Pretransplant Numbers of CD16+Monocytes as a Novel Biomarker to Predict Acute Rejection After Kidney Transplantation: A Pilot Study.
Acute rejection is one of the major immunological determinants of kidney graft function and survival. Early biomarkers to predict rejection are lacking. Emerging evidence reveals a crucial role for the monocyte/macrophage lineage cells in the pathogenesis of rejection. We hypothesized that higher pretransplant numbers of proinflammatory CD16+ monocytes can predict rejection. The study cohort consisted of 104 kidney transplant recipients (58 with no rejection and 46 with biopsy-proven rejection) and 33 healthy persons. Posttransplant median follow-up time was 14.7 mo (interquartile range 0.3-34 mo). Pretransplantation blood samples were analyzed by flow cytometry for monocyte immunophenotypes. Groups were compared by Cox regression models for the occurrence of acute rejection. We documented a significantly increased absolute number of pretransplant CD16+ monocytes in patients who developed biopsy-proven rejection after transplantation compared with those with no rejection (hazard ratio [HR] 1.60, 95% CI 1.28-2.00, p < 0.001) and healthy persons (HR 1.47, 95% CI 1.18-1.82, p < 0.001). In parallel, significantly fewer absolute numbers of CD16- monocytes were observed at pretransplant time points in rejectors versus nonrejectors (HR 0.74, 95% CI 0.58-0.94, p < 0,014). A higher pretransplant number of CD16+ monocytes is significantly associated with a higher risk of acute rejection after kidney transplantation.
Department Internal Medicine, Section of Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands.
T P P
TPP
van den Bosch
Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands.
L B
LB
Hilbrands
Department Internal Medicine, Section of Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands.
R
R
Kraaijeveld
Department Internal Medicine, Section of Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands.
N H R
NHR
Litjens
Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
F
F
Rezaee
Department of Cell Biology, University Medical Center Groningen, Groningen, The Netherlands.|Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
D
D
Nieboer
Department of Cell Biology, University Medical Center Groningen, Groningen, The Netherlands.|Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
E W
EW
Steyerberg
Department Internal Medicine, Section of Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands.
J A
JA
van Gestel
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
D L
DL
Roelen
Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
M C
MC
Clahsen-van Groningen
Department Internal Medicine, Section of Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands.
C C
CC
Baan
Department Internal Medicine, Section of Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands.
A T
AT
Rowshani
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D058851:GPI-Linked Proteins / Q000276:immunology; D006084:Graft Rejection; D006801:Humans; D016130:Immunophenotyping; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D010865:Pilot Projects; D017452:Receptors, IgG / Q000276:immunology*
D015415:Biomarkers; C428200:FCGR3B protein, human; D058851:GPI-Linked Proteins; D017452:Receptors, IgG
basic (laboratory) research/science; flow cytometry; immunobiology; kidney (allograft) function/dysfunction; kidney transplantation/nephrology; macrophage/monocyte biology: activation; macrophage/monocyte biology: trafficking; pathology/histopathology; rejection; translational research/science