Background

Angiotensin II type 1 receptor antibody (AT1R-Ab) is a non-HLA antibody that has been reported to cause antibody-mediated rejection and graft loss in kidney transplantation. The prevalence of positive AT1R-Ab varies between 8% and 18% in different regions. Thus, this study aims to determine the prevalence of AT1R-Ab among the Malaysian population.

Methodology

All sera for AT1R-Ab were collected at the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. The sera were centrifuged and kept refrigerated at −80 °C before being transported to the South Australian Transplantation and Immunogenetics Laboratory (SATIS). Enzyme-linked immunosorbent assay kit (One Lambda) was used for the detection of AT1R-Ab, and it was performed according to the manufacturer's instructions. The level of >17.1 U/mL was considered to be AT1R-Ab positive; 10.0–17.1 U/mL at risk, and <10.0 U/mL negative.

Results

A total of 115 samples were collected from 99 patients pre and post-kidney transplant recipients. From the pre-transplant sera (n = 68) 17.7% were positive, 35.3% were at risk and 47.0% were negative. The positive AT1R-Ab cohort were relatively younger, with a mean age of 34.7 ± 8.3 years old and statistically significant, with a p-value of 0.028. Among the sera that were tested positive, 19.0% were from the Chinese ethnicity, 6.7% from Malay and 16.7% from Indian. There was no difference in the rejection episodes, persistent or de novo HLA-DSA, and graft function between the group (AT1R-Ab negative vs AT1R-Ab at risk and positive) and the results were consistent in a model adjusted for all potential confounders.

Conclusion

The prevalence of positive (>17.1 U/mL) pre-transplant AT1R-Ab was 17.7% and 35.3% were at risk (10.0–17.1 U/mL) in our pre-transplant cohort.

中文翻译：

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AT1R 抗体（AT1R-Ab）在马来西亚多民族人群中的流行。

背景

血管紧张素 II 1 型受体抗体 (AT1R-Ab) 是一种非 HLA 抗体，据报道可在肾移植中引起抗体介导的排斥反应和移植物丢失。AT1R-Ab 阳性的患病率在不同地区介于 8% 和 18% 之间。因此，本研究旨在确定马来西亚人群中 AT1R-Ab 的流行情况。

方法

AT1R-Ab 的所有血清均在马来西亚吉隆坡的马来亚大学医学中心 (UMMC) 收集。血清在被运送到南澳大利亚移植和免疫遗传学实验室（SATIS）之前被离心并在-80°C 下冷藏。酶联免疫吸附测定试剂盒（One Lambda）用于检测AT1R-Ab，并按照制造商的说明进行。水平 >17.1 U/mL 被认为是 AT1R-Ab 阳性；10.0–17.1 U/mL 有风险，<10.0 U/mL 为阴性。

结果

总共从 99 名肾移植受者前后收集了 115 个样本。移植前血清 (n = 68) 17.7% 为阳性，35.3% 有风险，47.0% 为阴性。AT1R-Ab 阳性队列相对年轻，平均年龄为 34.7 ± 8.3 岁，具有统计学意义，p 值为 0.028。在检测呈阳性的血清中，华裔占 19.0%，马来人占 6.7%，印度人占 16.7%。组间排斥事件、持续性或新发 HLA-DSA 以及移植物功能没有差异（AT1R-Ab 阴性 vs AT1R-Ab 有风险和阳性），并且结果在针对所有潜在混杂因素调整的模型中是一致的.

结论

在我们的移植前队列中，移植前 AT1R-Ab 阳性 (>17.1 U/mL) 的患病率为 17.7%，35.3% 有风险 (10.0-17.1 U/mL)。