title: Clinical significance of the ratio between FOXP3 positive regulatory T cell and interleukin-17 secreting cell in renal allograft biopsies with acute T-cell-mediated rejection.
abstract: The aim of this study is to investigate the clinical significance of the ratio between interleukin-17 (IL-17) secreting cell and FOXP3-positive regulatory T cell (FOXP3(+) Treg) infiltration in renal allograft tissues with acute T-cell-mediated rejection (ATCMR). Fifty-six patients with biopsy-proven ATCMR were included. Infiltration of FOXP3(+) Treg and IL-17-secreting cells was evaluated with immunostaining for FOXP3 or IL-17 on the biopsy specimens, and the patients were divided into the FOXP3 high group (Log FOXP3/IL-17 > 0·45) or the IL-17 high group (Log FOXP3/IL-17 < 0·45). We compared the allograft function, severity of tissue injury, and clinical outcome between the two groups. In the IL-17 high group, allograft function was significantly decreased compared with the FOXP3 high group (P < 0·05). The severity of interstitial and tubular injury in the IL-17 high group was higher than the FOXP3 high group (P < 0·05). The proportions of steroid-resistant rejection, incomplete recovery and recurrent ATCMR were higher in the IL-17 high group than in the FOXP3 high group (all indicators, P < 0·05). The IL-17 high group showed lower 1-year (54% versus 90%, P < 0·05) and 5-year (38% versus 85%, P < 0·05) allograft survival rates compared with the FOXP3 high group. Multivariate analysis revealed that the FOXP3/IL-17 ratio was a significant predictor for allograft outcome. The FOXP3/IL-17 ratio is a useful indicator for representing the severity of tissue injury, allograft dysfunction and for predicting the clinical outcome of ATCMR.
authors.affiliation: Convergent Research Consortium for Immunological Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Byung H
authors.initials: BH
authors.lastname: Chung
authors.forename: Hye J
authors.initials: HJ
authors.lastname: Oh
authors.forename: Shang G
authors.initials: SG
authors.lastname: Piao
authors.forename: Hyeon S
authors.initials: HS
authors.lastname: Hwang
authors.forename: In O
authors.initials: IO
authors.lastname: Sun
authors.forename: Sun R
authors.initials: SR
authors.lastname: Choi
authors.forename: Hoon S
authors.initials: HS
authors.lastname: Park
authors.forename: Bum S
authors.initials: BS
authors.lastname: Choi
authors.forename: Yeong J
authors.initials: YJ
authors.lastname: Choi
authors.forename: Cheol W
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 W
authors.initials: CW
authors.lastname: Yang
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism*; D006084:Graft Rejection / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007150:Immunohistochemistry; D020381:Interleukin-17 / Q000096:biosynthesis*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000378:metabolism* / Q000473:pathology; D058504:Th17 Cells / Q000276:immunology
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D020381:Interleukin-17