title: Alterations of naïve and memory B-cell subsets are associated with risk of rejection and infection in heart recipients.
abstract: Rejection and infection are relevant causes of mortality in heart recipients. We evaluated the kinetics of the maturation status of B lymphocytes and its relationship with acute cellular rejection and severe infection in heart recipients. We analyzed B-cell subsets using 4-color flow cytometry in a prospective follow-up study of 46 heart recipients. Lymphocyte subsets were evaluated at specific times before and up to 1 year after transplantation. Higher percentages of pretransplant class-switched memory B cells (CD19+CD27+IgM-IgD- >14%) were associated with a 74% decrease in the risk of severe infection [Cox regression relative hazard (RH) 0.26, 95% confidence interval (CI), 0.07-0.86; P = 0.027]. Patients with higher percentages of naïve B cells at day 7 after transplantation (CD19+CD27-IgM+IgD+ >58%) had a 91% decrease in the risk of developing acute cellular rejection (RH 0.09; 95% CI, 0.01-0.80; P = 0.02). Patients with infections showed a strong negative correlation between baseline serum B-cell-activating factor (BAFF) concentration and absolute counts of memory class-switched B cells (R = -0.81, P = 0.01). The evaluation of the immunophenotypic maturation status of B lymphocytes could prove to be a useful marker for identifying patients at risk of developing rejection or infection after heart transplantation.
authors.affiliation: Transplant Immunology Group, Clinical Immunology Department, University Hospital Gregorio Marañon, Madrid, Spain.
authors.forename: Nallibe
authors.initials: N
authors.lastname: Lanio
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sarmiento
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallego
authors.forename: Leticia
authors.initials: L
authors.lastname: Calahorra
authors.forename: María
authors.initials: M
authors.lastname: Jaramillo
authors.forename: Joaquin
authors.initials: J
authors.lastname: Navarro
authors.forename: Jesus
authors.initials: J
authors.lastname: Palomo
authors.forename: Juan
authors.initials: J
authors.lastname: Fernandez-Yañez
authors.forename: Manuel
authors.initials: M
authors.lastname: Ruiz
authors.forename: Eduardo
authors.initials: E
authors.lastname: Fernandez-Cruz
authors.forename: Javier
authors.initials: J
authors.lastname: Carbone
mesh_terms: D000328:Adult; D000368:Aged; D053264:B-Cell Activating Factor / Q000097:blood; D016175:B-Lymphocyte Subsets / Q000276:immunology*; D006348:Cardiac Surgical Procedures; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D007156:Immunologic Memory / Q000276:immunology; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology; D014181:Transplantation Immunology
chemical_list: D053264:B-Cell Activating Factor; C505719:TNFSF13B protein, human
keywords: flow cytometry; heart transplantation; immune monitoring; infection; lymphocyte subsets; rejection