대한신장학회

논문분류	춘계학술대회 초록집
제목	Clinical significance of CD161+ lymphocyte in chronic antibody mediated rejection in kidney transplant recipients
저자	Ji-won MIN1, Kyoung woon KIM2, Bo-mi KIM2, Kyoung chan DOH2, Mi-la CHO2, Chan-duck KIM3, Sang-ho LEE4, Chul woo YANG1,2, *Byung ha CHUNG 1,2
출판정보	2017; 2017(1):
키워드	cAMR, kidney transplantation, flow cytometry, T cell, B cell
초록	Objectives : Previous studies have shown that lymphocyte subset analysis is useful in predicting the clinical status of kidney transplant recipients (KTRs). In this study, we performed a multi-color flow cytometry to investigate T cell and B cell subset proportions in KTRs with chronic antibody mediated rejection (cAMR) in comparison to KTRs in different clinical or pathologic situations. Methods : We included 90 KTRs from three transplant centers and isolated PBMC from samples taken at the time of allograft biopsy. These were then divided into 5 groups according to pathologic diagnosis; the Normal biopsy control group (n=13), T cell mediated rejection group (n=21), Acute antibody mediated rejection (ABMR) group (n=11), Chronic antibody mediated rejection (cAMR) group (n=18), and the Long-term good outcome (LGO) group (n=27). We performed a multi-color flow cytometry analysis using the following platforms: CD4+ (PE-cy7) CCR4+(PE) CCR6+(APC), CD4+ (PE-cy7) CCR7+(APC) CD45RA+ (FITC), CD8+ (APC) CCR7+ (streptavidin cy5.5) CD45RA+ (FITC), CD4+ (PE-cy7) CD28null (PE) CCR6+ (APC), CD4+ (PEcy7) CD28null (PE) CD57+ (FITC) CD161+(APC), CD8+ (APC) CD28null (PE) CD57+(FITC), CD4+ (PE-cy7) CD25high (APC) CD127low (FITC), and CD19+(FITC) CD24+ (PE) CD38+ (Percp cy5.5). We compared the proportion of each immune cell subset among the 5 groups. Results : Out of various T cell and B cell subsets, only CD161+CD4+ T cells or CD161+ lymphocytes showed significant increase in the cAMR group in comparison to the other 4 clinical groups. In an ex-vivo analysis, CD161+ T cells showed significant correlation with those of Th1 (IFN-r+/CD4+T), Th17 (IL-17+/CD4+T) and also CCR4-CCR6+CD4+T and CCR4+CCR6+CD4+T cells. However, they did not show correlation to Th2 (IL-4+/CD4+ T cells). In addition, the proportion of CD161+ T cells was higher in the HLA-DSA positive group in comparison to the HLA-DSA negative group at the time of allograft biopsy. Conclusions : This study suggests that CD161+ T cells may have a role in the development of cAMR, and detection of CD161+ T cells can be proposed as marker for the diagnosis of cAMR.
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