Examination of anti-CD20 monoclonal antibody showing false positive results with CDC-XM in organ transplantation

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  • KOBAYASHI Yuri
    Department of Transplant Immunology, Tokyo Women’s Medical University
  • ISHIZUKA Tsutomu
    Department of Transplant Immunology, Tokyo Women’s Medical University
  • SASANO Mayu
    Department of Transplant Immunology, Tokyo Women’s Medical University
  • TAKAYANAGI Kayo
    Department of Transplant Immunology, Tokyo Women’s Medical University
  • HOSOBA Emiko
    Department of Transplant Immunology, Tokyo Women’s Medical University
  • MIURA Hitomi
    Department of Transplant Immunology, Tokyo Women’s Medical University
  • ISHIDA Hideki
    Transplant Medicine, Tokyo Women’s Medical University
  • EGAWA Hiroto
    Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University

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Other Title
  • 臓器移植における補体依存性細胞傷害試験において偽陽性を示す抗CD20モノクローナル抗体の検討
  • ゾウキ イショク ニ オケル ホタイ イソンセイ サイボウ ショウガイ シケン ニ オイテ ニセ ヨウセイ オ シメス コウCD20 モノクローナル コウタイ ノ ケントウ

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Abstract

<p>The administration of rituximab to an organ transplantation recipient has the effects of depleting a part of B cells and temporarily suppressing their differentiation into antibody-producing cells. Therefore, rituximab has been used as a therapeutic drug to suppress the production of nascent antibodies that could develop into donor-specific alloantibodies (DSA) and treat antibody-mediated rejection. However, rituximab is known to cause a false positive result in the complement-dependent cytotoxicity crossmatch (CDC-XM) test using B cells, which is performed to detect DSA. In this study, to avoid the interference of rituximab, we investigated the protective effects against rituximab of a serum treatment method using magnetic beads and anti-idiotypic antibodies and a CD20 antigen treatment method using proteolytic enzymes on B cells. The serum treatment method enabled the prevention of false positives in patients administered with rituximab up to 600 mg/kg body weight. However, stable results could not be obtained with the B cell treatment method using proteolytic enzymes. The CDC-XM test is still the gold standard method for detecting only the complement-dependent antibodies that show reactivity with the rabbit complement. It is speculated that this serum treatment method will be a useful preconditioning method in the CDC-XM test for rituximab-administered cases.</p>

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