%0 Journal Article %T Differential Modulation of Donor-Specific Antibodies After B-Cell Depleting Therapies to Cure Chronic Antibody Mediated Rejection %+ Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI) %+ Institut de transplantation urologie-néphrologie (ITUN) %+ Etablissement Français du Sang [Nantes] %+ Service d'Anatomie Pathologique [CHU Nantes] %+ CIC biothérapies CBT 0503 [Nantes] %A Touzot, Maxime %A Couvrat-Desvergnes, Grégoire %A Castagnet, Stéphanie %A Cesbron, Anne %A Renaudin, Karine %A Cantarovich, Diego %A Giral, Magali %< avec comité de lecture %@ 0041-1337 %J Transplantation %I Lippincott, Williams & Wilkins %V 99 %N 1 %P 63-68 %8 2015 %D 2015 %R 10.1097/TP.0000000000000285 %Z Life Sciences [q-bio]/Human health and pathologyJournal articles %X Background. Donor-specific antibodies (DSA) are considered as reliable biomarkers for antibody-mediated rejection (ABMR) diagnosis. However, it is unclear whether DSA monitoring is necessary and could predict graft outcome after antire-jection treatment.Methods. We analyzed 28 non-sensitized kidney transplant patients with ABMR associated with de novo anti-human leukocyte antigen (HLA) DSA. Donor-specific antibody levels were measured by single antigen bead assays 12 months after antirejection therapy onset. Patients were placed in three groups according to their antirejection treatment: group I (n = 10), plasma exchange-Rituximab; group II (n = 8), Bortezomib; and group III (n = 10), optimization of maintenance immunosuppression. Half of the patients in group I demonstrated concomitant acute cellular rejection (ACR+).Results. De novo DSA were mainly anti-DQ (60%). Anti-class I and anti-DR DSA disappeared after treatment in group I and remained negative during follow-up, whereas anti-DQ DSA persisted without any modulation. In contrast, class I-II HLA-DSA mean fluorescence intensity remained unchanged in groups II and III. Graft loss was observed in 80% and 20% of patients from group I (ACR+) and group III, respectively. One year after the ABMR treatment, a 16-mL/min decline in estimated glomerular filtration rate was observed in patients from group I (ACR−) and group III. Group II showed better outcomes with a mean estimated glomerular filtration rate decline of 6.4 mL/min. Conclusion. Modulation of DSA at and after treatment of ABMR did not correlate with graft outcome over a 12-month period. %G English %2 https://inserm.hal.science/inserm-02147796/document %2 https://inserm.hal.science/inserm-02147796/file/2015Differential_Modulation_of_Donor_Specific.15%20%281%29.pdf %L inserm-02147796 %U https://inserm.hal.science/inserm-02147796 %~ INSERM %~ UNIV-NANTES %~ CRTI %~ NANTES-UNIVERSITE %~ UNIV-NANTES-AV2022 %~ CR2TI %~ UFR-MEDECINE-NANTES