| Plasma cell densities and glomerular filtration rates predict renal allograft outcomes following acute rejection. | |
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MedLine Citation:
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PMID: 22805456 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The contribution of T cells and graft-reactive antibodies to acute allograft rejection is widely accepted, but the role of graft-infiltrating B and plasma cells is controversial. We examined 56 consecutive human renal transplant biopsies classified by Banff schema into T-cell-mediated (N = 21), antibody-mediated (N = 18), and mixed (N = 17) acute rejection, using standard immunohistochemistry for CD3, CD20, CD138, and CD45. In a predominantly African-American population (75%), neither Banff classification nor C4d deposition predicted the return to dialysis. Immunohistochemical analysis revealed CD3(+) T cells as the dominant cell type, followed by CD20(+) B cells and CD138(+) plasma cells in all acute rejection types. Using univariate Cox Proportional Hazard analysis, plasma cell density significantly predicted graft failure while B-cell density trended toward significance. Surprisingly T-cell density did not predict graft failure. The estimated glomerular filtration rate (eGFR) at diagnosis of acute rejection also predicted graft failure, while baseline eGFR ≥6 months prior to biopsy did not. Using multivariate analysis, a model including eGFR at biopsy and plasma cell density was most predictive of graft loss. These observations suggest that plasma cells may be a critical mediator and/or an independently sensitive marker of steroid-resistant acute rejection. |
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Authors:
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Anthony Chang; Jocelyn M Moore; Michelle L Cowan; Michelle A Josephson; W James Chon; Roger Sciammas; Zeying Du; Susana R Marino; Shane M Meehan; Michael Millis; Michael Z David; James W Williams; Anita S Chong |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2012-07-17 |
Journal Detail:
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Title: Transplant international : official journal of the European Society for Organ Transplantation Volume: 25 ISSN: 1432-2277 ISO Abbreviation: Transpl. Int. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-09-11 Completed Date: 2013-02-11 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 8908516 Medline TA: Transpl Int Country: England |
Other Details:
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Languages: eng Pagination: 1050-8 Citation Subset: IM |
Copyright Information:
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© 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation. |
Affiliation:
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Departments of Pathology, University of Chicago Medical Center, Chicago, IL 60637, USA. anthony.chang@uchospitals.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antigens, CD20 / biosynthesis Antigens, CD3 / biosynthesis B-Lymphocytes / immunology Biopsy / methods Complement C4b / biosynthesis Female Glomerular Filtration Rate Graft Rejection Humans Immunohistochemistry / methods Kidney Transplantation / methods* Male Middle Aged Peptide Fragments / biosynthesis Plasma Cells / cytology* Proportional Hazards Models Renal Insufficiency / therapy* Syndecan-1 / biosynthesis Transplantation, Homologous |
| Grant Support | |
ID/Acronym/Agency:
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R01 AI083452/AI/NIAID NIH HHS; R01AI083452/AI/NIAID NIH HHS; R03AI069284/AI/NIAID NIH HHS; R56 AI043631/AI/NIAID NIH HHS; UL1 RR024999/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antigens, CD20; 0/Antigens, CD3; 0/Peptide Fragments; 0/Syndecan-1; 80295-50-7/Complement C4b; 80295-52-9/complement C4d |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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