Immune cell identified that may predict risk for rejection after kidney transplant
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Researchers from Ohio State University have identified an immune cell that could predict risk for graft rejection following kidney transplantation.
The research team, led by Ginny L. Bumgardner, MD, PhD, a transplant surgeon-scientist at The Ohio State University Wexner Medical Center, had previously observed that a CD8+ T immune cell subset reduced the formation of antibodies that are harmful to the transplant organ in experimental animal models.
Bumgardner told Healio Nephrology this study supported the hypothesis that these immune cells may function similarly in humans, as results showed the human transplant recipients with significantly fewer of the cells were the ones who developed donor-directed antibodies.
For the study, Bumgardner and colleagues included 95 first-time kidney transplant recipients who were donor-specific antibody (DSA)-negative prior to the procedure. All patients received a routine immunosuppression regimen, including steroid-free maintenance therapy.
Blood samples were obtained to determine the presence of DSA, which was tested for at 1, 3, 6, 9 and 12 months after transplantation.
Within 1 year, 24.2% of the study population developed DSA.
The researchers noted that while there were no significant differences regarding the primary cause of kidney disease, donor type (living or deceased) or length of dialysis prior to transplant between patients who developed DSA and those who did not, they observed the DSA-positive patients had significantly lower quantities of a particular subset of CD8+ T cells compared to the patients who were DSA negative.
Based on these results, Bumgardner suggested that monitoring of the number of these cells in transplant recipients may aid clinician risk assessment for the development of DSAs, and help to determine how best to adjust immunosuppressive medications for each patient.
She also suggested more research be done in the area, specifically examining how the CD8+ T cells interact with other immune cells (namely B cells, as they produce antibodies), how immunosuppressive medications may influence the cells, where the cells migrate in the body and how the cells develop and expand.
“Research performed in our lab is geared toward generating new knowledge that will ultimately improve transplant patient care,” Bumgardner said. “Understanding more about how these cells work may allow us to develop therapies to treat patients who experience antibody mediated rejection.”
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