1. Perturbations of the T-cell immune repertoire in kidney transplant rejection
- Author
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Sigdel, Tara K, Fields, Paul A, Liberto, Juliane, Damm, Izabella, Kerwin, Maggie, Hood, Jill, Towfighi, Parhom, Sirota, Marina, Robins, Harlan S, and Sarwal, Minnie M
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Immunology ,Digestive Diseases ,Kidney Disease ,Rare Diseases ,Transplantation ,Clinical Research ,Organ Transplantation ,Renal and urogenital ,Inflammatory and immune system ,Humans ,T-Lymphocytes ,Kidney Transplantation ,Cross-Sectional Studies ,Postoperative Complications ,Biopsy ,Antibodies ,kidney transplantation ,TCR sequencing ,acute rejection ,immune repertoire ,T cell-mediated rejection ,antibody-mediated rejection ,Medical Microbiology ,Biochemistry and cell biology ,Genetics - Abstract
In this cross-sectional and longitudinal analysis of mapping the T-cell repertoire in kidney transplant recipients, we have investigated and validated T-cell clonality, immune repertoire chronology at rejection, and contemporaneous allograft biopsy quantitative tissue injury, to better understand the pathobiology of acute T-cell fraction, T-cell repertoire and antibody-mediated kidney transplant rejection. To follow the dynamic evolution of T-cell repertoire changes before and after engraftment and during biopsy-confirmed acute rejection, we sequenced 323 peripheral blood samples from 200 unique kidney transplant recipients, with (n=100) and without (n=100) biopsy-confirmed acute rejection. We report that patients who develop acute allograft rejection, have lower (p=0.01) T-cell fraction even before transplantation, followed by its rise after transplantation and at the time of acute rejection accompanied by high TCR repertoire turnover (p=0.004). Acute rejection episodes occurring after the first 6 months post-transplantation, and those with a component of antibody-mediated rejection, had the highest turnover; p=0.0016) of their T-cell repertoire. In conclusion, we validated that detecting repertoire changes in kidney transplantation correlates with post-transplant rejection episodes suggesting that T-cell receptor sequencing may provide recipient pre-transplant and post-transplant predictors of rejection risk.
- Published
- 2022