Journal
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
Volume 25, Issue 8, Pages 1856-1868Publisher
AMER SOC NEPHROLOGY
DOI: 10.1681/ASN.2013080848
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Funding
- Grant Recherche translationnelle Pays de la Loire-Delegation Interregionale a la Recherche Clinique Grand Ouest
- European Society of Organ Transplantation Junior Clinical Research Grant
- Fondation Centaure
- Fondation pour la Recherche Medicale
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Despite the effectiveness of immunosuppressive drugs, kidney transplant recipients still face late graft dysfunction. Thus, it is necessary to identify biomarkers to detect the first pathologic events and guide therapeutic target development. Previously, we identified differences in the T-cell receptor V beta repertoire in patients with stable graft function. In this prospective study, we assessed the long-term effect of CD8(+) T-cell differentiation and function in 131 patients who had stable graft function. In 45 of 131 patients, a restriction of TCR V beta diversity was detected and associated with the expansion of terminally differentiated effector memory (TEMRA; CD45RA(+)CCR7(-)CD27(-)CD28(-))CD8(+) T cells expressing high levels of perform, granzyme B, and T-bet. This phenotype positively correlated with the level of CD57 and the ability of CD8(+) T cells to secrete TNF-alpha and IFN-gamma. Finally, 47 of 131 patients experienced kidney dysfunction during the median 15-year follow-up period. Using a Cox regression model, we found a 2-fold higher risk (P=0.06) of long-term graft dysfunction in patients who had increased levels of differentiated TEMRA CD8(+) T cells at inclusion. Collectively, these results suggest that monitoring the phenotype and function of circulating CD8(+) T cells may improve the early identification of at-risk patients.
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