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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Effect of panel reactive antibodies on T cell immunity reinstatement following renal transplantation
Lampros Vagiotas, Maria Stangou, Efstratios Kasimatis, Aliki Xochelli, Grigorios Myserlis, Georgios Lioulios, Vasiliki Nikolaidou, Manolis Panteli, Konstantinos Ouranos, Nikolaos Antoniadis, Daoudaki Maria, Aikaterini Papagianni, Georgios Tsoulfas, Asimina Fylaktou
Lampros Vagiotas, Grigorios Myserlis, Nikolaos Antoniadis, Georgios Tsoulfas, Department of Transplant Surgery, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece
Maria Stangou, Efstratios Kasimatis, Georgios Lioulios, Manolis Panteli, Konstantinos Ouranos, Aikaterini Papagianni, Department of Nephrology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece
Aliki Xochelli, Vasiliki Nikolaidou, Asimina Fylaktou, Department of Immunology, National Peripheral Histocompatibility Center, Hippokration General Hospital, Thessaloniki 54642, Greece
Daoudaki Maria, Medical School Aristotle University of Thessaloniki, Biochemistry Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
Author contributions: Fylaktou A, Papagianni A, and Tsoulfas G designed the research study; Xochelli A, Nikolaidou V, Panteli M, and Ouranos K contributed new reagents and analytic tools; Vagiotas L, Kasimatis E, and Lioulios G performed the study; Antoniadis N, Miserlis G, and Vagiotas L provided the patients; Vagiotas L, Stangou M, and Daoudaki M analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Aristotle University of Thessaloniki. This registration identification number is 611/30-09-2020.
Clinical trial registration statement: This study is registered at the Aristotle University of Thessaloniki. This registration identification number is 611/30-09-2020.
Informed consent statement: All participants provided informed consent before their enrollment to the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Participants gave informed consent for data sharing. The relevant document was given.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Maria Stangou, PhD, Assistant Professor, Department of Nephrology, School of Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece. mstangou@auth.gr
Received: July 3, 2022
Peer-review started: July 3, 2022
First decision: August 4, 2022
Revised: August 5, 2022
Accepted: September 9, 2022
Article in press: September 9, 2022
Published online: October 18, 2022
ARTICLE HIGHLIGHTS
Research background
It is essential to try to both understand and evaluate the effect of panel reactive antibodies (PRAs) on T cell immunity reinstatement, which follows renal transplantation. The potential association between subset changes and posttransplant graft function should be studied further.
Research motivation
This study demonstrated that T cell reinstatement following renal transplantation was closely affected by the presence of PRAs. Although the lymphocyte population increased early after kidney transplantation, this beneficial effect did not involve all subpopulations. Natural killer (NK) cells are reduced in both groups, regulatory T cells (Tregs) were increased, but only in PRA(-) patients, whereas CD28null cells were not significantly restored regardless of the presence of PRAs.
Research objectives
Patients were classified into two groups: PRA(-) (n = 43) and PRA(+) (n = 28). Patients who underwent preemptive kidney transplantation had a better immune profile than those already enrolled in hemodialysis or continuous ambulatory peritoneal dialysis.
Research methods
Flow cytometry analysis was performed in 71 recipients of kidney transplantation at the time of transplantation, and at 3 and 6 mo after transplantation to estimate CD4CD28null, CD8CD28null, NK, and Treg cells.
Research results
The impact of positive PRA on the restoration of T cell phenotype after renal transplantation was evaluated.
Research conclusions
Given the fact that PRA screening is a widely used test performed routinely in patients with chronic kidney disease (CKD) before renal transplantation to assess recipients’ exposure and sensitization, we believe it is essential to try to both understand and carefully evaluate the effect of PRA on T cell immunity reinstatement, which follows renal transplantation.
Research perspectives
CKD is associated with phenotypic and functional changes in the immune system, including both innate and adaptive immunity, with detrimental clinical consequences. A successful renal transplantation will allow patients to stop dialysis and reinstates kidney function. Accordingly, as part of returning to normality, it is also expected to restore patients’ immune profile.
