title: Presence of FoxP3+ regulatory T Cells predicts outcome of subclinical rejection of renal allografts.
abstract: Subclinical rejection (SCR) of renal allografts refers to histologic patterns of acute rejection despite stable renal function. The clinical approach to SCR is controversial; it would be helpful to identify biomarkers that could determine whether the identified cellular infiltrates were detrimental. For investigation of whether the presence of FoxP3+ regulatory T cells (Treg) could help determine the functional importance of tubulointerstitial infiltrates observed in 6-mo protocol biopsies, 37 cases of SCR were evaluated. The presence of FoxP3+ Treg discriminated harmless from injurious infiltrates, evidenced by independently predicting better graft function 2 and 3 yr after transplantation. Furthermore, the FoxP3+ Treg/CD3+ T cell ratio positively correlated with graft function at 2 yr after transplantation, suggesting that an increasing proportion of Treg within the global T cell infiltrate may facilitate renal engraftment; therefore, immunostaining for FoxP3+ Treg in patients with SCR on protocol biopsies may ultimately be useful to identify patients who may require alterations in their immunosuppressive regimens.
authors.affiliation: Nephrology Department, Hospital Universitari de Bellvitge, Barcelona, Spain. 35830obm@comb.es
authors.forename: Oriol
authors.initials: O
authors.lastname: Bestard
authors.forename: Josep M
authors.initials: JM
authors.lastname: Cruzado
authors.forename: Inés
authors.initials: I
authors.lastname: Rama
authors.forename: Joan
authors.initials: J
authors.lastname: Torras
authors.forename: Montse
authors.initials: M
authors.lastname: Gomà
authors.forename: Daniel
authors.initials: D
authors.lastname: Serón
authors.forename: Francesc
authors.initials: F
authors.lastname: Moreso
authors.forename: Salvador
authors.initials: S
authors.lastname: Gil-Vernet
authors.forename: Josep M
authors.initials: JM
authors.lastname: Grinyó
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism*; D006084:Graft Rejection / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015996:Survival Rate; D050378:T-Lymphocytes, Regulatory / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors