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Blood, 1 January 2004, Vol. 103, No. 1, pp. 353-359.
Prepublished online as a Blood First Edition Paper on September 25, 2003; DOI 10.1182/blood-2003-03-0984.


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TRANSPLANTATION

Antibody response to DBY minor histocompatibility antigen is induced after allogeneic stem cell transplantation and in healthy female donors

David B. Miklos, Haesook T. Kim, Emmanuel Zorn, Ephraim P. Hochberg, Luxuan Guo, Alex Mattes-Ritz, Sebastien Viatte, Robert J. Soiffer, Joseph H. Antin, and Jerome Ritz

From the Departments of Medical Oncology and Biostatistical Science, Dana-Farber Cancer Institute Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston MA.

Minor histocompatibility antigens (mHAs) recognized by donor T cells play a central role as immunologic targets of graft-versus-host disease (GVHD) and graft versus leukemia after allogeneic hematopoietic stem cell transplantation (HSCT). Men who have undergone sex-mismatched allogeneic HSCT are at high risk for GVHD because of immune responses directed against mHAs encoded by genes on the Y chromosome (termed H-Y antigens). We hypothesized that the immunogenicity of mHAs results in a coordinated response involving B cells as well as T cells. To test this, we measured antibody responses to a well-characterized H-Y antigen, dead box RNAhelicase Y (DBY), and its homolog, DBX, in 150 HSCT patients. Using Western blot and enzyme-linked immunosorbent assay (ELISA), we found that 50% of male patients who received stem cell grafts from female donors developed antibody responses to recombinant DBY protein. Antibodies to DBY were also detected in 17% of healthy women, but not in healthy men. Antibody responses were directed primarily against areas of amino acid disparity between DBY and DBX. These studies demonstrate that the immune response to mHA includes the generation of specific antibodies and suggests that the serologic response to these antigens may also be useful in the identification of new mHAs.


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