Ectopic Lymphoid Structures Are Present in Type I T-Cell Mediated Kidney Transplant Rejection.
1Internal Medicine, Erasmus MC, Rotterdam, Netherlands
2Surgery, Division HPB and Transplant Surgery, Erasmus MC, Rotterdam, Netherlands
3Pathology, Erasmus MC, Rotterdam, Netherlands
4Pediatrics, Erasmus MC, Rotterdam, Netherlands
Meeting: 2017 American Transplant Congress
Abstract number: 180
Keywords: Biopsy, Kidney transplantation, Lymphocytes, Rejection
Session Information
Session Name: Concurrent Session: Pathways of Clinical Rejection
Session Type: Concurrent Session
Date: Sunday, April 30, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 4:30pm-4:42pm
Location: E351
Background
In renal transplantation, many allograft recipients develop donor-specific antibodies associated with an increased risk for graft rejection. Current immunosuppressive agents are principally aimed at T-cell-mediated alloimmunity, underestimating humoral effectors. Antibody responses are mainly mediated by BCL6+ T follicular helper (Tfh)-cells that activate B-cells predominantly via interleukin-21 (IL-21). Whether this reaction appears in the allograft is still being debated. Here, we investigated if ectopic lymphoid structures (ELSs) are present in T cell mediated rejection (type I and II) and antibody-mediated rejection after renal transplantation.
Material & Methods
Fifteen renal transplant biopsies were studied. Primary diagnosis were C4d+ antibody-mediated rejection (ABMR, n=5), T-cell mediated rejection type I (TCMRI, n=5), and T-cell mediated rejection type II (TCMRII, n=5). FFPE sections were stained for T-cells (CD3), B-cells (CD20), and follicular dendritic cells (FDCs, CD23). In addition, double immunofluorescent stainings for IL-21 and BCL6 were performed. Slides were analyzed for the presence and composition of infiltrate.
Results
In all 15 biopsies, infiltrates of CD3+ T cells were detected. In TCMRI, CD20+ B-cells formed aggregates surrounded by T-cells in the tubulo-interstitial compartment. In these aggregates CD23+ FDCs were detected, suggesting the presence ELSs. In contrast, ABMR and TCMRII showed diffuse spread of T cells and B cells and no CD23+ cell aggregates. IL-21 was present in all biopsies, however, co-localization with BCL6 was predominantly observed in TCMRI biopsies.
Conclusions
Nodal lymphoid proliferations with FDC networks and BCL6+IL-21+ cells are mainly found in TCMRI and may suggest a pivotal role for Tfh cell – B cell interaction.
CITATION INFORMATION: de Leur K, Clahsen-van Groningen M, de Graav G, Hesselink D, Samsom J, Baan C, Boer K. Ectopic Lymphoid Structures Are Present in Type I T-Cell Mediated Kidney Transplant Rejection. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Leur Kde, Groningen MClahsen-van, Graav Gde, Hesselink D, Samsom J, Baan C, Boer K. Ectopic Lymphoid Structures Are Present in Type I T-Cell Mediated Kidney Transplant Rejection. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/ectopic-lymphoid-structures-are-present-in-type-i-t-cell-mediated-kidney-transplant-rejection/. Accessed May 14, 2025.« Back to 2017 American Transplant Congress