PMID- 19424042
OWN - NLM
STAT- MEDLINE
DCOM- 20090708
LR  - 20090508
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 87
IP  - 9
DP  - 2009 May 15
TI  - Reconstitution of peripheral allospecific CD19+ B-cell subsets after B-lymphocyte 
      depletion therapy in renal transplant patients.
PG  - 1394-401
LID - 10.1097/TP.0b013e3181a27683 [doi]
AB  - BACKGROUND: Desensitization protocols, which frequently use lymphocyte depleting 
      agents have increased access to successful transplantation for sensitized 
      candidates. Here, we report on the reconstitution of human leukocyte antigen 
      (HLA)-specific B lymphocytes in renal transplant patients after treatment with 
      B-lymphocyte depletion. METHODS: Sixteen renal transplant candidates were 
      included in the study. Eleven patients were treated with anti-CD20 monoclonal 
      antibody (Ab), four of whom also underwent splenectomy perioperatively. Five 
      patients who did not undergo B-cell depletion were studied as controls. Blood 
      samples were obtained before any treatment and transplant, and at later time 
      points up to 44 months posttransplant. HLA-specific B-cell subpopulations were 
      identified by staining with fluorochrome-labeled HLA tetramers and anti-CD19, 
      CD27, and CD38 monoclonal Abs. RESULTS: Total circulating B lymphocytes 
      repopulated within 12 months post-B-cell depletion. The majority of the 
      recovering cells had the phenotype of transitional CD38 B cells and the 
      percentages of mature, memory CD27 B cells remained significantly depressed. 
      There was a sustained reduction in the proportion of HLA-specific CD27 memory B 
      cells, whereas the HLA-specific CD38 B-cell population returned to near 
      pretreatment levels by 12 months. The presence of mismatched HLA antigens seemed 
      to affect the reconstitution kinetics. The delay in reconstitution of 
      HLA-specific CD27 memory B cells was greater for donor-specific compared with 
      third party. CONCLUSIONS: A delay in functional maturity of repopulating 
      HLA-specific B cells, and in particular those specific for donor HLA, after 
      B-lymphocyte depletion treatment in renal transplant recipients may contribute to 
      the efficacy of desensitization protocols.
FAU - Kopchaliiska, Dessislava
AU  - Kopchaliiska D
AD  - Department of Medicine, Immunogenetics Laboratory, Johns Hopkins University 
      School of Medicine, Baltimore, MD 21205, USA. dkopchal@jhmi.edu
FAU - Zachary, Andrea A
AU  - Zachary AA
FAU - Montgomery, Robert A
AU  - Montgomery RA
FAU - Leffell, Mary S
AU  - Leffell MS
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antigens, CD)
RN  - 0 (Antigens, CD19)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antigens, CD
MH  - Antigens, CD19/*immunology
MH  - B-Lymphocyte Subsets/*immunology/transplantation
MH  - Female
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Kidney Transplantation/*immunology
MH  - Lymphocyte Depletion/*adverse effects
MH  - *Lymphocyte Transfusion
MH  - Male
MH  - Splenectomy
MH  - Transplantation, Homologous/immunology
EDAT- 2009/05/09 09:00
MHDA- 2009/07/09 09:00
CRDT- 2009/05/09 09:00
PHST- 2009/05/09 09:00 [entrez]
PHST- 2009/05/09 09:00 [pubmed]
PHST- 2009/07/09 09:00 [medline]
AID - 00007890-200905150-00021 [pii]
AID - 10.1097/TP.0b013e3181a27683 [doi]
PST - ppublish
SO  - Transplantation. 2009 May 15;87(9):1394-401. doi: 10.1097/TP.0b013e3181a27683.