Transplantation-Induced Ischemia-Reperfusion Injury Modulates Antigen Presentation by Donor Renal CD11c+F4/80+ Macrophages through IL-1R8 Regulation

Sistiana Aiello, Manuel Alfredo Podestà, Pamela Y Rodriguez-Ordonez, Francesca Pezzuto, Nadia Azzollini, Samantha Solini, Camillo Carrara, Marta Todeschini, Federica Casiraghi, Marina Noris, Giuseppe Remuzzi, Ariela Benigni

Research output: Contribution to journalArticlepeer-review


BACKGROUND: In donor kidneys subjected to ischemia-reperfusion injury during kidney transplant, phagocytes coexpressing the F4/80 and CD11c molecules mediate proinflammatory responses and trigger adaptive immunity in transplantation through antigen presentation. After injury, however, resident renal macrophages coexpressing these surface markers acquire a proreparative phenotype, which is pivotal in controlling inflammation and fibrosis. No data are currently available regarding the effects of transplant-induced ischemia-reperfusion injury on the ability of donor-derived resident renal macrophages to act as professional antigen-presenting cells.

METHODS: We evaluated the phenotype and function of intragraft CD11c+F4/80+ renal macrophages after cold ischemia. We also assessed the modifications of donor renal macrophages after reversible ischemia-reperfusion injury in a mouse model of congeneic renal transplantation. To investigate the role played by IL-1R8, we conducted in vitro and in vivo studies comparing cells and grafts from wild-type and IL-R8-deficient donors.

RESULTS: Cold ischemia and reversible ischemia-reperfusion injury dampened antigen presentation by renal macrophages, skewed their polarization toward the M2 phenotype, and increased surface expression of IL-1R8, diminishing activation mediated by toll-like receptor 4. Ischemic IL-1R8-deficient donor renal macrophages acquired an M1 phenotype, effectively induced IFNγ and IL-17 responses, and failed to orchestrate tissue repair, resulting in severe graft fibrosis and aberrant humoral immune responses.

CONCLUSIONS: IL-1R8 is a key regulator of donor renal macrophage functions after ischemia-reperfusion injury, crucial to guiding the phenotype and antigen-presenting role of these cells. It may therefore represent an intriguing pathway to explore with respect to modulating responses against autoantigens and alloantigens after kidney transplant.

Original languageEnglish
Pages (from-to)517-531
Number of pages15
JournalJournal of the American Society of Nephrology : JASN
Issue number3
Publication statusPublished - Mar 2020


  • Adaptive Immunity/genetics
  • Animals
  • Antigen Presentation
  • CD11c Antigen/immunology
  • Cells, Cultured
  • Cold Ischemia/methods
  • Disease Models, Animal
  • Gene Expression Regulation/genetics
  • Kidney Transplantation/adverse effects
  • Macrophages/immunology
  • Male
  • Mice
  • Receptors, Interleukin-1/genetics
  • Reperfusion Injury/genetics
  • Sensitivity and Specificity
  • Signal Transduction/genetics

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