing/releasing calcium from bone - thus leading to osteoporosis.

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