B cells in cluster or in a scattered pattern do not correlate with clinical outcome of renal allograft rejection.
BACKGROUND
The role of CD20+ B cells in renal allograft rejection has been reappreciated. Importantly, recent studies suggest a relation between CD20+ B cell aggregates and poorer clinical outcome. In the present study, we attempted to confirm these early reports in a tightly controlled patient population and to differentiate between scattered infiltrates and clusters of B cells.


METHODS
Fifty-four biopsies from renal transplant recipients with acute rejection were immunostained for CD20, CD3, and C4d. All patients received similar immunosuppressive therapy. Response to therapy was defined as a decrease in serum creatinine level within 2 weeks to 125% or less of the value before the clinically diagnosed episode of allograft rejection. Late clinical outcome was defined in creatinine clearance between 8 and 12 months after the episode of acute rejection or in graft failure.


CONCLUSIONS
A significant correlation was observed between interstitial infiltrates of CD20+ cells and CD3+ cells (r=0.720, P<0.001) suggesting that if B-cell infiltrates are present during rejection, they occur with T-cell infiltrates in a concurrent fashion. In contrast to previous reports, no relation was found between the number of CD20+ cells, in aggregates or in a scattered interstitial pattern, and response to conventional therapy. Remarkably, CD3+T cell aggregates did predict a favorable renal outcome.
Scheepstra
Cornelis
C
Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Bemelman
Fréderike J
FJ
van der Loos
Chris
C
Rowshani
Ajda T
AT
van Donselaar-Van der Pant
Karlijn A M I
KA
Idu
Mirza M
MM
ten Berge
Ineke J M
IJ
Florquin
Sandrine
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000276:immunology; D018951:Antigens, CD20 / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology* / Q000473:pathology; D001706:Biopsy; D017252:CD3 Complex / Q000276:immunology; D002102:Cadaver; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000473:pathology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000276:immunology / Q000473:pathology; D016896:Treatment Outcome
D015703:Antigens, CD; D018951:Antigens, CD20; D017252:CD3 Complex