Increased Circulating T Lymphocytes Expressing HLA-DR in Kidney Transplant Recipients with Microcirculation Inflammation

被引:10
作者
Jung, Hee-Yeon [1 ]
Kim, Yong-Jin [2 ]
Choi, Ji-Young [1 ]
Cho, Jang-Hee [1 ]
Park, Sun-Hee [1 ]
Kim, Yong-Lim [1 ]
Kim, Hyung-Kee [3 ]
Huh, Seung [3 ]
Won, Dong Il [4 ]
Kim, Chan-Duck [1 ]
机构
[1] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Daegu, South Korea
[2] Kyungpook Natl Univ, Sch Med, Dept Pathol, Daegu, South Korea
[3] Kyungpook Natl Univ, Sch Med, Dept Surg, Daegu, South Korea
[4] Kyungpook Natl Univ, Sch Med, Dept Clin Pathol, Daegu, South Korea
关键词
Microcirculation Inflammation; T Lymphocyte; Kidney Transplantation; Antibody-Mediated Rejection; ANTIBODY-MEDIATED REJECTION; RENAL-ALLOGRAFT REJECTION; DONOR-SPECIFIC ANTIBODIES; GRANZYME-B; NONINVASIVE DIAGNOSIS; GRAFT FUNCTION; MOLECULAR DIAGNOSIS; GENE-EXPRESSION; CELLS; PERFORIN;
D O I
10.3346/jkms.2017.32.6.908
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We consecutively enrolled 82 kidney transplant recipients (KTRs) with stable renal function and 24 KTRs who underwent indication biopsy to compare the histological grading of renal allografts with the activity of circulating T lymphocyte subsets and monocytes determined by flow cytometry, which were obtained at 2 weeks after kidney transplantation (KT) and at the time of indication biopsy, respectively. The sum of the scores of glomerulitis (g) + peritubular capillaritis (ptc), inflammation (i) + tubulitis (t), interstitial fibrosis (ci) + tubular atrophy (ct), and fibrointimal thickening (cv) + arteriolar hyaline thickening (ah) was used to assign a histological grade to the renal allograft samples. The frequencies of CD4(+)HLA-DR+/ CD4(+) T cells and CD8(+)HLA-DR+/CD8(+) T cells were significantly increased in KTRs with a microcirculation inflammation (MI) sum score >= 1 when compared with KTRs with an MI sum score = 0 as well as stable KTRs. In these 2 subsets, only CD4(+)HLA-DR+/CD4(+) T cells were positively correlated with MI sum scores. Analysis using the receiver operating characteristic (ROC) curve showed that antibody-mediated rejection (AMR) could be predicted with a sensitivity of 80.0% and a specificity of 94.7%, using a cutoff value of 29.6% frequency of CD4'HLA-DR'/CD4' T cells. MI was significantly associated with an increased frequency of activated T lymphocytes expressing human leukocyte antigenantigen D related (HLA-DR). Further studies should focus on validating the utility of circulating CD4(+)HLA-DR+/CD4(+) T cells as a noninvasive, immunologic monitoring tool for the prediction of AMR.
引用
收藏
页码:908 / 918
页数:11
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