{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:50:54Z","timestamp":1792698654914,"version":"4.5.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","funder":[{"DOI":"10.13039\/100011272","name":"FP7 Health","doi-asserted-by":"publisher","award":["305499"],"award-info":[{"award-number":["305499"]}],"id":[{"id":"10.13039\/100011272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010676","name":"H2020 Societal Challenges","doi-asserted-by":"publisher","award":["JTC2_29"],"award-info":[{"award-number":["JTC2_29"]}],"id":[{"id":"10.13039\/100010676","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004040","name":"KU Leuven","doi-asserted-by":"publisher","award":["C32\/17\/049"],"award-info":[{"award-number":["C32\/17\/049"]}],"id":[{"id":"10.13039\/501100004040","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1196119N"],"award-info":[{"award-number":["1196119N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"FWO","doi-asserted-by":"publisher","award":["1844019N"],"award-info":[{"award-number":["1844019N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"FWO","doi-asserted-by":"publisher","award":["1842919N"],"award-info":[{"award-number":["1842919N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>Donor-specific anti-HLA antibodies (HLA-DSAs) are often not detectable in serum of kidney allograft recipients whose biopsies display histology of antibody-mediated rejection (ABMR), which creates uncertainty in clinical decision making. The authors show that ABMR histology associates with a distinct transcriptional profile that is independent of the presence of HLA-DSAs, although the presence of HLA-DSAs is also an independent risk factor for graft failure after ABMR histology. However, molecular assessment of allograft biopsy specimens does not elucidate the underlying cause of ABMR histology, and these findings indicate that therapeutic decisions should not be based solely on the histologic and molecular presentation. Future studies should work toward identifying and targeting the underlying stimulus of ABMR histology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Circulating donor-specific anti-HLA antibodies (HLA-DSAs) are often absent in serum of kidney allograft recipients whose biopsy specimens demonstrate histology of antibody-mediated rejection (ABMR). It is unclear whether cases involving ABMR histology without detectable HLA-DSAs represent a distinct clinical and molecular phenotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter cohort study, we integrated allograft microarray analysis with extensive clinical and histologic phenotyping from 224 kidney transplant recipients between 2011 and 2017. We used the term ABMR histology for biopsy specimens that fulfill the first two Banff 2017 criteria for ABMR, irrespective of HLA-DSA status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 224 biopsy specimens, 56 had ABMR histology; 26 of these (46.4%) lacked detectable serum HLA-DSAs. Biopsy specimens with ABMR histology showed overexpression of transcripts mostly related to IFN\n                      <jats:italic toggle=\"yes\">\u03b3<\/jats:italic>\n                      -induced pathways and activation of natural killer cells and endothelial cells. HLA-DSA\u2013positive and HLA-DSA\u2013negative biopsy specimens with ABMR histology displayed similar upregulation of pathways and enrichment of infiltrating leukocytes. Transcriptional heterogeneity observed in biopsy specimens with ABMR histology was not associated with HLA-DSA status but was caused by concomitant T cell\u2013mediated rejection. Compared with cases lacking ABMR histology, those with ABMR histology and HLA-DSA had higher allograft failure risk (hazard ratio [HR], 7.24; 95% confidence interval [95% CI], 3.04 to 17.20) than cases without HLA-DSA (HR, 2.33; 95% CI, 0.85 to 6.33), despite the absence of transcriptional differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ABMR histology corresponds to a robust intragraft transcriptional signature, irrespective of HLA-DSA status. Outcome after ABMR histology is not solely determined by the histomolecular presentation but is predicted by the underlying etiologic factor. It is important to consider this heterogeneity in further research and in treatment decisions for patients with ABMR histology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.2020030306","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T17:25:12Z","timestamp":1594229112000},"page":"2168-2183","source":"Crossref","is-referenced-by-count":106,"title":["Transcriptional Changes in Kidney Allografts with Histology of Antibody-Mediated Rejection without Anti-HLA Donor-Specific Antibodies"],"prefix":"10.1681","volume":"31","clinical-trial-number":[{"clinical-trial-number":"nct02832661","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2235-9842","authenticated-orcid":false,"given":"Jasper","family":"Callemeyn","sequence":"first","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, Katholieke Universiteit (KU) Leuven, Leuven, Belgium"},{"name":"Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyne","family":"Lerut","sequence":"additional","affiliation":[{"name":"Department of Morphology and Molecular Pathology, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henriette","family":"de Loor","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, Katholieke Universiteit (KU) Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Arijs","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Laboratory of Translational Genetics, KU Leuven, Leuven, Belgium"},{"name":"Center for Cancer Biology, Vlaams Instituut voor Biotechnologie (VIB), Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Thaunat","sequence":"additional","affiliation":[{"name":"Center for Research in Infectious Diseases, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1111, Claude Bernard University Lyon I, Centre National de la Recherche Scientifique (CNRS) Unit\u00e9 Mixte de Recherche 5308, Ecole Normale Supe\u0301rieure de Lyon, University of Lyon, Lyon, France"},{"name":"Lyon-Est Medical Faculty, Claude Bernard University Lyon I, Lyon, France"},{"name":"Department of Transplantation, Nephrology and Clinical Immunology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Koenig","sequence":"additional","affiliation":[{"name":"Center for Research in Infectious Diseases, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1111, Claude Bernard University Lyon I, Centre National de la Recherche Scientifique (CNRS) Unit\u00e9 Mixte de Recherche 5308, Ecole Normale Supe\u0301rieure de Lyon, University of Lyon, Lyon, France"},{"name":"Lyon-Est Medical Faculty, Claude Bernard University Lyon I, Lyon, France"},{"name":"Department of Transplantation, Nephrology and Clinical Immunology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vannary","family":"Meas-Yedid","sequence":"additional","affiliation":[{"name":"Biological Image Analysis Unit, Pasteur Institute, CNRS Unit\u00e9 de Recherche Associ\u00e9e (URA) 2582, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Olivo-Marin","sequence":"additional","affiliation":[{"name":"Biological Image Analysis Unit, Pasteur Institute, CNRS Unit\u00e9 de Recherche Associ\u00e9e (URA) 2582, Paris, 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Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Essig","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis and Transplantation, University of Limoges, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Gwinner","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Internal Medicine, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5793-6174","authenticated-orcid":false,"given":"Dany","family":"Anglicheau","sequence":"additional","affiliation":[{"name":"Paris Descartes University, Sorbonne Paris Cit\u00e9 University, Paris, France"},{"name":"INSERM U1151, Paris, France"},{"name":"Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique--H\u00f4pitaux de Paris, Paris, 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