Copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Effect of panel reactive antibodies on T cell immunity reinstatement following renal transplantation
Lampros Vagiotas, Maria Stangou, Efstratios Kasimatis, Aliki Xochelli, Grigorios Myserlis, Georgios Lioulios, Vasiliki Nikolaidou, Manolis Panteli, Konstantinos Ouranos, Nikolaos Antoniadis, Daoudaki Maria, Aikaterini Papagianni, Georgios Tsoulfas, Asimina Fylaktou
Lampros Vagiotas, Grigorios Myserlis, Nikolaos Antoniadis, Georgios Tsoulfas, Department of Transplant Surgery, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece
Maria Stangou, Efstratios Kasimatis, Georgios Lioulios, Manolis Panteli, Konstantinos Ouranos, Aikaterini Papagianni, Department of Nephrology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece
Aliki Xochelli, Vasiliki Nikolaidou, Asimina Fylaktou, Department of Immunology, National Peripheral Histocompatibility Center, Hippokration General Hospital, Thessaloniki 54642, Greece
Daoudaki Maria, Medical School Aristotle University of Thessaloniki, Biochemistry Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
Author contributions: Fylaktou A, Papagianni A, and Tsoulfas G designed the research study; Xochelli A, Nikolaidou V, Panteli M, and Ouranos K contributed new reagents and analytic tools; Vagiotas L, Kasimatis E, and Lioulios G performed the study; Antoniadis N, Miserlis G, and Vagiotas L provided the patients; Vagiotas L, Stangou M, and Daoudaki M analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Aristotle University of Thessaloniki. This registration identification number is 611/30-09-2020.
Clinical trial registration statement: This study is registered at the Aristotle University of Thessaloniki. This registration identification number is 611/30-09-2020.
Informed consent statement: All participants provided informed consent before their enrollment to the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Participants gave informed consent for data sharing. The relevant document was given.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Maria Stangou, PhD, Assistant Professor, Department of Nephrology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece.
mstangou@auth.gr
Received: July 3, 2022
Peer-review started: July 3, 2022
First decision: August 4, 2022
Revised: August 5, 2022
Accepted: September 9, 2022
Article in press: September 9, 2022
Published online: October 18, 2022
Processing time: 105 Days and 16.5 Hours
BACKGROUND
Chronic kidney disease is associated with immunological disorders, presented as phenotypic alterations of T lymphocytes. These changes are expected to be restored after a successful renal transplantation; however, additional parameters may contribute to this process.
AIM
To evaluate the impact of positive panel reactive antibodies (PRAs) on the restoration of T cell phenotype, after renal transplantation.
METHODS
CD4CD28null, CD8CD28null, natural killer cells (NKs), and regulatory T cells (Tregs) were estimated by flow cytometry at T0, T3, and T6 which were the time of transplantation, and 3- and 6-mo follow-up, respectively. Changes were estimated regarding the presence or absence of PRAs.
RESULTS
Patients were classified in two groups: PRA(-) (n = 43) and PRA(+) (n = 28) groups. Lymphocyte and their subtypes were similar between the two groups at T0, whereas their percentage was increased at T3 in PRA(-) compared to PRA(+) [23 (10.9-47.9) vs 16.4 (7.5-36.8 μ/L, respectively; P = 0.03]. Lymphocyte changes in PRA(-) patients included a significant increase in CD4 cells (P < 0.0001), CD8 cells (P < 0.0001), and Tregs (P < 0.0001), and a reduction of NKs (P < 0.0001). PRA(+) patients showed an increase in CD4 (P = 0.008) and CD8 (P = 0.0001), and a reduction in NKs (P = 0.07). CD4CD28null and CD8CD28null cells, although initially reduced in both groups, were stabilized thereafter.
CONCLUSION
Our study described important differences in the immune response between PRA(+) and PRA(-) patients with changes in lymphocytes and lymphocyte subpopulations. PRA(+) patients seemed to have a worse immune profile after 6 mo follow-up, regardless of renal function.
Core Tip: Chronic kidney disease is associated with phenotypic and functional changes in the immune system. This study evaluated the impact of positive panel reactive antibodies (PRAs) on restoration of the T cell phenotype after renal transplantation. Our study described important differences in the immune response between PRA(+) and PRA(-) patients with changes in lymphocytes and lymphocyte subpopulations. PRA(+) patients seemed to have a worse immune profile after 6 mo follow-up, regardless of renal function.
