Abstract:
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.
journal_name
Transplantationjournal_title
Transplantationauthors
Scheepstra C,Bemelman FJ,van der Loos C,Rowshani AT,van Donselaar-Van der Pant KA,Idu MM,ten Berge IJ,Florquin Sdoi
10.1097/TP.0b013e3181860a74subject
Has Abstractpub_date
2008-09-27 00:00:00pages
772-8issue
6eissn
0041-1337issn
1534-6080pii
00007890-200809270-00005journal_volume
86pub_type
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