title: Clinical impacts of CD38+ B cells on acute cellular rejection with CD20+ B cells in renal allograft.
abstract: BACKGROUND
  There is an increasing evidence that the presence of CD20 B cells is associated with poor clinical outcomes in acute cellular rejection (ACR), but clinical significance of CD38 B cells is undetermined. We attempted to examine the clinical significance of the CD38 B cells alone or in combination with CD20 B cells in renal transplant recipients with ACR.
  
  
  METHODS
  Fifty-four patients with ACR were included. Biopsy specimens were stained for CD20 and CD38. The clinical outcomes of CD20 or CD38 B cells were evaluated with late-onset and repeated ACR, steroid resistance, incomplete recovery after rejection treatment, and allograft survival.
  
  
  RESULTS
  Twenty-three patients (42.6%) had CD20 and 25 (46.3%) patients had CD38 B cells. Of these, 15 patients (27.8%) were positive for both CD20 and CD38 (CD20CD38). CD38 patients had higher rates of late-onset or repeated ACR and incomplete recovery compared with CD38 patients (P<0.05). The patients with CD20CD38 had a higher incomplete recovery rate than did patients with only CD20 or CD38 (P<0.05). The 5-year allograft survival was lower in CD20 and CD38 patients than in CD20 or CD38 patients (P<0.05 for each). CD20CD38 patients had lower graft survival than did patients with CD20 or CD38 alone (P<0.05).
  
  
  CONCLUSIONS
  Infiltration of CD38 B cells alone or in combination with CD20 B cells is a predictor for poor clinical outcomes of ACR in renal allograft.
authors.affiliation: Transplantation Research Center, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Hyeon Seok
authors.initials: HS
authors.lastname: Hwang
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Song
authors.forename: Bok Jin
authors.initials: BJ
authors.lastname: Hyoung
authors.forename: So Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Youn Joo
authors.initials: YJ
authors.lastname: Jeon
authors.forename: Seok Hui
authors.initials: SH
authors.lastname: Kang
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.forename: Yeong Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Ji Il
authors.initials: JI
authors.lastname: Kim
authors.forename: In Sung
authors.initials: IS
authors.lastname: Moon
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000096:biosynthesis*; D000328:Adult; D017668:Age of Onset; D018951:Antigens, CD20 / Q000096:biosynthesis*; D001402:B-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D001706:Biopsy; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D018951:Antigens, CD20; D007166:Immunosuppressive Agents; D051997:ADP-ribosyl Cyclase 1