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.
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.
Authors: 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 Journal: Transpl Int Date: 2012-07-17 Impact factor: 3.782
Authors: Sarah E Panzer; Nancy A Wilson; Bret M Verhoven; Ding Xiang; C Dustin Rubinstein; Robert R Redfield; Weixiong Zhong; Shannon R Reese Journal: Transplantation Date: 2018-03 Impact factor: 4.939
Authors: Jack Ferdman; Fabrice Porcheray; Baoshan Gao; Carolina Moore; Julie DeVito; Sarah Dougherty; Margaret V Thomas; Evan A Farkash; Nahel Elias; Tatsuo Kawai; Sayeed K Malek; Stefan G Tullius; Waichi Wong; Emmanuel Zorn Journal: Transplantation Date: 2014-10-15 Impact factor: 4.939