So it seems that readily available parameters of HLA-DAS such as titer and sensitizing route are not sufficient to assign the clinical impact of an HLA-DSA. The question becomes then, what factors determine the pathogenicity of an HLA-DAS. Clearly, the clinical impact of an HLA-DAS likely depends on many factors. First, as suggested by Burns et al, the humoral memory response might be a very important but we have currently no assay at our hands to assess how strong this memory response will be after re-challenge. On the level of the antibody, the immunogenicity of the immunizing epitope of the HLA-molecule might be relevant. Possibly, there might even be a link between the immunogenicity of the immunizing epitope and the strength of the humoral memory response. The capacity of HLA-DAS to activate complement might be another relevant factor to determine the clinical impact of an HLA-DSA. Furthermore, the the density of HLA-molecule expression on endothelial cells of the donor and protective factors factors of endothelial cells might be relevant in this regard.
Per inserire una domanda, segnalare la tua esperienza, un tuo commento o una richiesta di precisazione fai il login con il tuo nome utente e password.
Se non lo sei ancora puoi registrati partendo da qui.