TY - JOUR
T1 - B cells in cluster or in a scattered pattern do not correlate with clinical outcome of renal allograft rejection
AU - Scheepstra, Cornelis
AU - Bemelman, Fréderike J.
AU - van der Loos, Chris
AU - Rowshani, Ajda T.
AU - van Donselaar-van der Pant, Karlijn A. M. I.
AU - Idu, Mirza M.
AU - ten Berge, Ineke J. M.
AU - Florquin, Sandrine
PY - 2008
Y1 - 2008
N2 - BACKGROUND: The role of CD20+ B cells in renal allograft rejection has been reappreciated. Importantly, recent studies suggest a relation between CD20+ B cell aggregates and poorer clinical outcome. In the present study, we attempted to confirm these early reports in a tightly controlled patient population and to differentiate between scattered infiltrates and clusters of B cells. METHODS: Fifty-four biopsies from renal transplant recipients with acute rejection were immunostained for CD20, CD3, and C4d. All patients received similar immunosuppressive therapy. Response to therapy was defined as a decrease in serum creatinine level within 2 weeks to 125% or less of the value before the clinically diagnosed episode of allograft rejection. Late clinical outcome was defined in creatinine clearance between 8 and 12 months after the episode of acute rejection or in graft failure. RESULTS AND CONCLUSION: A significant correlation was observed between interstitial infiltrates of CD20+ cells and CD3+ cells (r=0.720, P <0.001) suggesting that if B-cell infiltrates are present during rejection, they occur with T-cell infiltrates in a concurrent fashion. In contrast to previous reports, no relation was found between the number of CD20+ cells, in aggregates or in a scattered interstitial pattern, and response to conventional therapy. Remarkably, CD3+T cell aggregates did predict a favorable renal outcome
AB - BACKGROUND: The role of CD20+ B cells in renal allograft rejection has been reappreciated. Importantly, recent studies suggest a relation between CD20+ B cell aggregates and poorer clinical outcome. In the present study, we attempted to confirm these early reports in a tightly controlled patient population and to differentiate between scattered infiltrates and clusters of B cells. METHODS: Fifty-four biopsies from renal transplant recipients with acute rejection were immunostained for CD20, CD3, and C4d. All patients received similar immunosuppressive therapy. Response to therapy was defined as a decrease in serum creatinine level within 2 weeks to 125% or less of the value before the clinically diagnosed episode of allograft rejection. Late clinical outcome was defined in creatinine clearance between 8 and 12 months after the episode of acute rejection or in graft failure. RESULTS AND CONCLUSION: A significant correlation was observed between interstitial infiltrates of CD20+ cells and CD3+ cells (r=0.720, P <0.001) suggesting that if B-cell infiltrates are present during rejection, they occur with T-cell infiltrates in a concurrent fashion. In contrast to previous reports, no relation was found between the number of CD20+ cells, in aggregates or in a scattered interstitial pattern, and response to conventional therapy. Remarkably, CD3+T cell aggregates did predict a favorable renal outcome
U2 - https://doi.org/10.1097/TP.0b013e3181860a74
DO - https://doi.org/10.1097/TP.0b013e3181860a74
M3 - Article
C2 - 18813100
SN - 0041-1337
VL - 86
SP - 772
EP - 778
JO - Transplantation
JF - Transplantation
IS - 6
ER -