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논문분류	춘계학술대회 초록집
제목	Increased Circulating T lymphocytes Expressing HLA-DR in Kidney Transplant Recipients with Microcirculation Inflammation
저자	Hee-Yeon Jung*, Kyu Yeun Kim1, Minjung Kim1, Wonseok Do1, Youngae Yang1, Taehoon Yim1, Inryang Hwang1, Su Kyung Lee1, Ji-Young Choi1, Jang-Hee Cho1, Sun-Hee Park1, Yong-Lim Kim1, Yong-Jin Kim2, Hyung-Kee Kim3, Seung Huh3, Dong-Il Won4, Chan-Duck Kim1
출판정보	2016; 2016(1):
키워드	antibody-mediated rejection, kidney transplantation, Microcirculation inflammation, T-lymphocyte
초록	Background: The goal of this study was to compare the histological grading of renal allografts, according to the Banff scoring scheme, with the activity of circulating T lymphocyte subsets and HLA-DR positive monocytes in kidney transplant recipients (KTRs). Methods: In this study, we included 24 KTRs with acute renal allograft dysfunction who underwent indication biopsy. Flow cytometry was used to estimate the frequencies of serum HLA-DR+, CD4+, CD8+, and CD25+ T lymphocytes and HLA-DR-positive monocytes obtained at the time of biopsy. The sum of the scores of g + ptc, i + t, ci + ct, and cv + ah was used to assign a histological grade to the renal allograft samples, according to the Banff 2013 classification scheme. Results: The frequencies of CD4+HLA-DR+/CD4+ T cells and CD8+HLA-DR+/CD8+ T cells were significantly increased in KTRs with a microcirculation inflammation (MI) sum score ≥ 1 when compared with KTRs with an MI sum score = 0. Between these two T cell subsets, CD4+HLA-DR+/CD4+ T cells were positively correlated with the MI sum score. However, no significant differences were observed between the two groups categorized based on the sum of scores of i + t, ci + ct, and cv + ah. Analysis using the receiver operating characteristic curve showed that antibody-mediated rejection could be predicted with a sensitivity of 80.0% and a specificity of 94.7%, using a cutoff value of 29.6% frequency of CD4+HLA-DR+/CD4+ T cells. Conclusion: In KTRs, MI was significantly associated with an increased frequency of activated T lymphocytes expressing HLA-DR. Further large-scale studies are needed to confirm the utility of circulating CD4+HLA-DR+/CD4+ T cells as a noninvasive, immunologic monitoring tool for the prediction of antibody-mediated rejection.
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