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The long-term stability of renal grafts depends on the absence of chronic rejection. As T cells play a key role in rejection processes, analyzing the T-cell repertoire may be useful for understanding graft function outcomes. We have therefore investigated the power of a new statistical tool, used to analyze the peripheral blood TCR repertoire, for determining immunological differences in a group of 229 stable renal transplant patients undergoing immunosuppression. Despite selecting the patients according to stringent criteria, the patients displayed heterogeneous T-cell repertoire usage, ranging from unbiased to highly selected TCR repertoires; a skewed TCR repertoire correlating with an increase in the CD8(+) /CD4(+) T-cell ratio. T-cell repertoire patterns were compared in patients with clinically opposing outcomes i.e. stable drug-free operationally tolerant recipients and patients with the "suspicious" form of humoral chronic rejection and were found significantly different, from polyclonal to highly selected TCR repertoires, respectively. Moreover, a selected TCR repertoire was found to positively correlate with the Banff score grade. Collectively, these data suggest that TCR repertoire categorization might be included in the calculation of a composite score for the follow-up of patients after kidney transplantation.

Original publication

DOI

10.1002/eji.201040301

Type

Journal article

Journal

Eur J Immunol

Publication Date

11/2010

Volume

40

Pages

3280 - 3290

Keywords

Adult, Aged, CD4-CD8 Ratio, Female, Follow-Up Studies, Graft Rejection, Humans, Immunosuppression, Kidney Transplantation, Male, Middle Aged, Receptors, Antigen, T-Cell, T-Lymphocytes, Transplantation, Homologous