{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T10:50:09Z","timestamp":1775731809299,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["EPIHLA AAPG2022"],"award-info":[{"award-number":["EPIHLA AAPG2022"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006005","name":"Agence de la Biom\u00e9decine","doi-asserted-by":"publisher","award":["AOR 2022"],"award-info":[{"award-number":["AOR 2022"]}],"id":[{"id":"10.13039\/501100006005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002915","name":"Fondation pour la Recherche M\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002915","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HLA"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Imlifidase cleaves intact IgG molecules, generating F(ab\u2032)2 fragments that still bind to the target antigen but are devoid of the Fc\u2010dependent effector functions, notably complement activation. Imlifidase (Idefirix) has been conditionally approved for desensitisation to enable kidney transplantation in highly sensitised adult patients. We hypothesised that the F(ab\u2032)2 fragments can prevent the attachment of the full IgG at the time of anti\u2010HLA antibodies rebound when imlifidase action fades away, lowering the deleterious effect of the antibody burden on the transplant. This competition was explored in\u00a0vitro using the Luminex Mixed or Single Antigen bead assays, and with an antibody detecting the specific imlifidase\u2010cleaved IgG. Functional assays for complement activation were also performed, which were the C1q bead assay and complement\u2010dependent cytotoxicity crossmatches. We selected sera from patients with a high amount of class I or class II anti\u2010HLA antibodies. Competition by imlifidase\u2010digested serum was observed in Luminex antibody\u2010binding assays and cellular complement activation assays. F(ab\u2032)2 fragments generated from anti\u2010HLA antibodies after imlifidase cleavage had a biological impact on intact IgG binding, leading to reduced complement activation. Additional studies are needed to demonstrate whether these in\u00a0vitro features have beneficial clinical consequences in\u00a0vivo, that is, protecting the graft from potentially deleterious effects of DSA rebound.<\/jats:p>","DOI":"10.1111\/tan.70502","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T07:18:01Z","timestamp":1765783081000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Biological Effects of F(ab\u2032)2 Fragments Generated by Imlifidase From Anti\u2010\n                    <scp>HLA IgG<\/scp>\n                    Antibodies From Transplant Patients"],"prefix":"10.1111","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1198-4677","authenticated-orcid":false,"given":"Magali","family":"Devriese","sequence":"first","affiliation":[{"name":"Laboratoire d'Immunologie et Histocompatibilit\u00e9, H\u00f4pital Saint Louis  Paris France"},{"name":"INSERM 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H\u00f4pital Saint Louis  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sephora Da","family":"Silva","sequence":"additional","affiliation":[{"name":"Laboratoire d'Immunologie et Histocompatibilit\u00e9, H\u00f4pital Saint Louis  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Bockermann","sequence":"additional","affiliation":[{"name":"Hansa Biopharma  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5766-046X","authenticated-orcid":false,"given":"Jean\u2010Luc","family":"Taupin","sequence":"additional","affiliation":[{"name":"Laboratoire d'Immunologie et Histocompatibilit\u00e9, H\u00f4pital Saint Louis  Paris France"},{"name":"INSERM U1342, Institut de Recherche Saint\u2010Louis Universit\u00e9 Paris Cit\u00e9  Paris 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