Detection of Foxp3+ cells on biopsies of kidney transplants with early acute rejection.
This retrospective study was conducted to examine whether the presence of Foxp3+ cells in biopsies of kidney transplants displaying early acute rejection (AR) predicted the outcome of the episode. Seventeen biopsies showing AR included in this study were obtained at 42 +/- 30 days after transplantation. Lesions were graded according to the Banff classification. Foxp3 staining was performed on paraffin-embedded sections with a monoclonal antibody after antigen retrieval. We evaluated relationships between the number and the location of Foxp3+ cells, the type of rejection, and the serum creatinine value at 1 year. Foxp3+ cells were detected in 11 of 17 biopsies with AR (9.5 +/- 13.3 cells/mm(2)). These elements were mixed with other interstitial inflammatory cells. Intraepithelial tubular Foxp3+ cells were seen in 9 biopsies (1.5 +/- 2.5 cells/mm(2)). Foxp3+ cells were associated with borderline lesions (25.5 +/- 22.4/mm(2)); type 1 AR (7.18 +/- 9/mm(2)) and type 2 AR (1.99 +/- 3.46/mm(2)). The average number of cells per field was not different in C4d(+) and C4d(-) AR (6 +/- 8.35 vs 8.5 +/- 14.7/mm(2)). Graft loss within the first year was higher among the group of recipients without Foxp3+ cells (3/6) than those with Foxp3+ cells (0/11). All AR with intraepithelial tubular Foxp3 cells had favorable outcomes. Foxp3 has been proposed as a relevant marker of CD4(+)CD25(+) regulatory T cells. This study showed that Foxp3+ cells can be detected in kidney transplant biopsies with AR. The absence of Foxp3+ cells, especially in epithelial tubular cells, might indicate a poor prognosis following an AR episode.
Martin
L
L
Department of Pathology, Faculty of Medicine, Centre Hospitalier Universitaire, 7 boulevard Jeanne d'Arc, 21079 Dijon Cedex, France. laurent.martin@chu-dijon.fr
Funes de la Vega
M
M
Bocrie
O
O
Harzallah
A
A
Justrabo
E
E
Rifle
G
G
Mousson
C
C
D000208:Acute Disease; D000328:Adult; D001706:Biopsy; D005260:Female; D051858:Forkhead Transcription Factors / Q000032:analysis*; D006084:Graft Rejection / Q000473:pathology*; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values
C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors