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Prospective Analyses of Circulating B Cell Subsets in ABO ‐Compatible and ABO ‐Incompatible Kidney Transplant Recipients
Author(s) -
Schlößer H. A.,
Thelen M.,
Dieplinger G.,
BergweltBaildon A.,
GarciaMarquez M.,
Reuter S.,
ShimabukuroVornhagen A.,
Wennhold K.,
Haustein N.,
Buchner D.,
Heiermann N.,
Kleinert R.,
Wahba R.,
Ditt V.,
Kurschat C.,
Cingöz T.,
Becker J.,
Stippel D. L.,
BergweltBaildon M.
Publication year - 2017
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14013
Subject(s) - medicine , abo blood group system , transplantation , immunology , immunosuppression , b cell , antibody , kidney transplantation , rituximab , context (archaeology) , t cell , immune system , biology , paleontology
Immunosuppressive strategies applied in renal transplantation traditionally focus on T cell inhibition. B cells were mainly examined in the context of antibody‐mediated rejection, whereas the impact of antibody‐independent B cell functions has only recently entered the field of transplantation. Similar to T cells, distinct B cell subsets can enhance or inhibit immune responses. In this study, we prospectively analyzed the evolution of B cell subsets in the peripheral blood of ABO ‐compatible (n = 27) and ABO ‐incompatible (n = 10) renal transplant recipients. Activated B cells were transiently decreased and plasmablasts were permanently decreased in patients without signs of rejection throughout the first year. In patients with histologically confirmed renal allograft rejection, activated B cells and plasmablasts were significantly elevated on day 365. Rituximab treatment in ABO ‐incompatible patients resulted in long‐lasting B cell depletion and in a naïve phenotype of repopulating B cells 1 year following transplantation. Acute allograft rejection was correlated with an increase of activated B cells and plasmablasts and with a significant reduction of regulatory B cell subsets. Our study demonstrates the remarkable effects of standard immunosuppression on circulating B cell subsets. Furthermore, the B cell compartment was significantly altered in rejecting patients. A specific targeting of deleterious B cell subsets could be of clinical benefit in renal transplantation.