The Maastricht Transplant Center: clinical setting and epitope searches in HLA class II molecules: does the structural localization of a polymorphic site contribute to its immunogenicity?

Transpl Immunol. 2014 Oct;31(4):213-8. doi: 10.1016/j.trim.2014.09.002. Epub 2014 Sep 21.

Abstract

Our understanding of the immunological processes influencing the clinical outcome after kidney transplantation has advanced majorly over the last few decades. However, many factors still restrict graft and patient survival. Within the Maastricht transplant center we have successfully implemented an alternative immunosuppressive regimen involving Tacrolimus monotherapy in order to minimize the adverse effects associated with long-term use of immunosuppressive drugs. This clinical development has an impact on pre-transplant risk stratification which requires that patients are closely monitored immunologically. In this review we will elaborate on our strategy regarding the analysis of epitopes in HLA-DQ and HLA-DP molecules. In this respect we have also looked at the immunodominance of certain epitopes by assessing their structural localization, conformation and physiochemical properties.

Keywords: HLA epitope analysis; Kidney transplantation; Minimal immunosuppression.

Publication types

  • Review

MeSH terms

  • Graft Rejection / immunology
  • Graft Survival / immunology*
  • HLA-DP Antigens / immunology*
  • HLA-DQ Antigens / immunology*
  • Histocompatibility Testing
  • Humans
  • Immunodominant Epitopes / immunology*
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / therapeutic use
  • Kidney / surgery
  • Kidney Transplantation*
  • Tacrolimus / therapeutic use

Substances

  • HLA-DP Antigens
  • HLA-DQ Antigens
  • Immunodominant Epitopes
  • Immunosuppressive Agents
  • Tacrolimus