Prognostic value of cytotoxic T-lymphocytes and CD40 in biopsies with early renal allograft rejection
| Autor: | Hermann Haller, Matthias Behrend, Joerg Radermacher, Reinhard von Wasielewski, Imke Mueller, Michael Mengel, Anke Schwarz, Hans Kreipe |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Nephrology
Adult Graft Rejection Male Pore Forming Cytotoxic Proteins medicine.medical_specialty Pathology Urinary system Biopsy Granzymes Risk Factors Internal medicine medicine Humans CD40 Antigens Aged Aged 80 and over Kidney Transplantation Hematology Membrane Glycoproteins medicine.diagnostic_test biology business.industry Perforin Graft Survival Serine Endopeptidases RNA-Binding Proteins Middle Aged Prognosis Immunohistochemistry Kidney Transplantation Granzyme B medicine.anatomical_structure Granzyme Acute Disease Chronic Disease biology.protein Female business T-Lymphocytes Cytotoxic |
| Zdroj: | Transplant International. 17 |
| ISSN: | 0934-0874 1432-2277 |
| DOI: | 10.1111/j.1432-2277.2004.tb00446.x |
| Popis: | After renal transplantation, different immunological and non-immunological factors lead to long-term allograft deterioration. Acute rejection episodes are one risk factor for chronic renal allograft dysfunction (CRAD). Following the current Banff classification the histological grade in acute rejection episodes is of limited prognostic value, therefore, additional morphological surrogate markers would be helpful. We investigated the biopsies of 91 patients with early acute rejection episodes for the immunohistochemical expression of key molecules (perforin, granzyme B, TIA-1, CD40) in the T cell-mediated rejection process. Staining results were correlated to long-term allograft outcome. Patients with greater than 2% of granzyme B or greater than 25% of CD40-positive cells in the interstitial infiltrate showed significantly shorter allograft survival. Patients with a CD40-positive vascular rejection or greater than 2% of granzyme B-positive cells in the interstitial infiltrate were significantly correlated with an earlier onset of CRAD. Our findings provide potential morphological surrogate markers in biopsies with early acute rejection episodes after renal transplantation. These could become part of combined clinical and histological algorithms, allowing patient-specific risk estimation and customized therapy options to be made. |
| Databáze: | OpenAIRE |
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