Bailly Elodie, Macedo Camila, Gu Xinyan, Hollingshead Deborah, Bentlejewski Carol, Fong Erica, Morel Penelope A, Randhawa Parmjeet, Zeevi Adriana, Lefaucheur Carmen, Metes Diana
Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; INSERM UMR-S976, Université Paris Cité, Paris, France.
Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Am J Transplant. 2025 Feb;25(2):302-315. doi: 10.1016/j.ajt.2024.09.018. Epub 2024 Sep 26.
Natural killer (NK) cell-mediated antibody-dependent cellular cytotoxicity (ADCC) is a major mechanism of humoral allograft injury. FCGR3A V/F polymorphism influences ADCC activity. Additionally, NK cell FcγRIIc expression, dictated by the Q/STP polymorphism, was never investigated in kidney transplantation. To assess the clinical relevance of FCGR2C Q/STP polymorphism in conjunction with FCGR3A V/F polymorphism, 242 kidney transplant recipients were genotyped. NK cell Fc gamma receptor (FcγR) expression and ADCC activity were assessed. RNA sequencing was performed on kidney allograft biopsies to explore the presence of infiltrating FcγR+ NK cells. The FCGR2C Q allele was enriched in antibody-mediated rejection patients. FcγRIIc Q+ NK cells had higher ADCC activity than FcγRIIc Q- NK cells. In combination with the high-affinity FCGR3A V allele, Q+V+ NK cells were the most functionally potent. Q+ was associated with worse microvascular inflammation and a higher risk of allograft loss. Among V- patients, previously described in the literature as lower-risk patients, Q+V- showed a lower graft survival than Q-V- patients. In antibody-mediated rejection biopsies, FCGR2C transcripts were enriched and associated with ADCC-related transcripts. Our results suggest that FCGR2C Q in addition to FCGR3A V is a significant risk allele that may enhance NK cell-mediated ADCC and contribute to allograft injury and poor survival.
自然杀伤(NK)细胞介导的抗体依赖性细胞毒性(ADCC)是体液同种异体移植损伤的主要机制。FCGR3A V/F多态性影响ADCC活性。此外,由Q/STP多态性决定的NK细胞FcγRIIc表达在肾移植中从未被研究过。为了评估FCGR2C Q/STP多态性与FCGR3A V/F多态性结合的临床相关性,对242例肾移植受者进行了基因分型。评估了NK细胞Fcγ受体(FcγR)表达和ADCC活性。对肾移植活检组织进行RNA测序,以探究浸润性FcγR+NK细胞的存在情况。FCGR2C Q等位基因在抗体介导的排斥反应患者中富集。FcγRIIc Q+NK细胞比FcγRIIc Q-NK细胞具有更高的ADCC活性。与高亲和力的FCGR3A V等位基因结合时,Q+V+NK细胞功能最强。Q+与更严重的微血管炎症和更高的移植失败风险相关。在文献中先前被描述为低风险患者的V-患者中,Q+V-患者的移植物存活率低于Q-V-患者。在抗体介导的排斥反应活检组织中,FCGR2C转录本富集并与ADCC相关转录本相关。我们的结果表明,除了FCGR3A V之外,FCGR2C Q也是一个重要的风险等位基因,可能增强NK细胞介导的ADCC并导致同种异体移植损伤和低存活率。
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