Human peripheral blood monocytes may be divided into different subsets based on the expression of membrane antigens. Our pilot data suggested that after the kidney transplantation, the proportion of proinflammatory intermediate/nonclassical CD14+CD16+ monocytes was downregulated while the percentage of peripheral CD14+CD163+ monocytes (related to immunosuppressive M2 macrophages) was increased.

The aim of our prospective observational study was to monitore changes of peripheral monocyte expression of CD16, CD163, CD206, CD209, HLA-DR, and CD47 in kidney allograft recipients. In total, 88 patients who underwent renal transplantation from a deceased donor were enrolled in the study. The phenotype was evaluated by a multicolor flow cytometry in defined time points and in the case of complications requiring fine needle aspiration biopsy procedure.

The proportions of peripheral CD14+CD16+ monocytes were downregulated during the first week after the kidney transplantation while the percentage of CD14+CD163+ monocytes were dramaticaly increased early after the kidney transplantation and remained higher for four months in most patients. The expression of CD206 (another marker of M2 macrophages) was limited only to a small population of monocytes (less than 5% in most patients) but the receiver operating characteristic (ROC) curve analysis showed its potential importance to distinguish between patients with and without acute rejection with a sensitivity of 70% and specificity of 80.33% (area under the ROC curve 0.7787, p-value: 0.004973). No correlation between two alternative M2 markers CD163 and CD206 has been found. The expression of CD209 (DC-SIGN) was low and did not show any time or rejection related changes. HLA-DR (MHC II) and CD47 (integrin associated protein) were constitutively expressed without any significant changes in patients with acute rejection of the allograft.

We assume from our data that kidney allograft transplantation is associated with early reciprocal modulation of monocyte subpopulations (CD14+CD16+ and CD14+CD163+). A low percentage of CD206 positive monocytes seems to have a relationship to an increased risk of acute rejection.

Supported by MZCR grant NR 15-26883A. All rights reserved.

CITATION INFORMATION: Striz I, Svachova V, Sekerkova A, Slatinska J, Kopecka K, Fialova M, Viklicky O. Subpopulations of Peripheral Blood Monocytes in Kidney Allograft Recipients. Am J Transplant. 2017;17 (suppl 3).

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