Serum Aberrant N-Glycan Profile as a Marker Associated with Early Antibody-Mediated Rejection in Patients Receiving a Living Donor Kidney Transplant

• Published in: International journal of molecular sciences 2017-08, Vol.18 (8), p.1731
• Main Authors: Noro, Daisuke, Yoneyama, Tohru, Hatakeyama, Shingo, Tobisawa, Yuki, Mori, Kazuyuki, Hashimoto, Yasuhiro, Koie, Takuya, Tanaka, Masakazu, Nishimura, Shin-Ichiro, Sasaki, Hideo, Saito, Mitsuru, Harada, Hiroshi, Chikaraishi, Tatsuya, Ishida, Hideki, Tanabe, Kazunari, Satoh, Shigeru, Ohyama, Chikara
• Format: Article
• Language: English
• Subjects: Aberration; Adult; Aged; Antibody-Dependent Cell Cytotoxicity - immunology; antibody-mediated rejection; biomarker; Biomarkers; Case-Control Studies; Diagnostic systems; Discriminant analysis; Female; Glycan; Graft rejection; Graft Rejection - blood; Graft Rejection - immunology; Humans; Immunoglobulin Isotypes - blood; Immunoglobulin Isotypes - immunology; Immunoglobulins; Kaplan-Meier Estimate; Kidney Transplantation - adverse effects; Kidney Transplantation - mortality; Kidney transplants; Kidneys; Living Donors; Lymphocytes T; Male; Mass spectrometry; Mass spectroscopy; Middle Aged; N-glycan; Polysaccharides - blood; Rejection; Reproducibility of Results; ROC Curve; Sensitivity analysis; Time Factors; Transplants & implants; Young Adult
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms18081731

We determined if the serum -glycan profile can be used as a diagnostic marker of antibody-mediated rejection (ABMR) in living donor kidney transplant (LKTx) recipients. Glycoblotting, combined with mass spectrometry, was used to retrospectively examine -glycan levels in the postoperative sera of 197 LKTx recipients of whom 16 recipients had ABMR with or without T-cell-mediated rejection (TCMR), 40 recipients had TCMR, and 141 recipients had no adverse events. Multivariate discriminant analysis for prediction of ABMR was performed by inputting an ABMR event as an explanatory variable and sex, age, and serum N-glycan level as objective variables. The N-glycan score was calculated by multiplying the level of candidate objective variables by objective function values. The ABMR predictive performance of the N-glycan score was assessed by receiver operator characteristic curve and Kaplan-Meier curve analyses. The -glycan score discriminated ABMR with 81.25% sensitivity, 87.85% specificity, and an area under the curve (AUC) of 0.892 that was far superior to that of preformed donor-specific antibody status (AUC, 0.761). Recipients with N-glycan-positive scores >0.8770 had significantly shorter ABMR survival than that of recipients with N-glycan-negative scores. Although the limitations of our study includ its small sample size and retrospective nature, the serum N-glycan score may contribute to prediction of ABMR.