Transitional B lymphocytes are associated with protection from kidney allograft rejection: a prospective study
| Autor: | Sourabh Chand, Helen Smith, C. Navarrete, Baksho Kaul, Sunil Daga, Shazia Shabir, David Briggs, Simon Ball, J. Girdlestone, S. Jham, Lorraine Harper, Richard Borrows |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Graft Rejection Male Cellular immunity Time Factors T cell Biopsy Context (language use) CD19 Antibodies Immunophenotyping HLA Antigens Immunology and Allergy Medicine Humans Pharmacology (medical) Prospective Studies Renal Insufficiency B cell Transplantation B-Lymphocytes biology business.industry ELISPOT Middle Aged Kidney Transplantation Transplant Recipients Immunity Humoral medicine.anatomical_structure Phenotype Treatment Outcome Immunology biology.protein Patient Compliance Female Transplantation Tolerance Antibody business Biomarkers Immunosuppressive Agents |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 15(5) |
| ISSN: | 1600-6143 |
| Popis: | Recent cross-sectional studies suggest an important role for transitional B lymphocytes (CD19 + CD24hiCD38hi) in promoting transplant tolerance, and protecting from late antibody-mediated rejection (ABMR). However, prospective studies are lacking. This study enrolled 73 de novo transplant recipients, and collected serial clinical, immunological and biochemical information over 48 ± 6 months. Cell phenotyping was conducted immediately prior to transplantation, and then on five occasions during the first year posttransplantation. When modeled as a time-dependent covariate, transitional B cell frequencies (but not total B cells or "regulatory" T cells) were associated with protection from acute rejection (any Banff grade; HR: 0.60; 95% CI: 0.37-0.95; p = 0.03). No association between transitional B cell proportions and either de novo donor-specific or nondonor-specific antibody (dnDSA; dnNDSA) formation was evident, although preserved transitional B cell proportions were associated with reduced rejection rates in those patients developing dnDSA. Three episodes of ABMR occurred, all in the context of nonadherence, and all associated with in vitro anti-HLA T cell responses in an ELISPOT assay (p = 0.008 versus antibody-positive patients not experiencing ABMR). This prospective study supports the potential relevance of transitional ("regulatory") B cells as a biomarker and therapeutic intervention in transplantation, and highlights relationships between humoral immunity, cellular immunity and nonadherence. |
| Databáze: | OpenAIRE |
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