在同种异体反应性微环境中,空间分辨的免疫衰竭可预测肝移植排斥。

Spatially resolved immune exhaustion within the alloreactive microenvironment predicts liver transplant rejection.

机构信息

Division of Abdominal Organ Transplantation and Hepatobiliary Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Division of Biostatistics, Department of Population and Public Health, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

出版信息

Sci Adv. 2024 Apr 12;10(15):eadm8841. doi: 10.1126/sciadv.adm8841.

Abstract

Allograft rejection is common following clinical organ transplantation, but defining specific immune subsets mediating alloimmunity has been elusive. Calcineurin inhibitor dose escalation, corticosteroids, and/or lymphocyte depleting antibodies have remained the primary options for treatment of clinical rejection episodes. Here, we developed a highly multiplexed imaging mass cytometry panel to study the immune response in archival biopsies from 79 liver transplant (LT) recipients with either no rejection (NR), acute T cell-mediated rejection (TCMR), or chronic rejection (CR). This approach generated a spatially resolved proteomic atlas of 461,816 cells (42 phenotypes) derived from 96 pathologist-selected regions of interest. Our analysis revealed that regulatory (HLADR T) and PD1 T cell phenotypes (CD4 and CD8 subsets), combined with variations in M2 macrophage polarization, were a unique signature of active TCMR. These data provide insights into the alloimmune microenvironment in clinical LT, including identification of potential targets for focused immunotherapy during rejection episodes and suggestion of a substantial role for immune exhaustion in TCMR.

摘要

同种异体移植排斥反应在临床器官移植后很常见,但确定介导同种异体免疫的特定免疫亚群一直难以捉摸。钙调神经磷酸酶抑制剂剂量升级、皮质类固醇和/或淋巴细胞耗竭抗体仍然是治疗临床排斥反应发作的主要选择。在这里,我们开发了一种高度多重化的成像质谱细胞术面板,以研究 79 名肝移植 (LT) 受者的存档活检中的免疫反应,这些受者中无排斥反应 (NR)、急性 T 细胞介导的排斥反应 (TCMR) 或慢性排斥反应 (CR)。这种方法生成了源自 96 个由病理学家选择的感兴趣区域的 461,816 个细胞 (42 种表型) 的空间分辨蛋白质组图谱。我们的分析表明,调节性 (HLADR T) 和 PD1 T 细胞表型 (CD4 和 CD8 亚群) ,加上 M2 巨噬细胞极化的变化,是活跃的 TCMR 的独特特征。这些数据提供了对临床 LT 中的同种异体免疫微环境的深入了解,包括在排斥反应发作期间确定针对靶向免疫治疗的潜在目标,并提示免疫耗竭在 TCMR 中起重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/122d/11014454/5224e38ea928/sciadv.adm8841-f1.jpg

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