{"id":3622,"date":"2024-10-28T14:03:00","date_gmt":"2024-10-28T06:03:00","guid":{"rendered":"https:\/\/www.transplantation.com.cn\/?p=3622"},"modified":"2025-04-01T17:51:16","modified_gmt":"2025-04-01T09:51:16","slug":"%e9%87%8d%e8%a7%86hla-dq%e4%bd%8d%e7%82%b9%e9%94%99%e9%85%8d%e5%af%b9%e7%a7%bb%e6%a4%8d%e8%82%be%e6%8e%92%e6%96%a5%e5%8f%8d%e5%ba%94%e7%9a%84%e5%bd%b1%e5%93%8d","status":"publish","type":"post","link":"https:\/\/www.transplantation.com.cn\/en_US\/2024\/10\/28\/%e9%87%8d%e8%a7%86hla-dq%e4%bd%8d%e7%82%b9%e9%94%99%e9%85%8d%e5%af%b9%e7%a7%bb%e6%a4%8d%e8%82%be%e6%8e%92%e6%96%a5%e5%8f%8d%e5%ba%94%e7%9a%84%e5%bd%b1%e5%93%8d\/","title":{"rendered":"Pay Attention to the Effect of HLA-DQ Mismatch on Kidney Allograft Rejection"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>October 28, 2024, Immune Tolerance<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"688\" height=\"134\" src=\"http:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-94.png\" alt=\"\" class=\"wp-image-3529\" style=\"width:750px;height:auto\" srcset=\"https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-94.png 688w, https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-94-300x58.png 300w\" sizes=\"auto, (max-width: 688px) 100vw, 688px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Tissue or organ rejection may occur when transplants are performed between individuals of different species or between individuals of the same species but different genetic lineages; it is fundamentally an immune response triggered by allogeneic antigens on the cell surface.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Such an allogeneic antigen, which represents individual specificity, is called a transplantation antigen or histocompatibility antigen. Antigens causing strong and rapid rejection are termed major histocompatibility antigens (MHAs), while those causing weaker or slower rejection are termed minor histocompatibility antigens (MiHAs).<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"796\" height=\"531\" src=\"https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-113.png\" alt=\"\" class=\"wp-image-3624\" srcset=\"https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-113.png 796w, https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-113-300x200.png 300w, https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-113-768x512.png 768w\" sizes=\"auto, (max-width: 796px) 100vw, 796px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">In clinical tissue or organ transplantation, MHA matching is typically a prerequisite for successful transplantation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In humans, MHAs are also known as human leukocyte antigens (HLAs).<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\">HLAs are primarily categorized into two main types:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Class I, which includes HLA-A, HLA-B, and HLA-C, is widely distributed across various tissues and cells.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Class II, which includes HLA-DP, HLA-DQ, and HLA-DR, is present in B cells, macrophages, and activated T cells.<\/p>\n<\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\">In clinical kidney transplantation, only HLA-A, HLA-B, and HLA-DR are typically tested, totaling six loci, because previous studies have demonstrated that these three molecules are most closely associated with graft rejection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Recently, international research teams have investigated the impact of HLA-DQ mismatch on kidney allograft rejection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The study utilized data from dialysis and transplant centers in Australia and New Zealand from 2004 to 2012, employing an adjusted Cox regression model to examine the relationship between HLA-DQ locus mismatch and acute rejection in living or deceased kidney transplant recipients.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nearly 800 kidney transplant patients underwent an average follow-up of nearly 3 years, with 40.7% of patients receiving no HLA-DQ locus mismatch or a single HLA-DQ locus mismatch from the donor kidney, while 59.3% received donor kidneys with two HLA-DQ locus mismatches. Patients who received kidney transplants with one or two HLA-DQ mismatches were more prone to developing rejection (with late rejection more likely to occur 6 months post-transplantation) and antibody-mediated rejection compared to those who received kidneys without HLA-DQ mismatches.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">After adjusting for factors such as age, race, donor kidney type, BMI, the number of HLA-A, B, and DR mismatches, panel reactive antibodies, kidney transplant wait time, ischemia time, induction therapy, and primary immunosuppressive response, follow-up results indicated that kidney transplant recipients with one or two HLA-DQ mismatched donor kidneys had a significantly higher risk of heart failure compared to those without HLA-DQ mismatches. The adjusted hazard ratios for acute or late rejection were 1.54 and 2.85, respectively. HLA-DR loci can effectively modulate the impact of HLA-DQ mismatch and antibody-mediated rejection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Therefore, the association was more pronounced in recipients of donor kidneys with one or two HLA-DQ mismatches, with an adjusted hazard ratio of 2.50.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"795\" height=\"552\" src=\"https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-114.png\" alt=\"\" class=\"wp-image-3625\" srcset=\"https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-114.png 795w, https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-114-300x208.png 300w, https:\/\/www.transplantation.com.cn\/wp-content\/uploads\/2024\/10\/image-114-768x533.png 768w\" sizes=\"auto, (max-width: 795px) 100vw, 795px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The findings confirmed that the increased incidence of acute rejection in this study was attributable to HLA-DQ mismatch, not HLA-A, B, DR mismatches, or primary immunosuppression.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Therefore, in our clinical practice, in addition to focusing on HLA-A, B, and DR locus matching, we should also prioritize HLA-DQ locus matching when assessing the immune-related risks of kidney transplant patients prior to surgery.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Written by | Jina Wang, Edited by | Yichen Jia, Photography | C.M. et al<\/strong><\/p>\n\n\n\n<div class=\"gspb_button_wrapper gspb_button-id-gsbp-9b0f7c0\" id=\"gspb_button-id-gsbp-9b0f7c0\"><a class=\"wp-block-greenshift-blocks-buttonbox gspb-buttonbox wp-element-button\" href=\"https:\/\/mp.weixin.qq.com\/s\/T5FSAIqf0S_ZuCYGH4jc4Q\" title=\"\u5168\u56fd\u9996\u4f8b\u5c3f\u8def\u611f\u67d3\u6cbb\u7597\u6848\u4f8b\" target=\"_blank\" rel=\"noopener\"><span class=\"gspb-buttonbox-textwrap\"><span class=\"gspb-buttonbox-text\"><span class=\"gspb-buttonbox-title\">Read the original article<\/span><\/span><span class=\"gspb-buttonbox-icon\"><svg class=\"\" style=\"display:inline-block;vertical-align:middle\" width=\"15\" height=\"15\" viewBox=\"0 0 896 1024\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path style=\"fill:#565D66\" d=\"M436.202 76.202l-39.598 39.598c-9.372 9.372-9.372 24.568 0 33.942l310.26 310.258h-682.864c-13.254 0-24 10.746-24 24v56c0 13.254 10.746 24 24 24h682.864l-310.26 310.26c-9.372 9.372-9.372 24.568 0 33.942l39.598 39.598c9.372 9.372 24.568 9.372 33.942 0l418.828-418.828c9.372-9.372 9.372-24.568 0-33.942l-418.83-418.828c-9.372-9.374-24.568-9.374-33.94 0z\"><\/path><\/svg><\/span><\/span><\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p><!-- wp:paragraph --><\/p>\n<p><strong>October 28, 2024, Immune Tolerance<\/strong><\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:image {\"id\":3529,\"width\":\"750px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} --><\/p>\n<figure class=\"wp-block... \n\n","protected":false},"author":1,"featured_media":3626,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_gspb_post_css":"#gspb_button-id-gsbp-9b0f7c0{display:flex;justify-content:center}#gspb_button-id-gsbp-9b0f7c0 .gspb-buttonbox-text{display:flex;flex-direction:column}#gspb_button-id-gsbp-9b0f7c0>.gspb-buttonbox{box-sizing:border-box}#gspb_button-id-gsbp-9b0f7c0>.gspb-buttonbox>.gspb-buttonbox-textwrap>.gspb-buttonbox-icon{display:flex}#gspb_button-id-gsbp-9b0f7c0>.gspb-buttonbox .gspb-buttonbox-icon svg,#gspb_button-id-gsbp-9b0f7c0>.gspb-buttonbox .gspb-buttonbox-icon svg path,#gspb_button-id-gsbp-9b0f7c0>.gspb-buttonbox:hover .gspb-buttonbox-icon svg,#gspb_button-id-gsbp-9b0f7c0>.gspb-buttonbox:hover .gspb-buttonbox-icon svg 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