ELISA AT1R

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  • AT1R cutoffs

    For the One Lambda AT1R antibody tests, the manufacturer recommended cutoffs are: <10 Units/ml = negative, 10-17 = borderline or at risk, >17 = positive.  Published papers have shown that other cutoff values may be clinically relevant (1-3).  Please comment on the AT1R antibody test cutoffs in use in your laboratory.  If different from the manufacturer’s recommended cutoffs, are your cutoffs based on outcome data, mean values of test data, etc.  Are the cutoffs the same for all types of patients (renal, heart, etc.)? Do you evaluate your cutoff values with each new lot?   

    (1. Reinsmoen NL, et al.  Transplantation 97: 595, 2014.  2. In JW, et al.  Transplant Proc. 46: 3371, 2014.  3. Banasik M, et al.  Transplant Proc. 46: 2618, 2014.)

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  • M. Taniguchi, L.M.Rebellato, J.Cai, J.Hopfield, K.P.Briley, C.E.Haisch, P.G.Catrou, P.Bolin, K.Parker, W.T.Kendrick, S.A.Kendrick, R.C.Harland and P.I.Terasaki

    Reports have associated non-HLA antibodies, specifically those against angiotensin IItype-1receptor(AT1R), with antibody-mediated kidney graft rejection. However, association of anti-AT1R with graft failure had not been demonstrated. We tested anti-AT1R and donorspecific HLA antibodies(DSA) in pre-and posttransplant sera from 351 consecutive kidney recipients: 134 with biopsy-proven rejection and/or lesions (abnormal biopsy group [ABG]) and 217 control group (CG) patients. The ABG’s rate of anti-AT1R was significantly higher than the CG’s (18%vs. 6%, p<0.001). Moreover, 79% of ABG patients with anti-AT1R lost their rafts (vs. 0%, CG), anti-AT1R levels in 58% of those failed grafts increasing posttransplant. With anti-AT1R detectable before DSA, time to graft failure was 31 months—but 63 months with DSA detectable before anti-AT1R. Patients with both anti-AT1R and DSA had lower graft survival than those with DSA alone (log-rank p¼0.007). Multivariate analysis showed that de novo anti-AT1R was anindependent predictorof graft failure in theABG, alone (HR: 6.6), and in the entire population (HR: 5.4). In conclusion, this study found significant association of anti-AT1R with graft failure. Further study is needed to establish causality between anti-AT1R and graft failure and, thus, the importance of routine anti-AT1R monitoring and therapeutic targeting.

    Keywords: Angiotensin II type-1 receptor antibodies, AT1R, DSA, kidney transplantation, rejection

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  • AT1R New Lot QC

    Additional testing has confirmed these results. We are running historical samples with the new lot and reporting interpretations based on manufacturer's cutoff values.  Has anyone else used Lot 006? Have you observed changes in interpretation?  We would appreciate feedback on how you report these changes.  Have you also noticed differences with the standards?

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  • Lot 006 QC

    Results of lot 006 QC, showed that standards 3 and 4 are higher than in lot 005?  This results in some borderline samples becoming positive and some negative samples becoming borderline.  Has anyone noticed this trend? Are you reporting these as "increases"?

    Borderline: 10-17 units/ml

    Positive: >17 units/ml

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  • AT1R

    Hello,

    Our lot QC for lot 004 shows high negative control concentrations, but the actual standard curve is very similar to Lot 002, has anyone else observed this in their QC?

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