TY - JOUR
T1 - Next generation sequencing based assessment of the alloreactive T cell receptor repertoire in kidney transplant patients during rejection
T2 - A prospective cohort study
AU - Aschauer, Constantin
AU - Jelencsics, Kira
AU - Hu, Karin
AU - Heinzel, Andreas
AU - Vetter, Julia
AU - Fraunhofer, Thomas
AU - Schaller, Susanne
AU - Winkler, Stephan
AU - Pimenov, Lisabeth
AU - Gualdoni, Guido
AU - Eder, Michael
AU - Kainz, Alexander
AU - Regele, Heinz
AU - Reindl-Schwaighofer, Roman
AU - Oberbauer, Rainer
N1 - Publisher Copyright:
© 2019 The Author(s).
PY - 2019/9/2
Y1 - 2019/9/2
N2 - Background: Kidney transplantation is the optimal treatment in end stage renal disease but the allograft survival is still hampered by immune reactions against the allograft. This process is driven by the recognition of allogenic antigens presented to T-cells and their unique T-cell receptor (TCR) via the major histocompatibility complex (MHC), which triggers a complex immune response potentially leading to graft injury. Although the immune system and kidney transplantation have been studied extensively, the subtlety of alloreactive immune responses has impeded sensitive detection at an early stage. Next generation sequencing of the TCR enables us to monitor alloreactive T-cell populations and might thus allow the detection of early rejection events. Methods/design: This is a prospective cohort study designed to sequentially evaluate the alloreactive T cell repertoire after kidney transplantation. The TCR repertoire of patients who developed biopsy confirmed acute T cell mediated rejection (TCMR) will be compared to patients without rejection. To track the alloreactive subsets we will perform a mixed lymphocyte reaction between kidney donor and recipient before transplantation and define the alloreactive TCR repertoire by next generation sequencing of the complementary determining region 3 (CDR3) of the T cell receptor beta chain. After initial clonotype assembly from sequencing reads, TCR repertoire diversity and clonal expansion of T cells of kidney transplant recipients in periphery and kidney biopsy will be analyzed for changes after transplantation, during, prior or after a rejection. The goal of this study is to describe changes of overall T cell repertoire diversity, clonality in kidney transplant recipients, define and track alloreactive T cells in the posttransplant course and decipher patterns of expanded alloreactive T cells in acute cellular rejection to find an alternative monitoring to invasive and delayed diagnostic procedures. Discussion: Changes of the T cell repertoire and tracking of alloreactive T cell clones after combined bone marrow and kidney transplant has proven to be of potential use to monitor the donor directed alloresponse. The dynamics of the donor specific T cells in regular kidney transplant recipients in rejection still rests elusive and can give further insights in human alloresponse. Trial registration: Clinicaltrials.gov: NCT03422224, registered February 5th 2018.
AB - Background: Kidney transplantation is the optimal treatment in end stage renal disease but the allograft survival is still hampered by immune reactions against the allograft. This process is driven by the recognition of allogenic antigens presented to T-cells and their unique T-cell receptor (TCR) via the major histocompatibility complex (MHC), which triggers a complex immune response potentially leading to graft injury. Although the immune system and kidney transplantation have been studied extensively, the subtlety of alloreactive immune responses has impeded sensitive detection at an early stage. Next generation sequencing of the TCR enables us to monitor alloreactive T-cell populations and might thus allow the detection of early rejection events. Methods/design: This is a prospective cohort study designed to sequentially evaluate the alloreactive T cell repertoire after kidney transplantation. The TCR repertoire of patients who developed biopsy confirmed acute T cell mediated rejection (TCMR) will be compared to patients without rejection. To track the alloreactive subsets we will perform a mixed lymphocyte reaction between kidney donor and recipient before transplantation and define the alloreactive TCR repertoire by next generation sequencing of the complementary determining region 3 (CDR3) of the T cell receptor beta chain. After initial clonotype assembly from sequencing reads, TCR repertoire diversity and clonal expansion of T cells of kidney transplant recipients in periphery and kidney biopsy will be analyzed for changes after transplantation, during, prior or after a rejection. The goal of this study is to describe changes of overall T cell repertoire diversity, clonality in kidney transplant recipients, define and track alloreactive T cells in the posttransplant course and decipher patterns of expanded alloreactive T cells in acute cellular rejection to find an alternative monitoring to invasive and delayed diagnostic procedures. Discussion: Changes of the T cell repertoire and tracking of alloreactive T cell clones after combined bone marrow and kidney transplant has proven to be of potential use to monitor the donor directed alloresponse. The dynamics of the donor specific T cells in regular kidney transplant recipients in rejection still rests elusive and can give further insights in human alloresponse. Trial registration: Clinicaltrials.gov: NCT03422224, registered February 5th 2018.
KW - Alloreactivity
KW - Kidney transplant
KW - Next generation sequencing
KW - Rejection
KW - T cell receptor
KW - High-Throughput Nucleotide Sequencing/methods
KW - Receptors, Antigen, T-Cell/blood
KW - Kidney Transplantation/adverse effects
KW - Prospective Studies
KW - Humans
KW - Graft Rejection/blood
KW - Cohort Studies
UR - http://www.scopus.com/inward/record.url?scp=85071775999&partnerID=8YFLogxK
U2 - 10.1186/s12882-019-1541-5
DO - 10.1186/s12882-019-1541-5
M3 - Article
C2 - 31477052
VL - 20
SP - 346
JO - BMC Nephrology
JF - BMC Nephrology
IS - 1
M1 - 346
ER -