Immune Responses to Collagen‐IV and Fibronectin in Renal Transplant Recipients With Transplant Glomerulopathy

ABSTRACT Antibodies (Abs) to donor HLA (donor‐specific antibodies [DSA]) have been associated with transplant glomerulopathy (TG) following kidney transplantation (KTx). Immune responses to tissue‐restricted self‐antigens (self‐Ags) have been proposed to play a role in chronic rejection. We determined whether KTx with TG have immune responses to self‐Ags, Collagen‐IV (Col‐IV) and fibronectin (FN). DSA were determined by solid phase assay, Abs against Col‐IV and FN by enzyme‐linked immunosorbent assay and CD4+ T cells secreting interferon gamma (IFN‐γ), IL‐17 or IL‐10 by ELISPOT. Development of Abs to self‐Ags following KTx increased the risk for TG with an odds ratio of 22 (p‐value = 0.001). Abs to self‐Ags were IgG and IgM isotypes. Pretransplant Abs to self‐Ags increased the risk of TG (22% vs. 10%, p