[HTML][HTML] Identification of a B cell signature associated with renal transplant tolerance in humans

KA Newell, A Asare, AD Kirk, TD Gisler… - The Journal of …, 2010 - Am Soc Clin Investig
KA Newell, A Asare, AD Kirk, TD Gisler, K Bourcier, M Suthanthiran, WJ Burlingham
The Journal of clinical investigation, 2010Am Soc Clin Investig
Establishing long-term allograft acceptance without the requirement for continuous
immunosuppression, a condition known as allograft tolerance, is a highly desirable
therapeutic goal in solid organ transplantation. Determining which recipients would benefit
from withdrawal or minimization of immunosuppression would be greatly facilitated by
biomarkers predictive of tolerance. In this study, we identified the largest reported cohort to
our knowledge of tolerant renal transplant recipients, as defined by stable graft function and …
Establishing long-term allograft acceptance without the requirement for continuous immunosuppression, a condition known as allograft tolerance, is a highly desirable therapeutic goal in solid organ transplantation. Determining which recipients would benefit from withdrawal or minimization of immunosuppression would be greatly facilitated by biomarkers predictive of tolerance. In this study, we identified the largest reported cohort to our knowledge of tolerant renal transplant recipients, as defined by stable graft function and receiving no immunosuppression for more than 1 year, and compared their gene expression profiles and peripheral blood lymphocyte subsets with those of subjects with stable graft function who are receiving immunosuppressive drugs as well as healthy controls. In addition to being associated with clinical and phenotypic parameters, renal allograft tolerance was strongly associated with a B cell signature using several assays. Tolerant subjects showed increased expression of multiple B cell differentiation genes, and a set of just 3 of these genes distinguished tolerant from nontolerant recipients in a unique test set of samples. This B cell signature was associated with upregulation of CD20 mRNA in urine sediment cells and elevated numbers of peripheral blood naive and transitional B cells in tolerant participants compared with those receiving immunosuppression. These results point to a critical role for B cells in regulating alloimmunity and provide a candidate set of genes for wider-scale screening of renal transplant recipients.
The Journal of Clinical Investigation