Antigen quantity is responsible for the discrepancy between phenotype and single antigen beads for the detection of human leukocyte antigen DQ antibody: Potential clinical implications
Bibliographic record
Abstract
De novo donor-specific human leukocyte antigen DQ antibodies detected by single antigen beads (SAB) are significantly associated with chronic antibody-mediated rejection and lower overall graft survival. However, some DQ antibodies identified by SAB cannot be confirmed by phenotype antigen-bearing class II bead assays, raising concerns about the validity of SAB data. The inability to detect these antibodies on phenotype antigen beads could be due to a lower quantity of DQ antigens present on the surface of the beads compared to DR antigens. In this study, we demonstrate that DQ-enriched phenotype antigens exhibit the same reactivity with DQ antibodies detected by SAB, confirming the hypothesis that it is antigen quantity and not structural differences that account for discrepancies in human leukocyte antigen DQ antibody detection between phenotype antigen beads and SAB. In addition, we show that the expression of individual DQ antigens in heterozygous cells can vary significantly, further confounding correlation studies. Therefore, the common clinical practice of using the phenotype antigen beads as a screening assay, reflexing to SAB testing only when positive, may inadvertently fail to detect DQ-specific antibodies. Such errors could impact organ acceptance practices, immunosuppression treatment decisions, and/or the need for additional diagnostic testing to rule out antibody-mediated rejection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".