Histopathological analysis of infiltrating T cell subsets in acute T cell-mediated rejection in the kidney transplant

Figure 1 Representative T cell subsets infiltrating a kidney transplant undergoing acute T cell-mediated rejection using antibodies to CD4, CD8, CD19, Foxp3, IL-17 and granzyme B as labeled on the pictures (the arrows indicate positive cells). All pictures derived from the same region cut at consecutive levels (immunohistochemistry staining, magnification × 200).

Figure 2 T cell subsets infiltrating kidney tissue, including %CD4⁺ cells (A), %CD8⁺ cells (B), %CD19⁺ cells (C), granzyme B⁺ cells/mm² (D), IL-17⁺ cells/mm² (E) and Foxp3⁺ cells/mm² (F) (all detected by immunohistochemistry) are compared between patients with acute T cell-mediated rejection in the kidney transplant (n = 14) and patients with no rejection (n = 7). The horizontal lines indicate the median values. Wilcoxon rank-sum test P values for all comparisons were statistically non-significant. ATCMR: Acute T cell-mediated rejection; CTL: Cytotoxic T lymphocyte.

Figure 3 The ratios of (A) infiltrating granzyme B⁺ cells (CTL) over Foxp3⁺ cells (Tregs) and of (B) of infiltrating IL-17⁺ cells (Th17) over Foxp3⁺ cells (Tregs) are compared between patients with acute T cell-mediated rejection in the kidney transplant (n = 14) and patients with no rejection (n = 7). All cell types were detected by immunohistochemistry. The horizontal lines indicate the median values. Wilcoxon rank-sum test p values for both comparisons were statistically non-significant. ATCMR: Acute T cell-mediated rejection; CTL: Cytotoxic T lymphocyte.

Figure 4 Longitudinal analysis comparing the dynamic changes in serum creatinine (A), glomerular filtration rate (B) and proteinuria (C) throughout the follow up period in the acute T cell-mediated rejection in the kidney transplant (red non-continuous line) and non-rejection (blue continuous line) groups. The comparisons between overall mean values and mean values at follow-up times were statistically non- significant. Upper and lower limits for 95%CIs at the different time points are indicated. ATCMR-KTx: Acute T cell-mediated rejection in the kidney transplant; GFR: Glomerular filtration rate.

Figure 5 Time-to-event plots of (A) time to any rejection (borderline, acute T cell-mediated rejection in the kidney transplant or antibody-mediated rejection) post-biopsy, of (B) time to doubling of creatinine post-biopsy, and of (C) time to confirmed or suspected immune-mediated transplant loss in patients with acute T cell-mediated rejection in the kidney transplant (n = 14) and patients with no rejection (n = 7). Log-rank test P values for all the comparisons were statistically not significant. ATCMR: Acute T cell-mediated rejection.