Early acute microvascular kidney transplant rejection in the absence of anti-HLA antibodies is associated with preformed IgG antibodies against diverse glomerular endothelial cell antigens

International audienceBACKGROUND: Although anti-HLA antibodies (Abs) cause most antibody-mediated rejections of renal allografts, non-anti-HLA Abs have also been postulated to contribute. A better understanding of such Abs in rejection is needed.METHODS: We conducted a nationwide study to identify kidney transplant recipients without anti-HLA donor-specific Abs who experienced acute graft dysfunction within 3 months after transplantation and showed evidence of microvascular injury, called acute microvascular rejection (AMVR). We developed a crossmatch assay to assess serum reactivity to human microvascular endothelial cells, and used a combination of transcriptomic and proteomic approaches to identify non-HLA Abs.RESULTS: We identified a highly selected cohort of 38 patients with early acute AMVR. Biopsy specimens revealed intense microvascular inflammation and the presence of vasculitis (in 60.5%), interstitial hemorrhages (31.6%), or thrombotic microangiopathy (15.8%). Serum samples collected at the time of transplant showed that previously proposed anti-endothelial cell Abs-angiotensin type 1 receptor (AT1R), endothelin-1 type A and natural polyreactive Abs-did not increase significantly among patients with AMVR compared with a control group of stable kidney transplant recipients. However, 26% of the tested AMVR samples were positive for AT1R Abs when a threshold of 10 IU/ml was used. The crossmatch assay identified a common IgG response that was specifically directed against constitutively expressed antigens of microvascular glomerular cells in patients with AMVR. Transcriptomic and proteomic analyses identified new targets of non-HLA Abs, with little redundancy among individuals.CONCLUSIONS: Our findings indicate that preformed IgG Abs targeting non-HLA antigens expressed on glomerular endothelial cells are associated with early AMVR, and that cell-based assays are needed to improve risk assessments before transplant

A study on absence legitimacy and its implications.

Absenteeism has been established to be one of the leading factors that causes a dip in productivity and may eventually lead to employee turnover. Despite the fact that antecedents of absenteeism has been extensively researched upon, there have yet to be conclusive results on the relationship between the antecedents and absenteeism. Our research is based on 89 teachers and 108 employees from the IT manufacturing industry, who participated in the survey. From the results, we were able to find 1) that Polychronicity, Gender Roles and Work Centrality are significant cause of Collective Legitimacy, 2) Collective Legitimacy is a good mediating variable in predicting Actual Absenteeism 3) Demographics such as Age Group, Industry and Gender showed significant relationships with actual absenteeism. This results from the teaching and IT manufacturing profession help to shed light onto collective legitimacy as a mediating factor in predicting legitimacy. The implications of these findings will be further discussed in the paper.BUSINES