Analysis of the peripheral T-cell repertoire in kidney transplant patients.
The long-term stability of renal grafts depends on the absence of chronic rejection. As T cells play a key role in rejection processes, analyzing the T-cell repertoire may be useful for understanding graft function outcomes. We have therefore investigated the power of a new statistical tool, used to analyze the peripheral blood TCR repertoire, for determining immunological differences in a group of 229 stable renal transplant patients undergoing immunosuppression. Despite selecting the patients according to stringent criteria, the patients displayed heterogeneous T-cell repertoire usage, ranging from unbiased to highly selected TCR repertoires; a skewed TCR repertoire correlating with an increase in the CD8(+) /CD4(+) T-cell ratio. T-cell repertoire patterns were compared in patients with clinically opposing outcomes i.e. stable drug-free operationally tolerant recipients and patients with the "suspicious" form of humoral chronic rejection and were found significantly different, from polyclonal to highly selected TCR repertoires, respectively. Moreover, a selected TCR repertoire was found to positively correlate with the Banff score grade. Collectively, these data suggest that TCR repertoire categorization might be included in the calculation of a composite score for the follow-up of patients after kidney transplantation.
INSERM Unité 643, CHU de Nantes, Institut de Transplantation et de Recherche en Transplantation, Université de Nantes, Faculté de Médecine de Nantes. RTRS Centaure, Nantes, France.
Patrick
P
Miqueu
Nicolas
N
Degauque
Marina
M
Guillet
Magali
M
Giral
Catherine
C
Ruiz
Annaïck
A
Pallier
Cécile
C
Braudeau
Gwenaëlle
G
Roussey-Kesler
Joanna
J
Ashton-Chess
Jean-Christophe
JC
Doré
Eric
E
Thervet
Christophe
C
Legendre
Maria P
MP
Hernandez-Fuentes
Anthony N
AN
Warrens
Michel
M
Goldman
Hans-Dieter
HD
Volk
Uwe
U
Janssen
Kathryn J
KJ
Wood
Robert I
RI
Lechler
Dominique
D
Bertrand
Véronique
V
Sébille
Jean-Paul
JP
Soulillou
Sophie
S
Brouard
D000328:Adult; D000368:Aged; D016516:CD4-CD8 Ratio; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011948:Receptors, Antigen, T-Cell / Q000276:immunology* / Q000378:metabolism; D013601:T-Lymphocytes / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D014184:Transplantation, Homologous
D011948:Receptors, Antigen, T-Cell