Does borderline kidney allograft rejection always require treatment?

Transplantation
Dorottya NémethCaner Süsal

Abstract

Borderline rejection (Bord-R) is a frequent diagnosis in renal transplantation, and there is increasing evidence that regulatory T lymphocytes are involved in its pathogenesis. Current histopathologic practice does not differentiate between graft-protecting and -damaging T lymphocytes, and patients with Bord-R routinely receive rejection treatment. We analyzed Treg-associated forkhead box P3 (Foxp3) gene expression in Bord-R and more severe forms of acute rejection episodes (ARE). Foxp3 transcripts were measured in 520 serial peripheral blood samples from 177 kidney graft recipients obtained during the first 20 days posttransplantation. The highest Foxp3 transcripts were observed in patients with Bord-R or without rejection and the lowest in patients with ARE. Patients with Bord-R on posttransplant days 5 to 7 showed an increased Foxp3 transcript level of 156%, which increased to 302% by posttransplant days 14 to 16. In contrast, patients with ARE demonstrated significantly lower Foxp3 gene expression than that observed in Bord-R, nonrejectors, or acute tubular necrosis patients (P=0.001, P<0.001, and P=0.005, respectively, on days 11-13). Acute tubular necrosis patients demonstrated intermediately high Foxp3 gene expression. O...Continue Reading

References

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Citations

Jul 30, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L K HendersonJ R Chapman
Jan 3, 2013·Transplant International : Official Journal of the European Society for Organ Transplantation·Matthias SchaierAndrea Steinborn
Jul 15, 2015·Expert Opinion on Pharmacotherapy·Jamal BamoulidKlemens Budde
Oct 9, 2012·Current Opinion in Nephrology and Hypertension·Jeremy R Chapman
Apr 1, 2017·Transplantation Direct·Caroline WehmeierStefan Schaub
May 18, 2021·Transplantation Proceedings·Ana Carolina FigueiredoRui Alves

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