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1.
Am J Transplant ; 17(7): 1754-1769, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28101959

RESUMEN

We annotated the top transcripts associated with kidney transplant rejection by p-value, either universal for all rejection or selective for T cell-mediated rejection (TCMR) or antibody-mediated rejection (ABMR; ClinicalTrials.gov NCT01299168). We used eight class-comparison algorithms to interrogate microarray results from 703 biopsies, 205 with rejection. The positive comparators were all rejection, TCMR, or ABMR; the negative comparators varied from normal biopsies to all nonrejecting biopsies, including other diseases. The universal algorithm, rejection versus all nonrejection, identified transcripts mainly inducible by interferon γ. Selectivity for ABMR or TCMR required the other rejection class as well as nonrejection biopsies in the comparator to avoid selecting universal transcripts. Direct comparison of ABMR versus TCMR yielded only transcripts related to TCMR, the stronger signal. Transcripts highly associated with rejection were never completely specific for rejection: Many were increased in biopsies without rejection, reflecting sharing between rejection and injury-induced innate immunity. Union of the top 200 transcripts from universal and selective algorithms yielded 454 transcripts that permitted unsupervised analysis of biopsies in principal component analysis: PC1 was rejection, and PC2 was separation of TCMR from ABMR. Appreciating rejection-associated molecular changes requires a diverse case mix, accurate histologic classification (including C4d-negative ABMR), and both selective and universal algorithms.


Asunto(s)
Algoritmos , Biomarcadores/metabolismo , Perfilación de la Expresión Génica , Rechazo de Injerto/diagnóstico , Enfermedades Renales/cirugía , Trasplante de Riñón/efectos adversos , Aloinjertos , Regulación de la Expresión Génica , Rechazo de Injerto/etiología , Humanos , Estudios Prospectivos
2.
Am J Transplant ; 17(1): 129-139, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27340822

RESUMEN

Histologic diagnosis of antibody-mediated rejection (ABMR) in kidney transplant biopsies uses lesion score cutoffs such as 0 versus >0 rather than actual scores and requires donor-specific antibody (DSA); however, cutoffs lose information, and DSA is not always reliable. Using microarray-derived molecular ABMR scores as a histology-independent estimate of ABMR in 703 biopsies, we reassessed criteria for ABMR to determine relative importance of various lesions, the utility of equations using actual scores rather than cutoffs, and the potential for diagnosing ABMR when DSA is unknown or negative. We confirmed that the important features for ABMR diagnosis were peritubular capillaritis (ptc), glomerulitis (g), glomerular double contours, DSA and C4d staining, but we questioned some features: arterial fibrosis, vasculitis, acute tubular injury, and sum of ptc+g scores. Regression equations using lesion scores predicted molecular ABMR more accurately than score cutoffs (area under the curve 0.85-0.86 vs. 0.75). DSA positivity improved accuracy, but regression equations predicted ABMR with moderate accuracy when DSA was unknown. Some biopsies without detectable DSA had high probability of ABMR by regression, although most had HLA antibody. We concluded that regression equations using lesion scores plus DSA maximized diagnostic accuracy and can estimate probable ABMR when DSA is unknown or undetectable.


Asunto(s)
Rechazo de Injerto/diagnóstico , Supervivencia de Injerto/inmunología , Isoanticuerpos/inmunología , Fallo Renal Crónico/cirugía , Trasplante de Riñón/efectos adversos , Aloinjertos , Estudios de Seguimiento , Tasa de Filtración Glomerular , Rechazo de Injerto/etiología , Humanos , Isoanticuerpos/sangre , Pruebas de Función Renal , Pronóstico , Estudios Prospectivos , Factores de Riesgo
3.
Am J Transplant ; 15(5): 1336-48, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25787894

RESUMEN

The recent recognition that antibody-mediated rejection (ABMR) is the major cause of kidney transplant loss creates strong interest in its pathogenesis. We used microarray analysis of kidney transplant biopsies to identify the changes in pure ABMR. We found that the ABMR transcript changes in the initial Discovery Set were strongly conserved in a subsequent Validation Set. In the Combined Set of 703 biopsies, 2603 transcripts were significantly changed (FDR < 0.05) in ABMR versus all other biopsies. In cultured cells, the transcripts strongly associated with ABMR were expressed in endothelial cells, e.g. cadherins CDH5 and CDH13; IFNG-treated endothelial cells, e.g. phospholipase PLA1A and chemokine CXCL11; or NK cells, e.g. cytotoxicity molecules granulysin (GNLY) and FGFBP2. Other ABMR transcripts were expressed in normal kidney but not cell lines, either increased e.g. Duffy chemokine receptor (DARC) or decreased e.g. sclerostin (SOST). Pathway analysis of ABMR transcripts identified angiogenesis, with roles for angiopoietin and vascular endothelial growth factors; leukocyte-endothelial interactions; and NK signaling, including evidence for CD16a Fc receptor signaling elements shared with T cells. These data support a model of ABMR involving injury-repair in the microcirculation induced by cognate recognition involving antibody and CD16a, triggering IFNG release and antibody-dependent NK cell-mediated cytotoxicity.


Asunto(s)
Rechazo de Injerto , Trasplante de Riñón , Receptores de IgG/metabolismo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Algoritmos , Anticuerpos/química , Biopsia , Linfocitos T CD4-Positivos/citología , Linfocitos T CD8-positivos/citología , Estudios de Cohortes , Bases de Datos Factuales , Femenino , Células Endoteliales de la Vena Umbilical Humana , Humanos , Enfermedades Renales/patología , Enfermedades Renales/cirugía , Células Asesinas Naturales/citología , Macrófagos/metabolismo , Masculino , Microcirculación , Persona de Mediana Edad , Adulto Joven
4.
Am J Transplant ; 14(11): 2565-76, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25219326

RESUMEN

We used expression microarrays to characterize the changes most specific for pure T cell-mediated rejection (TCMR) compared to other diseases including antibody-mediated rejection in 703 human kidney transplant biopsies, using a Discovery Set-Validation Set approach. The expression of thousands of transcripts--fold change and association strength--changed in a pattern that was highly conserved between the Discovery and Validation sets, reflecting a hierarchy of T cell signaling, costimulation, antigen-presenting cell (APC) activation and interferon-gamma (IFNG) expression and effects, with weaker associations for inflammasome activation, innate immunity, cytotoxic molecules and parenchymal injury. In cell lines, the transcripts most specific for TCMR were expressed most strongly in effector T cells (e.g. CTLA4, CD28, IFNG), macrophages (e.g. PDL1, CD86, SLAMF8, ADAMDEC1), B cells (e.g. CD72, BTLA) and IFNG-treated macrophages (e.g. ANKRD22, AIM2). In pathway analysis, the top pathways included T cell receptor signaling and CTLA4 costimulation. These results suggest a model in which TCMR creates an inflammatory compartment with a rigorous hierarchy dominated by the proximal aspects of cognate engagement of effector T cell receptor and costimulator triggering by APCs. The prominence of inhibitors like CTLA4 and PDL1 raises the possibility of active negative controls within the rejecting tissue.


Asunto(s)
Antígeno B7-H1/inmunología , Antígeno CTLA-4/inmunología , Rechazo de Injerto/inmunología , Trasplante de Riñón , Linfocitos T/inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Ligandos , Masculino , Persona de Mediana Edad , ARN Mensajero/genética , Adulto Joven
5.
Am J Transplant ; 13(4): 971-983, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23414212

RESUMEN

Antibody-mediated rejection is the major cause of kidney transplant failure, but the histology-based diagnostic system misses most cases due to its requirement for C4d positivity. We hypothesized that gene expression data could be used to test biopsies for the presence of antibody-mediated rejection. To develop a molecular test, we prospectively assigned diagnoses, including C4d-negative antibody-mediated rejection, to 403 indication biopsies from 315 patients, based on histology (microcirculation lesions) and donor-specific HLA antibody. We then used microarray data to develop classifiers that assigned antibody-mediated rejection scores to each biopsy. The transcripts distinguishing antibody-mediated rejection from other conditions were mostly expressed in endothelial cells or NK cells, or were IFNG-inducible. The scores correlated with the presence of microcirculation lesions and donor-specific antibody. Of 45 biopsies with scores>0.5, 39 had been diagnosed as antibody-mediated rejection on the basis of histology and donor-specific antibody. High scores were also associated with unanimity among pathologists that antibody-mediated rejection was present. The molecular score also strongly predicted future graft loss in Cox regression analysis. We conclude that microarray assessment of gene expression can assign a probability of ABMR to transplant biopsies without knowledge of HLA antibody status, histology, or C4d staining, and predicts future failure.


Asunto(s)
Anticuerpos/inmunología , Rechazo de Injerto/diagnóstico , Rechazo de Injerto/inmunología , Trasplante de Riñón , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Complemento C4b/inmunología , Células Endoteliales/citología , Femenino , Regulación de la Expresión Génica , Supervivencia de Injerto , Humanos , Interferón gamma/metabolismo , Células Asesinas Naturales/citología , Masculino , Persona de Mediana Edad , Análisis de Secuencia por Matrices de Oligonucleótidos , Fragmentos de Péptidos/inmunología , Probabilidad , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Análisis de Regresión , Adulto Joven
6.
Am J Transplant ; 13(2): 415-26, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23282320

RESUMEN

We hypothesized that measurement of previously defined acute kidney injury-induced transcripts at the time of implantation would add a new dimension to existing methods based on donor factors, histology and recipient factors. We analyzed microarray results from implantation biopsies taken after reperfusion from 70 kidneys from 53 deceased donors. We used two definitions of early dysfunction: serum creatinine > 265 umol/L at day 7 posttransplant; and dialysis in the first week. The strongest correlate with early dysfunction was the mean expression of 30 injury transcripts. Older donor and recipient age were associated with early dysfunction, but histologic lesions were not. Prediction was best when the injury transcript expression was combined with donor or recipient age, particularly in standard criteria donors. In contrast, although extended criteria donor kidneys had a high risk of early dysfunction, no variables tested, including injury transcripts, predicted risk significantly, probably because these kidneys were allocated preferentially to old, high risk recipients. The injury transcripts did not predict late function, which was mainly associated with donor age. Thus, measurement of injury-induced transcripts at the time of implantation improves the prediction of early kidney dysfunction, but risk prediction may fail when old kidneys are transplanted into old recipients.


Asunto(s)
Rechazo de Injerto , Trasplante de Riñón/métodos , Insuficiencia Renal/terapia , Medición de Riesgo , Adulto , Factores de Edad , Anciano , Biopsia , Muerte Encefálica , Femenino , Humanos , Riñón/fisiopatología , Masculino , Persona de Mediana Edad , Análisis de Secuencia por Matrices de Oligonucleótidos , ARN Mensajero/metabolismo , Donantes de Tejidos
7.
Am J Transplant ; 12(1): 191-201, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21992503

RESUMEN

In kidney transplantation, many inflamed biopsies with changes insufficient to be called T-cell-mediated rejection (TCMR) are labeled "borderline", leaving management uncertain. This study examined the nature of borderline biopsies as a step toward eventual elimination of this category. We compared 40 borderline, 35 TCMR and 116 nonrejection biopsies. TCMR biopsies had more inflammation than borderline but similar degrees of tubulitis and scarring. Surprisingly, recovery of function after biopsy was similar in all categories, indicating that response to treatment is unreliable for defining TCMR. We studied the molecular changes in TCMR, borderline and nonrejection using microarrays, measuring four published features: T-cell burden; a rejection classifier; a canonical TCMR classifier; and risk score. These reassigned borderline biopsies as TCMR-like 13/40 (33%) or nonrejection-like 27/40 (67%). A major reason that histology diagnosed molecularly defined TCMR as borderline was atrophy-scarring, which interfered with assessment of inflammation and tubulitis. Decision tree analysis showed that i-total >27% and tubulitis extent >3% match the molecular diagnosis of TCMR in 85% of cases. In summary, most cases designated borderline by histopathology are found to be nonrejection by molecular phenotyping. Both molecular measurements and histopathology offer opportunities for more precise assignment of these cases after clinical validation.


Asunto(s)
Biopsia , Rechazo de Injerto , Trasplante de Riñón , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
8.
Am J Transplant ; 10(9): 2105-15, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20883545

RESUMEN

Histopathology of endomyocardial biopsies (EMB) is the standard rejection surveillance for heart transplants. However, ISHLT consensus criteria for interpreting biopsies are arbitrarily defined. Gene expression offers an independent re-evaluation of existing diagnostic systems. We performed histologic and microarray analysis on 105 EMB from 45 heart allograft recipients. Histologic lesions, diagnosis and transcripts were compared to one another, time posttransplantation, indication for biopsy and left ventricular ejection fraction (LVEF). Histologic lesions presented in two groups: myocyte-interstitial and microcirculation lesions. Expression of transcript sets reflecting T cell and macrophage infiltration, and γ-interferon effects correlated strongly with each other and with transcripts indicating tissue/myocardium injury. This molecular phenotype correlated with Quilty (p < 0.005), microcirculation lesions (p < 0.05) and decreased LVEF (p < 0.007), but not with the histologic diagnosis of rejection. In multivariate analysis, LVEF was associated (p < 0.03) with γ-interferon inducible transcripts, time posttransplantation, ischemic injury and clinically indicated biopsies, but not the diagnosis of rejection. The results indicate that (a) the current ISHLT system for diagnosing rejection does not reflect the molecular phenotype in EMB and lacks clinical relevance; (b) the interpretation of Quilty lesions has to be revisited; (c) the assessment of molecules in heart biopsy can guide improvements of current diagnostics.


Asunto(s)
Endocardio/metabolismo , Endocardio/patología , Trasplante de Corazón/patología , Miocardio/metabolismo , Miocardio/patología , Fenotipo , Enfermedad Aguda , Adolescente , Adulto , Anciano , Biopsia , Técnicas de Diagnóstico Cardiovascular/normas , Femenino , Rechazo de Injerto/diagnóstico , Rechazo de Injerto/prevención & control , Corazón/fisiopatología , Humanos , Interferón gamma/farmacología , Masculino , Análisis por Micromatrices , Microcirculación , Persona de Mediana Edad , Análisis Multivariante , Volumen Sistólico , Donantes de Tejidos , Transcripción Genética/efectos de los fármacos , Trasplante Homólogo/patología , Enfermedades Vasculares/metabolismo , Función Ventricular Izquierda , Adulto Joven
9.
Am J Transplant ; 10(10): 2215-22, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20931695

RESUMEN

Microarray studies of kidney transplant biopsies provide an opportunity to define the molecular phenotype. To facilitate this process, we used experimental systems to annotate transcripts as members of pathogenesis-based transcript sets (PBTs) representing biological processes in injured or diseased tissue. Applying this annotation to microarray results revealed that changes in single molecules and PBTs reflected a large-scale coordinate disturbance, stereotyped across various diseases and injuries, without absolute specificity of individual molecules or PBTs for rejection. Nevertheless, expression of molecules and PBTs was quantitatively specific: IFNG effects for rejection; T cell and macrophage transcripts for T cell-mediated rejection; endothelial and NK transcripts for antibody-mediated rejection. Various diseases and injuries induced the same injury-repair response, undetectable by histopathology, involving epithelium, stroma and endothelium, with increased expression of developmental, cell cycle and apoptosis genes and decreased expression of differentiated epithelial features. Transcripts reflecting this injury-repair response were the best correlates of functional disturbance and risk of future graft loss. Late biopsies with atrophy-fibrosis, reflecting their cumulative burden of injury, displayed more transcripts for B cells, plasma cells and mast cells. Thus the molecular phenotype is best described in terms of three elements: specific diseases, including rejection; the injury-repair response and the cumulative burden of injury.


Asunto(s)
Rechazo de Injerto/genética , Trasplante de Riñón/patología , Animales , Atrofia , Biopsia , Perfilación de la Expresión Génica , Rechazo de Injerto/inmunología , Rechazo de Injerto/patología , Humanos , Inflamación/fisiopatología , Interferón gamma/fisiología , Riñón/patología , Riñón/fisiopatología , Macrófagos/fisiología , Ratones , Análisis de Secuencia por Matrices de Oligonucleótidos , Fenotipo , Linfocitos T/fisiología
10.
Am J Transplant ; 10(10): 2223-30, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20931696

RESUMEN

Data-driven approaches to deteriorating kidney transplants, incorporating histologic, molecular and HLA antibody findings, have created a new understanding of transplant pathology and why transplants fail. Transplant dysfunction is best understood in terms of three elements: diseases, the active injury-repair response and the cumulative burden of injury. Progression to failure is mainly attributable to antibody-mediated rejection, nonadherence and glomerular disease. Antibody-mediated rejection usually develops late due to de novo HLA antibodies, particularly anti-class II, and is often C4d negative. Pure treated T cell-mediated rejection does not predispose to graft loss because it responds well, even with endothelialitis, but it may indicate nonadherence. The cumulative burden of injury results in atrophy-fibrosis (nephron loss), arterial fibrous intimal thickening and arteriolar hyalinosis, but these are not progressive without ongoing disease/injury, and do not explain progression. Calcineurin inhibitor toxicity has been overestimated because burden-of-injury lesions invite this default diagnosis when diseases such as antibody-mediated rejection are missed. Disease/injury triggers a stereotyped active injury-repair response, including de-differentiation, cell cycling and apoptosis. The active injury-repair response is the strongest correlate of organ function and future progression to failure, but should always prompt a search for the initiating injury or disease.


Asunto(s)
Rechazo de Injerto/inmunología , Trasplante de Riñón/inmunología , Biopsia , Costo de Enfermedad , Progresión de la Enfermedad , Fibrosis , Humanos , Riñón/inmunología , Riñón/patología , Cooperación del Paciente , Fenotipo , Resultado del Tratamiento
11.
Am J Transplant ; 10(3): 490-7, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20121742

RESUMEN

Macrophages display two activation states that are considered mutually exclusive: classical macrophage activation (CMA), inducible by IFNG, and alternative macrophage activation (AMA), inducible by IL4 and IL13. CMA is prominent in allograft rejection and AMA is associated with tissue remodeling after injury. We studied expression of AMA markers in mouse kidney allografts and in kidneys with acute tubular necrosis (ATN). In rejecting allografts, unlike interferon gamma (IFNG) effects and T-cell infiltration that developed rapidly and plateaued by day 7, AMA transcripts (Arg1, Mrc1, Mmp12 and Ear1) rose progressively as tubulitis and parenchymal deterioration developed at days 21 and 42, despite persistent IFNG effects. AMA in allografts was associated with transcripts for AMA inducers IL4, IL13 and inhibin A, but also occurred when hosts lacked IL4/IL13 receptors, suggesting a role for inhibin A. Kidneys with ATN injured by ischemia/reperfusion also had increased expression of AMA markers and inhibin A. Thus kidneys undergoing T-cell-mediated rejection progressively acquire macrophages with alternative activation phenotype despite strong local IFNG effects, independent of IL4 and IL13. Although the mechanisms and causal relationships remain to be determined, high AMA transcript levels in rejecting allografts are strongly associated with and may be a consequence of parenchymal deterioration similar to ATN.


Asunto(s)
Trasplante de Riñón/métodos , Activación de Macrófagos , Macrófagos/citología , Linfocitos T/citología , Activinas/metabolismo , Animales , Rechazo de Injerto , Inhibinas/metabolismo , Interleucina-13/metabolismo , Interleucina-4/metabolismo , Macrófagos/metabolismo , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos CBA , Modelos Biológicos , Daño por Reperfusión/metabolismo , Linfocitos T/metabolismo
12.
Am J Transplant ; 9(3): 483-93, 2009 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19260832

RESUMEN

We studied the early events in mouse kidney allografts and isografts to define when allorecognition begins and when alloimmune tissue injury begins. Allografts but not isografts showed T-cell infiltration in perivascular areas from day 1, but tubulitis and arteritis did not develop until day 7. Flow cytometry confirmed the early allospecific CD3(+)CD8(+) T-cell infiltrate. At day 1, both allografts and isografts showed extensive transcriptome changes, reflecting the response to surgery, but only allografts showed expression of interferon-gamma (IFN-gamma)-inducible transcripts and T-cell-associated transcripts. Although the number of CD68(+) myeloid cell numbers did not increase in day 1 isografts or allografts, mRNA expression for myeloid markers was increased in isografts and allografts, suggesting activation of resident cells of the macrophage-dendritic cell series (MMDCs) in response to injury, followed by increased CD68(+) cell numbers from day 2. By day 3, an interstitial T-cell and MMDC infiltrate was established in allografts, corresponding with the emergence of allospecific tissue injury, as reflected by decreased parenchymal transcripts. Thus, in renal allografts, allorecognition by T cells occurs in perivascular sites by day 1, but alloimmune parenchymal damage begins at day 3, coinciding with the emergence of the interstitial T-cell-MMDC infiltrate.


Asunto(s)
Rechazo de Injerto/inmunología , Trasplante de Riñón/inmunología , Animales , Diferenciación Celular/efectos de los fármacos , Diferenciación Celular/inmunología , Células Dendríticas/efectos de los fármacos , Células Dendríticas/inmunología , Citometría de Flujo , Inmunohistoquímica , Interferón gamma/farmacología , Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Masculino , Ratones , Análisis de Secuencia por Matrices de Oligonucleótidos , Fenotipo , ARN Mensajero/genética , Factores de Tiempo , Transcripción Genética/genética , Trasplante Homólogo/inmunología
13.
Am J Transplant ; 8(10): 2049-55, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18828768

RESUMEN

It is important to resolve whether T-cell-mediated rejection (TCMR) is mediated by contact-dependent cytotoxicity or by contact-independent inflammatory mechanisms. We recently showed that the cytotoxic molecules perforin and granzymes A and B are not required for TCMR of mouse kidney transplants. Nevertheless, TCMR could still be mediated by cytotoxicity via Fas on donor cells engaging Fas ligand on host T cells. We examined whether the diagnostic TCMR lesions would be abrogated if donor Fas was absent, particularly in hosts deficient in perforin or granzymes A and B. Kidneys from Fas-deficient donors transplanted into major histocompatibility complex (MHC)- mismatched hosts developed tubulitis and diffuse interstitial infiltration indistinguishable from wild-type (WT) allografts, even in hosts deficient in perforin and granzymes A and B. Gene expression analysis revealed similar molecular disturbances in Fas-deficient and WT allografts at day 21 transplanted into WT, perforin and granzyme A/B-deficient hosts, indicating epithelial injury and dedifferentiation. Thus, donor Fas is not necessary for TCMR diagnostic lesions or molecular changes, even in the absence of perforin-granzyme mechanisms. We propose that in TCMR, interstitial effector T cells mediate parenchymal injury by inflammatory mechanisms that require neither the perforin-granzyme nor the Fas-Fas ligand cytotoxic mechanisms.


Asunto(s)
Proteína Ligando Fas/metabolismo , Rechazo de Injerto , Granzimas/metabolismo , Trasplante de Riñón/métodos , Perforina/metabolismo , Linfocitos T/metabolismo , Receptor fas/metabolismo , Animales , Perfilación de la Expresión Génica , Complejo Mayor de Histocompatibilidad , Masculino , Ratones , Ratones Endogámicos C3H , Ratones Endogámicos C57BL
14.
Am J Transplant ; 8(1): 78-85, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18021287

RESUMEN

Improved assessment of donor organ quality at time of transplantation would help in management of potentially usable organs. The transcriptome might correlate with risk of delayed graft function (DGF) better than conventional risk factors. Microarray results of 87 consecutive implantation biopsies taken postreperfusion in 42 deceased (DD) and 45 living (LD) donor kidneys were compared to clinical and histopathology-based scores. Unsupervised analysis separated the 87 kidneys into three groups: LD, DD1 and DD2. Kidneys in DD2 had a greater incidence of DGF (38.1 vs. 9.5%, p < 0.05) than those in DD1. Clinical and histopathological risk scores did not discriminate DD1 from DD2. A total of 1051 transcripts were differentially expressed between DD1 and DD2, but no transcripts separated DGF from immediate graft function (adjusted p < 0.01). Principal components analysis revealed a continuum from LD to DD1 to DD2, i.e. from best to poorest functioning kidneys. Within DD kidneys, the odds ratio for DGF was significantly increased with a transcriptome-based score and recipient age (p < 0.03) but not with clinical or histopathologic scores. The transcriptome reflects kidney quality and susceptibility to DGF better than available clinical and histopathological scoring systems.


Asunto(s)
Funcionamiento Retardado del Injerto/genética , Funcionamiento Retardado del Injerto/patología , Perfilación de la Expresión Génica , Trasplante de Riñón/patología , Riñón/patología , Donantes de Tejidos , Biopsia , Cadáver , Funcionamiento Retardado del Injerto/fisiopatología , Femenino , Humanos , Riñón/metabolismo , Riñón/fisiopatología , Pruebas de Función Renal , Trasplante de Riñón/inmunología , Donadores Vivos , Masculino , Persona de Mediana Edad , Medición de Riesgo
15.
Am J Transplant ; 6(9): 2109-20, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16869802

RESUMEN

One of the defining lesions of kidney allograft rejection is epithelial deterioration and invasion by inflammatory cells (tubulitis). We examined epithelial changes and their relationship to effector T cells and to CD103/E-cadherin interactions in mouse kidney allografts. Rejecting allografts showed interstitial mononuclear infiltration from day 5. Loss of epithelial mass, estimated by tubular surface area, and tubulitis were minimal through day 7 and severe by day 21. Tubules in day 21 allografts manifested severe reduction of E-cadherin and Ksp-cadherin by immunostaining with redistribution to the apical membrane, indicating loss of polarity. By flow cytometry T cells isolated from allografts were 25% CD103+. Laser capture microdissection and RT-PCR showed increased CD103 mRNA in the interstitium and tubules. However, allografts in hosts lacking CD103 developed tubulitis, cadherin loss, and epithelial deterioration similar to wild-type hosts. The loss of cadherins and epithelial mass was also independent of perforin and granzymes A and B. Thus rejection is characterized by severe tubular deterioration associated with CD103+ T cells but not mediated by CD103/cadherin interactions or granzyme-perforin cytotoxic mechanisms. We suggest that alloimmune effector T cells mediate epithelial injury by contact-independent mechanisms related to delayed type hypersensitivity, followed by invasion of the altered epithelium to produce tubulitis.


Asunto(s)
Antígenos CD/metabolismo , Células Epiteliales/patología , Rechazo de Injerto/patología , Cadenas alfa de Integrinas/metabolismo , Trasplante de Riñón , Túbulos Renales/patología , Proteínas de la Membrana/metabolismo , Nefritis/patología , Serina Endopeptidasas/metabolismo , Animales , Antígenos CD/genética , Células Epiteliales/metabolismo , Rechazo de Injerto/metabolismo , Granzimas , Técnicas para Inmunoenzimas , Cadenas alfa de Integrinas/genética , Túbulos Renales/metabolismo , Masculino , Proteínas de la Membrana/genética , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos CBA , Ratones Noqueados , Nefritis/metabolismo , Proteínas Citotóxicas Formadoras de Poros , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Serina Endopeptidasas/genética , Linfocitos T/inmunología , Trasplante Homólogo
16.
Biochem J ; 350 Pt 2: 505-10, 2000 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-10947965

RESUMEN

We have determined that the mutation of the cysteine-230 residue to either glycine or serine in TRAIL (tumour necrosis factor-alpha-related apoptosis-inducing ligand) results in the formation of a structurally incompetent dimer and a consequent loss of apoptotic activity. Similarly, chemical modification of the thiol residues present in both reduced and Zn(2+)-depleted trimer converts TRAIL into an inactive dimer. We postulate that cysteine-230 plays a critical role in homotrimerization of this tumoricidal cytokine.


Asunto(s)
Cisteína/química , Glicoproteínas de Membrana/química , Glicoproteínas de Membrana/fisiología , Factor de Necrosis Tumoral alfa/química , Factor de Necrosis Tumoral alfa/fisiología , Proteínas Reguladoras de la Apoptosis , Cromatografía , Colon/patología , Neoplasias del Colon/patología , ADN Complementario/metabolismo , Dimerización , Relación Dosis-Respuesta a Droga , Glutatión Transferasa/metabolismo , Humanos , Glicoproteínas de Membrana/genética , Mutagénesis Sitio-Dirigida , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo , Ligando Inductor de Apoptosis Relacionado con TNF , Factores de Tiempo , Células Tumorales Cultivadas , Factor de Necrosis Tumoral alfa/genética , Zinc/química
17.
FEBS Lett ; 453(1-2): 183-6, 1999 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-10403399

RESUMEN

Recent indirect evidence suggests that a Ca2+/ calmodulin-dependent pathway, which may involve calmodulin-dependent protein kinase II (CaMKII), mediates the S-phase delay manifested by gamma-ray-exposed human fibroblasts. This pathway is severely impaired in ataxia telangiectasia (A-T) cells [Mirzayans et al. (1995) Oncogene 11, 15971. To extend these findings, we assayed CaMKII activity in irradiated normal and A-T fibroblasts. The radiation treatment induced the autonomous activity of the kinase in normal cells. In contrast, this activity was not elevated in either (i) normal cells pretreated with the selective CaMKII antagonist KN-62 or (ii) gamma-irradiated A-T cells. Moreover, A-T fibroblasts, unlike normal cells, failed to mobilize intracellular Ca2+ upon mitogenic stimulation. These findings identify a novel role for CaMKII in radiation-induced signal transduction and suggest its involvement in effecting the S-phase delay. The data also implicate ATM, the product of the gene responsible for A-T, as a key mediator of both intracellular Ca2+ mobilization and CaMKII activation in response not only to genotoxic stress but also to physiological stimuli.


Asunto(s)
Ataxia Telangiectasia/enzimología , Proteínas Quinasas Dependientes de Calcio-Calmodulina/biosíntesis , Rayos gamma , 1-(5-Isoquinolinesulfonil)-2-Metilpiperazina/análogos & derivados , 1-(5-Isoquinolinesulfonil)-2-Metilpiperazina/farmacología , Señalización del Calcio , Proteína Quinasa Tipo 2 Dependiente de Calcio Calmodulina , Proteínas Quinasas Dependientes de Calcio-Calmodulina/antagonistas & inhibidores , Células Cultivadas , Inducción Enzimática/efectos de la radiación , Fibroblastos/citología , Fibroblastos/enzimología , Humanos , Mitógenos/farmacología
18.
Cell Death Differ ; 6(3): 281-9, 1999 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10200579

RESUMEN

Intracellular acidification caused by agents such as UV(C), etoposide or ceramide accompanies the progression of apoptosis. It is suggested that cellular acidosis may set favorable conditions for a dormant, low pH-dependent (acidic) nuclease, which could be involved in intranucleosomal genome degradation, a hallmark of programmed cell death. Here we show that exposure of HL-60 cells to acidotic/apoptotic agents results in the several-fold activation of a novel low pH-dependent (acidic) nuclease activity, as revealed by zymography. Its activity, which resides in nuclei, is associated with four polypeptides with apparent Mr of 56, 48, 45 and 40 kDa. Treatment of HeLa cells with UV(C) or ceramide causes also the up-regulation of an acidic nuclease activity which is represented by 70 and 62 kDa polypeptides. These observations suggest that acidic nuclease activation can be induced by the same apoptotic agents in different cell types. In HL-60 cells, acidic nuclease up-regulation triggered by acidotic agents follows the induction of AP-1 transcription factor active complexes and accompanies the progression of apoptosis. Inhibition of AP-1 factor activity caused by either anti-caspase/anti-acidotic agent Zn2+ or curcumin, an inhibitor of AP-1 binding to DNA and c-jun synthesis, protects cells from genome destruction. Acidic nuclease activation, however, is only partially inhibited by these factors. We propose that (i) the up-regulation of an acidic nuclease activity is governed by a regulatory pathway different from that responsible for AP-1 factor induction, caspases activation and intracellular acidification, and (ii) activation of an acidic nuclease does not cause any deleterious effects when AP-1 transcription factor induction, caspases activation and intracellular acidification are down-regulated. Thus, the acidic nuclease up-regulation alone is not a sufficient prerequisite for apoptosis.


Asunto(s)
Apoptosis/fisiología , Desoxirribonucleasas/metabolismo , Apoptosis/efectos de los fármacos , Apoptosis/efectos de la radiación , Ceramidas/farmacología , Activación Enzimática/efectos de los fármacos , Activación Enzimática/efectos de la radiación , Etopósido/farmacología , Células HL-60 , Humanos , Concentración de Iones de Hidrógeno , Factor de Transcripción AP-1/biosíntesis , Rayos Ultravioleta , Zinc/farmacología
19.
Oncogene ; 11(8): 1597-605, 1995 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-7478584

RESUMEN

Cultured cells from patients inheriting the rare cancer-prone and radiotherapy-sensitive disorder ataxia-telangiectasia (A-T) exhibit anomalies in cell cycle control and protein kinase C (PKC)-mediated upregulation of p53 protein following exposure to ionizing radiation. It remains unclear, however, as to whether this irregularity in a p53-dependent signal transduction pathway controlling the G1/S checkpoint is causally linked to the most consistent molecular hallmark of A-T-namely, marked attenuation in the inhibition of replicative DNA synthesis at early times (< or = 2 h) after irradiation [radioresistant DNA synthesis (RDS)]. We report here that treatment of normal human fibroblast strains with inhibitors of calmodulin (CaM) (i.e. W7 and W13) and CaM-dependent protein kinases II and IV (i.e. KN62) prior to radiation exposure elicits an 'A-T-like' RDS phenotype, whereas treatment with PKC inhibitors (e.g. staurosporine) does not produce this response. Moreover, at 1 h post-gamma irradiation A-T fibroblasts undergo normal induction of p53 protein while exhibiting the RDS trait. At later times (e.g. 4 h) following irradiation, however, these A-T cells contain abnormally low levels of p53 protein, as do their lymphoblastoid cell line counterparts during the entire post-gamma ray incubation period. On the other hand, human cells which either lack the p53 gene completely (i.e. HL60 leukemia cells) or harbor a germline mutation in the gene (i.e. Li-Fraumeni syndrome cells) shut down their DNA replication machinery normally upon sustaining radiation damage. We thus conclude that the transitory delay in DNA synthesis routinely experienced by human cells in the face of radiation injury is mediated through a CaM-dependent regulatory cascade which involves neither PKC nor p53 protein. Accordingly, A-T cells appear to be malfunctional in at least two distinct radiation-responsive signalling pathways, one regulating the G1/S checkpoint and governed by p53 and PKC and another controlling passage through S phase and requiring CaM.


Asunto(s)
Calmodulina/fisiología , Reparación del ADN/efectos de la radiación , Replicación del ADN/efectos de la radiación , Proteína Quinasa C/fisiología , Proteína p53 Supresora de Tumor/fisiología , Ataxia Telangiectasia/genética , Calmodulina/antagonistas & inhibidores , Células Cultivadas , Relación Dosis-Respuesta en la Radiación , Rayos gamma , Células HL-60 , Humanos , Transducción de Señal
20.
Biochim Biophys Acta ; 1068(2): 167-73, 1991 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-1832962

RESUMEN

Sarcolemma membrane lipid phase of skeletal muscles of hyperthyroid animals was compared to that of control (euthyroid) ones. Hyperthyroidism caused 15% decrease in cholesterol and 70% increase in the phospholipid content of the membrane. This was accompanied by the alterations in proportions between individual phospholipid classes, and was followed by changes in the composition of phospholipid fatty acids. The calculated fatty acid unsaturation index was higher for membrane lipid phase of hyperthyroid animals than of euthyroid ones. Thyroxine-induced alterations in the lipid composition of sarcolemma caused changes in the membrane fluidity and the activity of calmodulin-stimulated (Ca(2+)-Mg(2+)-ATPase. Measurements of the steady-state fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene indicated that the lipid phase transition of membrane vesicles occurred at 25.9 degrees C and at 28.9 degrees C for preparations isolated from hyperthyroid and euthyroid rabbits, respectively. Arrhenius plot break-point temperature for CaM-stimulated (Ca(2+)-Mg(2+)-ATPase activity was lower in membrane preparations isolated from hyperthyroid (26.9 degrees C) than from euthyroid ones (30.0 degrees C). Thus, the increase of the membrane fluidity presumably caused that the enzyme was characterized by the lower activation energy value. This phenomenon may be viewed as a supplementary mechanism for activation of the enzyme by thyroid hormones to previously reported elevation of the amount of (Ca(2+)-Mg(2+)-ATPase protein exerted by hyperthyroidism (Famulski et al. (1988) Eur. J. Biochem., 171, 363-368; Famulski and Wrzosek (1988) in The Ion Pumps-Structure, Function and Regulation (Stein, W.D., ed.), pp. 355-360, Alan R. Liss, New York).


Asunto(s)
Fluidez de la Membrana/fisiología , Lípidos de la Membrana/metabolismo , Sarcolema/metabolismo , Hormonas Tiroideas/fisiología , Animales , ATPasa de Ca(2+) y Mg(2+)/metabolismo , ATPasas Transportadoras de Calcio/metabolismo , Activación Enzimática , Ácidos Grasos/análisis , Polarización de Fluorescencia , Hipertiroidismo/metabolismo , Músculos/metabolismo , Conejos , Temperatura
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