The emerging issue of MICA antibodies: antibodies to MICA and other antigens of endothelial cells.

The major histocompatibility complex (MHC) encodes the HLA class I antigens expressed on the surface of most nucleated cells and the HLA class II antigens which are expressed mostly in B lymphocytes, monocytes and dendritic cells. Mismatched HLA antigens are the main source of the immune response that leads to the rejection of allografts. In some patients however, rejection may occur without a detectable response to donor HLA antigens. We have been interested in characterizing antibodies that develop in transplant recipients who do not appear to have antibodies against HLA. For this purpose, we focused our attention to antigens which are expressed on the surface of endothelial cells and are not found on peripheral blood lymphocytes. These include the MICA and MICB antigens, which are encoded by loci in the MHC; certain autoantigens expressed on the endothelium; and a family of polymorphic antigens expressed on endothelial cells which are distinct from HLA and elicit production of antibodies that appear also to be associated with graft failure. Antibodies against MICA have been associated with allograft rejection. MICB antibodies are only rarely found. The autoantibodies and the endothelial specific alloantibodies are being characterized in ongoing studies.