Resumen de Phenotypic and Transcriptional Biomarkers In Organ Transplantation
Isabel Puig-Pey Comas
This is a compound work comprising two independent studies.1. Characterization of gamma-delta-T cell subsets in organ transplantationgamma-delta-T cells are innate-type lymphocytes that preferentially act as regulators of local effector immune responses. Recent reports found an altered distribution of the two main subpopulations of blood gamma-delta-T cells (V-delta-1 and V-delta-2) in operationally tolerant liver transplant recipients. Based on this, gamma-delta-T cells subset quantification was proposed as a biomarker of immunologic risk in liver transplantation. The specific characteristics of gamma-delta-T cell subsets in transplantation remain however unknown. We have investigated here the phenotype, repertoire and functional properties of gamma-delta-T cell subsets in a large population of allograft recipients. Our results indicate that alterations in the gamma-delta-T cell compartment are not restricted to tolerant liver recipients. In fact, most immunosuppressed liver and kidney recipients also display an enlarged peripheral blood gamma-delta-T cell pool mainly resulting from an expansion of V-delta-1 T cells exhibiting an oligoclonal repertoire and different phenotypic and cytokine production traits than V-delta-2 T cells. We propose that persistent viral infections are likely to contribute to these alterations. Our data provide novel insight in the biology of gamma-delta-T cells and a rationale for exploring these lymphocytes in more depth into the pathogenesis of viral infections in transplantation.2. Comparative Transcriptional and Phenotypic Peripheral Blood Analysis of Kidney Recipients under Cyclosporin A or Sirolimus Monotherapy Due to its low level of nephrotoxicity and capacity to harness tolerogenic pathways, sirolimus (SRL) has been proposed as an alternative to calcineurin inhibitors in organ transplantation. However, the exact mechanisms underlying its unique immunosuppressive profile in humans are still not well understood. In the current study, we aimed to depict the in vivo effects of SRL in comparison with cyclosporine A (CSA) by employing gene expression profiling and multiparameter flow cytometry on blood cells collected from stable kidney recipients under monotherapy with either SRL or CSA. In addition, the overall effect of these drugs on immunoregulatory pathways was assessed by measuring a transcriptional signature characteristic of operationally tolerant kidney recipients. Samples from SRL recipients displayed an increased frequency of effector memory T cells and were enriched in NFkB-related pro-inflammatory expression pathways and in monocyte and NK cell lineage-specific transcripts. Furthermore neither SRL nor CSA induced a gene expression profile comparable with that of tolerant kidney recipients. In conclusion, we show here that the overall pattern of SRL effect in vivo is dominated by innate immune cells and NFkB-related pro-inflammatory events. These data provide novel insights on the complex effects of SLR on the immune system in clinical transplantation.
