Evaluation of the humoral immune response to human leukocyte antigens in Brazilian renal transplant candidates.

Pre-transplant sensitization to human leukocyte antigens (HLA) is a risk factor for graft failure. Studies of the immunological profile related to anti-HLA antibodies in Brazilian renal transplant candidates are few. In this study, we evaluated the humoral immune response to HLA antigens in 269 renal transplant candidates, in Paraná State, Brazil. The HLA typing was performed by the polymerase chain reaction sequence-specific oligonucleotide method (PCR-SSO) combined with Luminex technology, using an SSO-LABType commercial kit (One Lambda, Inc., Canoga Park, CA, USA). The percentages of panel-reactive antibodies (PRA) and the specificity of anti-HLA antibodies were determined using the LS1PRA and LS2PRA commercial kits (One Lambda, Inc.). The PRA-positive group consisted of 182 (67.7%) patients, and the PRA-negative group of 87 (32.3%) patients. The two groups differed significantly only with respect to gender. Females were the most sensitized. Among the 182 patients with PRA- positive, 62 (34.1%) were positive for class I and negative for class II, 39 (21.4%) were negative for class I and positive for class II, and 81 (44.5%) were positive for both classes I and II. The HLA-A*02, A*24, A*01, B*44, B*35, B*15, DRB1*11, DRB1*04 and DRB1*03 allele groups were the most frequent. The specificities of anti-HLA antibodies were more frequent: A34, B57, Cw15, Cw16, DR51, DQ8 and DP14. This study documented the profile of anti-HLA antibodies in patients with chronic renal failure who were on waiting lists for an organ in Paraná, and found high sensitization to HLA antigens in the samples

MICA diversity and linkage disequilibrium with HLA-B alleles in renal-transplant candidates in southern Brazil.

The major histocompatibility complex (MHC) class I chain-related gene A (MICA) is located centromerically to the human leukocyte antigen (HLA)-B. The short distance between these loci in the MHC indicates the presence of linkage disequilibrium (LD). Similarly to the HLA, the MICA is highly polymorphic, and this polymorphism has not been well documented in different populations. In this study, we estimated the allelic frequencies of MICA and the linkage disequilibrium with HLA-B alleles in 346 renal-transplant candidates in southern Brazil. MICA and HLA were typed using the polymerase chain reaction-sequence-specific primer method (PCR-SSO), combined with the Luminex technology. A total of 19 MICA allele groups were identified. The most frequent allele groups were MICA*008 (21.6%), MICA*002 (17.0%) and MICA*004 (14.8%). The most common haplotypes were MICA*009-B*51 (7.8%), MICA*004-B*44 (6.06%) and MICA*002-B*35 (5.63%). As expected from the proximity of the MICA and HLA-B loci, most haplotypes showed strong LD. Renal patients and healthy subjects in the same region of Brazil showed statistically significant differences in their MICA polymorphisms. The MICA*027 allele group was more frequent in renal patients (Pc = 0.018, OR: 3.421, 95% CI: 1.516-7.722), while the MICA*019 allele group was more frequent in healthy subjects (Pc = 0.001, OR: 0.027, 95% CI: 0.002-0.469). This study provided information on the distribution of MICA polymorphisms and linkage disequilibrium with HLA-B alleles in Brazilian renal-transplant candidates. This information should help to determine the mechanisms of susceptibility to different diseases in patients with chronic kidney disease, and to elucidate the mechanisms involved in allograft rejection associated with MICA polymorphisms in a Brazilian population

Chronic kidney disease: information on southern brazilian patients with kidney disease = Insuficiência renal crônica: conhecendo o paciente nefropata sulbrasileiro

The profile of patients undergoing haemodialysis in the dialysis unit of Hospital Santa Casa de Maringá, Maringá PR Brazil, is provided. A questionnaire on social and economic data and underlying diseases prior to the Chronic Kidney Disease (CKD) identified the patients’ profile. The project was approved by the Ethics Committee of the institution. Eighty-three patients, with 54.21% males, were interviewed. Age bracket ranged between 20 and 59 years in 65.06% of patients. Only 27.71% maintained jobs after the diagnosis and the start of treatment; 63.86% had an average personal income between 1 and 3 minimum wages; 63.85% did not practice any physical activity. Moreover, 53.01% belonged to the European-Brazilian white group; 20.48% to the Afro-Brazilian brown group; 19.28% to the Afro-Brazilian Negro group; 6.02% to other ethnic groups. Further, 85.54% patients reported having an underlying disease prior to the CKD, namely, 61.45% were hypertensive; 31.33% were diabetics and 20.48% had other diseases. Results show the need of a greater attention to these patients’ health care to reduce the negative impacts related to the chronic disease focused.<br><br>Este estudo teve como objetivo identificar o perfil dos pacientes em tratamento hemodialítico do setor de diálise do Hospital Santa Casa de Maringá - Paraná, Brasil. Para a identificação do perfil destes pacientes foi utilizado um questionário contendo questões que abrangem dados socioeconômicos e doenças de base anteriores à Insuficiência Renal Crônica (IRC). O projeto foi aprovado pelo Comitê de Ética em Pesquisa da instituição. Entre os 83 pacientes entrevistados, 54,21% eram do sexo masculino. A faixa etária variou de 20 a 59 anos para 65,06% dos pacientes. Somente 27,71% continuaram trabalhando após o diagnóstico e início do tratamento. A renda pessoal média ficou entre um e três salários mínimos para 63,86% dos indivíduos. A atividade física está ausente em 63,85%. Quanto à etnia, foi verificado que 53,01% eram brasileiros descendentes de europeus/brancos, 20,48% brasileiros afrodescendentes/pardos, 19,28% brasileiros afrodescendentes/negros e 6,02% declararam como pertencentes à outras etnias. Entre os pacientes, 85,54% declararam possuir outra doença de base anterior à IRC sendo: 61,45% hipertensão arterial, 31,33% diabetes e 20,48% outras doenças. Estes resultados indicam a necessidade de uma melhor atenção ao cuidado da saúde desses pacientes para a redução dos impactos negativos relacionados à cronicidade da doença

<b>Chronic kidney disease: information on southern brazilian patients with kidney disease</b> - 10.4025/actascihealthsci.v34ispec.16048 <b>Chronic kidney disease: information on southern brazilian patients with kidney disease</b> - 10.4025/actascihealthsci.v34ispec.16048

<p class="aresumo">The profile of patients undergoing haemodialysis in the dialysis unit of Hospital Santa Casa de Maringá, Maringá PR Brazil, is provided. A questionnaire on social and economic data and underlying diseases prior to the Chronic Kidney Disease (CKD) identified the patients’ profile. The project was approved by the Ethics Committee of the institution. Eighty-three patients, with 54.21% males, were interviewed. Age bracket ranged between 20 and 59 years in 65.06% of patients. Only 27.71% maintained jobs after the diagnosis and the start of treatment; 63.86% had an average personal income between 1 and 3 minimum wages; 63.85% did not practice any physical activity. Moreover, 53.01% belonged to the European-Brazilian white group; 20.48% to the Afro-Brazilian brown group; 19.28% to the Afro-Brazilian Negro group; 6.02% to other ethnic groups. Further, 85.54% patients reported having an underlying disease prior to the CKD, namely, 61.45% were hypertensive; 31.33% were diabetics and 20.48% had other diseases. Results show the need of a greater attention to these patients’ health care to reduce the negative impacts related to the chronic disease focused.</p><br><p class="aresumo">The profile of patients undergoing haemodialysis in the dialysis unit of Hospital Santa Casa de Maringá, Maringá PR Brazil, is provided. A questionnaire on social and economic data and underlying diseases prior to the Chronic Kidney Disease (CKD) identified the patients’ profile. The project was approved by the Ethics Committee of the institution. Eighty-three patients, with 54.21% males, were interviewed. Age bracket ranged between 20 and 59 years in 65.06% of patients. Only 27.71% maintained jobs after the diagnosis and the start of treatment; 63.86% had an average personal income between 1 and 3 minimum wages; 63.85% did not practice any physical activity. Moreover, 53.01% belonged to the European-Brazilian white group; 20.48% to the Afro-Brazilian brown group; 19.28% to the Afro-Brazilian Negro group; 6.02% to other ethnic groups. Further, 85.54% patients reported having an underlying disease prior to the CKD, namely, 61.45% were hypertensive; 31.33% were diabetics and 20.48% had other diseases. Results show the need of a greater attention to these patients’ health care to reduce the negative impacts related to the chronic disease focused.</p> <p class="akeyword"> </p

Anti-HLA class I antibodies in patients with a positive PRA.

<p>Anti-HLA class I antibodies in patients with a positive PRA.</p

Demographic characteristics and potential risk factors for the development of anti-HLA antibodies, according to the PRA results.

<p>Demographic characteristics and potential risk factors for the development of anti-HLA antibodies, according to the PRA results.</p

HLA-A, -B and -DRB1 alleles and phenotype frequencies of the total patient group.

<p>HLA-A, -B and -DRB1 alleles and phenotype frequencies of the total patient group.</p

Anti-HLA class II antibodies in patients with a positive PRA.

<p>Anti-HLA class II antibodies in patients with a positive PRA.</p

Distribution of anti-HLA antibodies according to the percentage of PRA.

<p>Distribution of anti-HLA antibodies according to the percentage of PRA.</p