Monocyte infiltration and kidney allograft dysfunction during acute rejection.

Journal Article (Journal Article)

Multiple cell types infiltrate acutely rejecting renal allografts. Typically, monocytes and T cells predominate. Although T cells are known to be required for acute rejection, the degree to which monocytes influence this process remains incompletely defined. Specifically, it has not been established to what degree monocytes impact the clinical phenotype of rejection or how their influence compares to that of T cells. We therefore investigated the relative impact of T cells and monocytes by correlating their presence as measured by immunohistochemical staining with the magnitude of the acute change in renal function at the time of biopsy in 78 consecutive patients with histological acute rejection. We found that functional impairment was strongly associated with the degree of overall cellular infiltration as scored using Banff criteria. However, when cell types were considered, monocyte infiltration was quantitatively associated with renal dysfunction while T-cell infiltration was not. Similarly, renal tubular stress, as indicated by HLA-DR expression, increased with monocyte but not T-cell infiltration. These data suggest that acute allograft dysfunction is most closely related to monocyte infiltration and that isolated T-cell infiltration has less acute functional impact. This relationship may be useful in assigning acute clinical relevance to biopsy findings.

Full Text

Duke Authors

Cited Authors

  • Girlanda, R; Kleiner, DE; Duan, Z; Ford, EAS; Wright, EC; Mannon, RB; Kirk, AD

Published Date

  • March 2008

Published In

Volume / Issue

  • 8 / 3

Start / End Page

  • 600 - 607

PubMed ID

  • 18294156

Pubmed Central ID

  • PMC2813043

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

Digital Object Identifier (DOI)

  • 10.1111/j.1600-6143.2007.02109.x


  • eng

Conference Location

  • United States