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Abstract
Little is known about the characteristics and clinical implications of specific subsets of intragraft natural killer (NK) cells in kidney transplant recipients. We analyzed 39 for-cause renal transplant biopsies performed at our center from May 2015 to July 2017. According to histopathologic reports, 8 patients (20.5%) had no rejection (NR), 11 (28.2%) had T cell-mediated rejections (TCMR) only, and 20 (51.3%) had antibody-mediated rejection (ABMR). NK cells were defined as CD3–CD56+ lymphocytes that are positive for CD57, CD49b, NKG2A, or KIR. The density of NK cells was significantly higher in the ABMR group (2.57 ± 2.58/mm2) than in the NR (0.12 ± 0.22/mm2) or the TCMR (0.25 ± 0.34/mm2) group (P = 0.002). Notably, CD56+CD57+ infiltrates (2.16 ± 1.89) were the most frequently observed compared with CD56+CD49b+ (0.05 ± 0.13), CD56+NKG2A+ (0.21 ± 0.69), and CD56+KIR+ (0.15 ± 0.42) cells in the ABMR group (P < 0.001). Death-censored graft failure was significantly higher in patients with NK cell infiltration than those without (Log-rank test, P = 0.025). In conclusion, CD56+CD57+ infiltrates are a major subset of NK cells in kidney transplant recipients with ABMR and NK cell infiltration is significantly associated with graft failure post-transplant.
Highlights
Little is known about the characteristics and clinical implications of specific subsets of intragraft natural killer (NK) cells in kidney transplant recipients
The biopsies were divided into no rejection (NR; n = 8), T cell-mediated rejection (TCMR; n = 11), and antibody-mediated rejection (ABMR; n = 20) groups (Table 1)
We found that patients diagnosed as ABMR had higher densities of NK cells in for-cause biopsies
Summary
Little is known about the characteristics and clinical implications of specific subsets of intragraft natural killer (NK) cells in kidney transplant recipients. CD94/NKG2A heterodimer and the killer immunoglobulin-like receptor (KIR) family inactivate NK cells interacting with HLA-E and distinct sets of classical HLA class I molecules[19,20,21]. It has been unrevealed which subsets of NK cells are involved in ABMR after kidney transplantation. We characterized the specific subsets of intragraft NK cells in human kidney transplant biopsies from patients with ABMR by using multiplex immunohistochemistry and investigated clinical implications of each NK cell subset with respect to graft survival
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