title: Higher infiltration by Th17 cells compared with regulatory T cells is associated with severe acute T-cell-mediated graft rejection.
abstract: The aim of this study was to evaluate whether the Th17 and Treg cell infiltration into allograft tissue is associated with the severity of allograft dysfunction and tissue injury in acute T cell-mediated rejection (ATCMR). Seventy-one allograft tissues with biopsy-proven ATCMR were included. The biopsy specimens were immunostained for FOXP3 and IL-17. The allograft function was assessed at biopsy by measuring serum creatinine (Scr) concentration, and by applying the modified diet in renal disease (MDRD) formula, which provides the estimated glomerular filtration rate (eGFR). The severity of allograft tissue injury was assessed by calculating tissue injury scores using the Banff classification. The average numbers of infiltrating Treg and Th17 cells were 11.6 ± 12.2 cells/mm² and 5.6 ± 8.0 cells/mm², respectively. The average Treg/Th17 ratio was 5.6 ± 8.2. The Treg/Th17 ratio was significantly associated with allograft function (Scr and MDRD eGFR) and with the severity of interstitial injury and tubular injury (P < 0.05, all parameters). In separate analyses of the number of infiltrating Treg and Th17 cells, Th17 cell infiltration was significantly associated with allograft function and the severity of tissue injury. By contrast, Treg cell infiltration was not significantly associated with allograft dysfunction or the severity of tissue injury. The results of this study show that higher infiltration of Th17 cell compared with Treg cell is significantly associated with the severity of allograft dysfunction and tissue injury.
authors.affiliation: Conversant Research Consortium in Immunologic Disease, School of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
authors.forename: Hye Jwa
authors.initials: HJ
authors.lastname: Oh
authors.forename: Shang Guo
authors.initials: SG
authors.lastname: Piao
authors.forename: In O
authors.initials: IO
authors.lastname: Sun
authors.forename: Seok Hui
authors.initials: SH
authors.lastname: Kang
authors.forename: Sun Ryoung
authors.initials: SR
authors.lastname: Choi
authors.forename: Hoon Suk
authors.initials: HS
authors.lastname: Park
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.forename: Yeong Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Cheol Whee
authors.initials: CW
authors.lastname: Park
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Mi La
authors.initials: ML
authors.lastname: Cho
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
mesh_terms: D000208:Acute Disease; D003404:Creatinine / Q000378:metabolism; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006084:Graft Rejection / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D020381:Interleukin-17 / Q000378:metabolism*; D016030:Kidney Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000473:pathology; D058504:Th17 Cells / Q000276:immunology* / Q000473:pathology; D014184:Transplantation, Homologous
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D020381:Interleukin-17; D003404:Creatinine