title: Immunephenotype of glomerular and interstitial infiltrating cells in protocol renal allograft biopsies and histological diagnosis.
abstract: Patients with a protocol renal allograft biopsy simultaneously displaying interstitial fibrosis/tubular atrophy (IF/TA) and subclinical rejection (SCR) have a shortened graft survival than patients with a normal biopsy, or with a biopsy only displaying IF/TA or SCR. The poor outcome of these patients could be related with a more severe inflammation. We evaluate the immunophenotype of infiltrating cells in these diagnostic categories. Nonexhausted paraffin blocks from protocol biopsies done during the first year were stained with anti-CD45, CD3, CD20, CD68 and CD15 monoclonal antibodies. Glomerular and interstitial positive cells were counted. C4d deposition in peritubular capillaries was evaluated. Histological diagnoses were: normal (n = 80), SCR (n = 17), IF/TA (n = 42) and IF/TA + SCR (n = 17). Only interstitial CD20 positive cells were significantly increased in patients displaying IF/TA + SCR; normal (137 +/- 117), SCR (202 +/- 145), IF/TA (208 +/- 151) and IF/TA + SCR (307 +/- 180 cells/mm(2)), p < 0.01. The proportion of biopsies displaying C4d deposition was not different among groups. The upper tertile of CD20 positive interstitial cells was associated with a decreased death-censored graft survival (relative risk: 3.01, 95% confidence interval: 1.23-7.35; p = 0.015). These data suggest that B-cell interstitial infiltrates are associated with histological damage and outcome, but do not distinguish whether these infiltrates were the cause or the consequence of chronic tubulo-interstitial damage.
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Moreso
authors.forename: D
authors.initials: D
authors.lastname: Seron
authors.forename: F
authors.initials: F
authors.lastname: O'Valle
authors.forename: M
authors.initials: M
authors.lastname: Ibernon
authors.forename: M
authors.initials: M
authors.lastname: Gomà
authors.forename: M
authors.initials: M
authors.lastname: Hueso
authors.forename: J M
authors.initials: JM
authors.lastname: Cruzado
authors.forename: O
authors.initials: O
authors.lastname: Bestard
authors.forename: V
authors.initials: V
authors.lastname: Duarte
authors.forename: R García
authors.initials: RG
authors.lastname: del Moral
authors.forename: J M
authors.initials: JM
authors.lastname: Grinyó
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000175:diagnosis / Q000473:pathology; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D001706:Biopsy; D005260:Female; D005355:Fibrosis / Q000175:diagnosis / Q000473:pathology; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis* / Q000473:pathology*; D006085:Graft Survival; D006801:Humans; D016130:Immunophenotyping; D007678:Kidney Glomerulus / Q000276:immunology / Q000473:pathology*; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017154:Stromal Cells / Q000276:immunology / Q000473:pathology*