BACKGROUND: In the field of kidney transplantation, identifying early signatures of humoral rejection is a key challenge.
METHODS: We investigated the presence of anti-HLA antibodies and the distribution of lymphocyte subpopulations in 77 kidney-transplanted children and young adults compared to 23 healthy controls. Moreover, we tested whether the presence of anti-HLA antibodies could be related to modification in lymphocyte phenotype. Finally, we correlated the presence of anti-HLA antibodies and specific alteration of lymphocyte subsets with clinical outcomes.
RESULTS: In kidney-transplanted children who developed anti-HLA antibodies, we observed an expansion of double-negative B cells (CD19 + CD27-IgD-), indicating premature aging of this compartment. Moreover, we reported signs of impaired B cell regulation, indicated by a higher IL-21R+ B cell frequency associated with an abnormal increase of follicular helper T cells. Finally, a considerable reduction in CD8+ effector T and invariant Natural killer T (NKT) cells was observed. The stability of graft function over time is significantly correlated with the frequency of peripheral effector CD4+ and CD8+ T cells and invariant NKT cells.
CONCLUSIONS: This study supports the usefulness of lymphocyte subset as one of a spectrum of early diagnostic tools required to identify patients at risk of developing donor alloimmune response.
- Antilymphocyte Serum
- CD8-Positive T-Lymphocytes
- Child, Preschool
- Flow Cytometry
- Graft Rejection
- HLA Antigens
- Immunity, Cellular
- Kidney Transplantation
- Lymphocyte Subsets
- Natural Killer T-Cells
- T-Lymphocytes, Helper-Inducer
- Young Adult
- Journal Article
- Research Support, Non-U.S. Gov't