Transplant Immunology Group, Clinical Immunology Department, University Hospital Gregorio Marañon, Madrid, Spain.
Transpl Int. 2013 Aug;26(8):800-12. doi: 10.1111/tri.12131. Epub 2013 Jun 10.
Rejection and infection are relevant causes of mortality in heart recipients. We evaluated the kinetics of the maturation status of B lymphocytes and its relationship with acute cellular rejection and severe infection in heart recipients. We analyzed B-cell subsets using 4-color flow cytometry in a prospective follow-up study of 46 heart recipients. Lymphocyte subsets were evaluated at specific times before and up to 1 year after transplantation. Higher percentages of pretransplant class-switched memory B cells (CD19+CD27+IgM-IgD- >14%) were associated with a 74% decrease in the risk of severe infection [Cox regression relative hazard (RH) 0.26, 95% confidence interval (CI), 0.07-0.86; P = 0.027]. Patients with higher percentages of naïve B cells at day 7 after transplantation (CD19+CD27-IgM+IgD+ >58%) had a 91% decrease in the risk of developing acute cellular rejection (RH 0.09; 95% CI, 0.01-0.80; P = 0.02). Patients with infections showed a strong negative correlation between baseline serum B-cell-activating factor (BAFF) concentration and absolute counts of memory class-switched B cells (R = -0.81, P = 0.01). The evaluation of the immunophenotypic maturation status of B lymphocytes could prove to be a useful marker for identifying patients at risk of developing rejection or infection after heart transplantation.
排斥反应和感染是心脏受者死亡的相关原因。我们评估了 B 淋巴细胞成熟状态的动力学及其与心脏受者急性细胞排斥反应和严重感染的关系。我们在 46 例心脏受者的前瞻性随访研究中使用四色流式细胞术分析 B 细胞亚群。在移植前和移植后 1 年内的特定时间评估淋巴细胞亚群。移植前高比例的类别转换记忆 B 细胞（CD19+CD27+IgM-IgD->14%）与严重感染风险降低 74%相关[Cox 回归相对危险（RH）0.26，95%置信区间（CI）0.07-0.86；P=0.027]。移植后第 7 天高比例幼稚 B 细胞（CD19+CD27-IgM+IgD+>58%）的患者发生急性细胞排斥反应的风险降低 91%（RH 0.09；95%CI，0.01-0.80；P=0.02）。感染患者的血清 B 细胞激活因子（BAFF）浓度与记忆性类别转换 B 细胞的绝对计数之间存在强烈的负相关（R=-0.81，P=0.01）。B 淋巴细胞免疫表型成熟状态的评估可能被证明是识别心脏移植后发生排斥反应或感染风险患者的有用标志物。
