Increased circulating T lymphocytes expressing HLA-DR in kidney transplant recipients with microcirculation inflammation

Hee Yeon Jung, Yong Jin Kim, Ji Young Choi, Jang Hee Cho, Sun Hee Park, Yong Lim Kim, Hyung Kee Kim, Seung Huh, Dong Il Won, Chan Duck Kim

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

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+HLADR+/ 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.

Original languageEnglish
Pages (from-to)908-918
Number of pages11
JournalJournal of Korean Medical Science
Volume32
Issue number6
DOIs
StatePublished - 2017

Keywords

  • Antibody-mediated rejection
  • Kidney transplantation
  • Microcirculation inflammation
  • T lymphocyte

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