Abstract

Follicular helper T cells (Tfh cells) are closely related to the occurrence and development of antibody-mediated rejection (AMR) after renal transplantation. Exosomes play a key role in the rejection after organ transplantation. However, whether Tfh-derived exosomes are involved in AMR has not been reported. We collected peripheral blood from 42 kidney transplant patients and found no significant differences in CD4+CXCR5+ and CD4+CXCR5+CXCR3+CCR6-exosomes between AMR and non-AMR groups, whereas the proportion of CD4+CXCR5+CXCR3-exosomes was significantly higher in AMR group than that in non-AMR group; CTLA-4 expression of CD4+CXCR5+exosomes was significantly lower in AMR group than that in non-AMR group. HLA-G expression was not significantly different between two groups. We further separated CD4+CXCR5+cells from patients by magnetic beads. Coculture experiments showed that Tfh cell-derived exosomes in AMR patients significantly promoted B cell proliferation and differentiation, compared with non-AMR group, the percentage of B cells and plasma cells increased by 87.52% and 110.2%, respectively. In conclusion, our study found that Tfh cell-derived exosomes could promote the proliferation and differentiation of B cells and they may play an important role in the development of AMR after renal transplantation.

Highlights

  • Renal transplantation is the most effective way to treat endstage renal disease and improve the life quality of dialysis patients

  • In the chronic allograft dysfunction (CRAD) group, 14 patients were diagnosed with Antibody-mediated rejection (AMR) based on 2013 Banff Criteria, 14 patients were diagnosed with non-AMR

  • The proportion of CD4+CXCR5+CXCR3-exosomes was positively correlated with DSA. These results suggested that the decreased expression of CTLA-4 on CD4+CXCR5+exosomes and the increase in CD4+CXCR5+CXCR3-exosomes may be associated with the occurrence of AMR after renal transplantation

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Summary

Introduction

Renal transplantation is the most effective way to treat endstage renal disease and improve the life quality of dialysis patients. The use of immunosuppressive drugs significantly reduces T cell-mediated rejection after renal transplantation [1]. The long-term prognosis of renal transplant patients is not ideal. Antibody-mediated rejection (AMR) has gradually become a major cause of late renal transplantation failure. The treatment of AMR includes plasmapheresis and drug therapy, but these methods have large side effects and poor efficacy [2, 3]. It is of great clinical significance to search new therapeutic targets

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