Allospecific CD154+ T cells identify rejection-prone recipients after pediatric small-bowel transplantation
| Autor: | Brandon W. Higgs, George V. Mazariegos, Ankit Gupta, Qing Sun, Mylarappa Ningappa, Lisa Remaley, Geoffrey J. Bond, K Abu-Elmagd, Kyle Soltys, Rakesh Sindhi, Chethan Ashokkumar, Tamara Fazzolare |
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| Rok vydání: | 2008 |
| Předmět: |
Graft Rejection
Male Isoantigens Acute cellular rejection CD40 Ligand chemical and pharmacologic phenomena Tacrolimus immune system diseases T-Lymphocyte Subsets parasitic diseases Biopsy Intestine Small Medicine Humans CD154 Receptor medicine.diagnostic_test Receiver operating characteristic analysis business.industry hemic and immune systems T lymphocyte T-Lymphocytes Helper-Inducer Small intestine Transplantation surgical procedures operative medicine.anatomical_structure Child Preschool Immunology Surgery Female Lymphocyte Culture Test Mixed business Immunologic Memory Immunosuppressive Agents T-Lymphocytes Cytotoxic |
| Zdroj: | Surgery. 146(2) |
| ISSN: | 1532-7361 |
| Popis: | Up to 70% of children with small bowel transplantation (SBTx) experience acute cellular rejection (ACR). Allospecific CD154+ T cells predict liver ACR in children in a novel, 16-hour mixed leukocyte response (MLR) assay, but remain untested in SBTx.The expression of CD154 was measured in 4 subsets-naive (N) and memory (M) CD154+ T-helper (Th) and T-cytotoxic (Tc) cells (ie, CD154+ ThN, CD154+ ThM, CD154+ TcN, and CD154+ TcM, respectively)-in the MLR of single blood samples obtained from 32 children with SBTx within 60 days of SBTx biopsy. Children showing ACR in these biopsies were termed Rejectors. The ratio of donor-induced to third-party-induced CD154+ T cells was called the immunoreactivity index (IR). We hypothesized that IR1 denoted increased donor-specific alloreactivity and increased risk of rejection; in contrast, IR1 implied decreased risk. CD154 expression was correlated with the expression of CTLA4, a negative T-cell costimulator that antagonizes and is inversely related to CD154 (n = 18).Rejectors showed significantly greater numbers of donor-specific CD154+ T-cell subsets. Logistic regression analysis and leave-one-out cross validation followed by receiver operating characteristic analysis showed that, among the 4 subsets, IRor =1.23 for CD154+ TcM identified Rejectors with a sensitivity and specificity of 93% and 88%. Also, a significant negative correlation was observed between CD154 expression and CTLA4 expression in allospecific Tc (Spearman's rho = -0.616, P = .006) but not in Th.Allospecific CD154+ TcM identify rejection-prone children with SBTx. |
| Databáze: | OpenAIRE |
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