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Lymphocyte propagation from biopsies of kidney allografts: Correlation to morphological diagnosis and clinical outcome
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
Manuscript (Other academic)
URN: urn:nbn:se:uu:diva-90461OAI: oai:DiVA.org:uu-90461DiVA: diva2:162822
Available from: 2003-05-16 Created: 2003-05-16 Last updated: 2010-01-13Bibliographically approved
In thesis
1. Cellular Immune Responses to Allografts and Cytomegalovirus
Open this publication in new window or tab >>Cellular Immune Responses to Allografts and Cytomegalovirus
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Today the immunosuppressive treatment is kept to a level were the incidence of acute rejection is below 20% within the first year after transplantation. As a consequence, a group of transplanted patients is over-immunosuppressed and at risk for infections. There is therefore an urgent need for tools which are able to determine the cellular immune response after organ transplantation. This knowledge would facilitate the task of prospectively opimize the immunosuppressive treatment and identify patients at risk of developing rejection episodes or infections.

To address this issue, a rat-kidney transplantation model for acute rejection was developed to study immune responses to allografts. Infiltrating lymphocytes were analysed using an in vitro culture system which allowed cells to propagate from the biopsies to culture medium. The numbers of outgrowing cells were correlated with morphological and immunohistochemical signs of rejection. When immunosuppressive treatment was administered for 2 and four days after acute rejection, histology did not reveal any improvement, however cellular propagation was reduced by 50 and 75%, respectively. Using the tissue culture technique in human transplanted kidney grafts, which was originally developed for the animal model, the number of propagated cells measured was profoundly higher in grafts with acute cellular rejection than from grafts in other groups. In some cases the number of propagated cells was better correlated with the clinical outcome than the diagnosis made by morphological evaluation. To determine immune responses to cytomegalovirus (CMV), we utilised Human Leukocyte Antigen (HLA) tetramer staining and stimulation of T cells with viral antigens. Both of these techniques independently detected CMV specific T cells in immunosuppressed and healthy individuals with latent or active infection. Although the frequency of CMV specific T cells did not differ between groups, there was a functional impairment in immunosuppressed patients as evidenced by reduced interferon-gamma production. In conclusion, these techniques can be used to determine the cellular immune response to allografts and cytomegalovirus and prove valuable for the optimization of immunosuppressive protocols and antiviral treatment.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 100 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1269
Immunology, Transplantation, Rejection, Monitoring, Flow Cytometry, MHC, Tetramer, CMV, infection, Immunologi
National Category
Immunology in the medical area
urn:nbn:se:uu:diva-3441 (URN)91-554-5652-9 (ISBN)
Public defence
2003-06-06, Fåhraeussalen, C5, Rudbecklaboratoriet, Uppsala, 13:15
Available from: 2003-05-16 Created: 2003-05-16Bibliographically approved

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