Characterization of urinary CD4⁺ and CD8⁺ T cells in kidney transplantation patients with polyomavirus BK infection and allograft rejection

Transpl Infect Dis. 2014 Oct;16(5):733-43. doi: 10.1111/tid.12273. Epub 2014 Aug 5.

Abstract

Background and objectives: The objective of this study was to characterize CD4(+) and CD8(+) T-cell populations in blood and urine of renal transplant patients with BK virus (BKV) infection or allograft rejection.

Materials and methods: Percentages and absolute numbers of CD4(+) and CD8(+) effector memory T-cell subtype (TEM ) and terminal differentiated T cells (TTD ) in renal transplant patients with BKV infection (n = 14), with an episode of allograft rejection (n = 9), and in uncomplicated renal transplant patients with a stable kidney function (n = 12) were measured and compared using 4-color fluorescence-activated cell sorting. Results were correlated with the number of CD4(+) and CD8(+) T cells in renal biopsies.

Results: In patients with allograft rejection, the number of urinary CD4(+) TEM and CD8(+) TEM cells was significantly increased compared to patients with BKV infection or patients without complications. Positive correlation was found between the number of CD4(+) and CD8(+) cells in the renal biopsies and the number of CD4(+) and CD8(+) cells in urine. In patients with rejection, after 2 months of immunosuppressive therapy, a reduction in urinary CD8(+) TEM cells was found.

Conclusions: CD4(+) TEM and CD8(+) TEM cells in urine could be a marker to distinguish allograft rejection from BKV-associated nephropathy and to monitor therapy effectiveness in renal transplant patients with allograft rejection.

Keywords: BK nephropathy; BK virus; CD4+ T cells; CD8+ T cells; FACS; Urine; allograft rejection; renal transplantation; virology.

MeSH terms

  • Adult
  • Aged
  • Allografts / immunology
  • BK Virus*
  • Biopsy
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes*
  • CD8-Positive T-Lymphocytes*
  • Female
  • Graft Rejection / blood
  • Graft Rejection / immunology
  • Graft Rejection / urine*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney / pathology*
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Polyomavirus Infections / blood
  • Polyomavirus Infections / immunology
  • Polyomavirus Infections / urine*
  • T-Lymphocyte Subsets
  • Tumor Virus Infections / blood
  • Tumor Virus Infections / immunology
  • Tumor Virus Infections / urine*
  • Urine / cytology
  • Young Adult

Substances

  • Immunosuppressive Agents