Journal
AMERICAN JOURNAL OF TRANSPLANTATION
Volume 14, Issue 11, Pages 2565-2576Publisher
ELSEVIER SCIENCE INC
DOI: 10.1111/ajt.12946
Keywords
Basic (laboratory) research; science; biopsy; costimulation; kidney (allograft) function; dysfunction; kidney transplantation; nephrology; immunobiology; rejection: antibody-mediated (ABMR); rejection: T cell mediated (TCMR); translational research; science
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Funding
- Novartis Pharma AG
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We used expression microarrays to characterize the changes most specific for pure T cell-mediated rejection (TCMR) compared to other diseases including antibody-mediated rejection in 703 human kidney transplant biopsies, using a Discovery Set-Validation Set approach. The expression of thousands of transcriptsfold change and association strengthchanged in a pattern that was highly conserved between the Discovery and Validation sets, reflecting a hierarchy of T cell signaling, costimulation, antigen-presenting cell (APC) activation and interferon-gamma (IFNG) expression and effects, with weaker associations for inflammasome activation, innate immunity, cytotoxic molecules and parenchymal injury. In cell lines, the transcripts most specific for TCMR were expressed most strongly in effector T cells (e.g. CTLA4, CD28, IFNG), macrophages (e.g. PDL1, CD86, SLAMF8, ADAMDEC1), B cells (e.g. CD72, BTLA) and IFNG-treated macrophages (e.g. ANKRD22, AIM2). In pathway analysis, the top pathways included T cell receptor signaling and CTLA4 costimulation. These results suggest a model in which TCMR creates an inflammatory compartment with a rigorous hierarchy dominated by the proximal aspects of cognate engagement of effector T cell receptor and costimulator triggering by APCs. The prominence of inhibitors like CTLA4 and PDL1 raises the possibility of active negative controls within the rejecting tissue. The molecules that distinguish T cell-mediated rejection of human kidney transplants from other diseases reflect the cognate effector T cell antigen-presenting cell synapse and include negative costimulatory molecules, and they are distinct from the nonspecific inflammatory response and the response to injury.
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