Immunophenotyping of interstitial infiltrate does not distinguish between BK virus nephropathy and acute cellular rejection
SUMMARY Introduction: BK virus nephropathy (BKVN) is a significant cause of late renal allograft loss. It is characterized histologically by an interstitial nephritis that can be difficult to distinguish from acute cellular rejection (ACR). We investigated whether immunophenotyping of the infiltrat...
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| Veröffentlicht in: | Nephrology (Carlton, Vic.) Vic.), 2009-02, Vol.14 (1), p.118-122 |
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| creator | ROGERS, NATASHA M RUSS, GRAEME R COOPER, JOHN COATES, P TOBY |
| description | SUMMARY
Introduction: BK virus nephropathy (BKVN) is a significant cause of late renal allograft loss. It is characterized histologically by an interstitial nephritis that can be difficult to distinguish from acute cellular rejection (ACR). We investigated whether immunophenotyping of the infiltrate would aid this distinction.
Methods: Ten cases of biopsy‐proven BKVN, following renal transplantation, were identified from a single transplant centre. The infection was confirmed by renal biopsy and staining for SV‐40 T‐antigen. Biopsies from 20 consecutive patients with ACR were identified and used as controls. There was no evidence of BK infection serologically or histologically in these patients. Immunohistochemical staining with anti‐CD20, perforin and granzyme B was performed on remaining tissue samples.
Results: Clustered B cells were demonstrated in both BKVN and ACR. Hence, the CD20‐stained component within the interstitial infiltrate was not useful in distinguishing these biopsies. Perforin‐stained slides demonstrated fewer cytotoxic T cells in the biopsies with BK virus (average 2.4 ± 1.4 cells per 100 lymphocytes per field) compared with those samples with acute rejection (8.6 ± 5.7 cells per 100 lymphocytes, P |
| doi_str_mv | 10.1111/j.1440-1797.2008.01050.x |
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Introduction: BK virus nephropathy (BKVN) is a significant cause of late renal allograft loss. It is characterized histologically by an interstitial nephritis that can be difficult to distinguish from acute cellular rejection (ACR). We investigated whether immunophenotyping of the infiltrate would aid this distinction.
Methods: Ten cases of biopsy‐proven BKVN, following renal transplantation, were identified from a single transplant centre. The infection was confirmed by renal biopsy and staining for SV‐40 T‐antigen. Biopsies from 20 consecutive patients with ACR were identified and used as controls. There was no evidence of BK infection serologically or histologically in these patients. Immunohistochemical staining with anti‐CD20, perforin and granzyme B was performed on remaining tissue samples.
Results: Clustered B cells were demonstrated in both BKVN and ACR. Hence, the CD20‐stained component within the interstitial infiltrate was not useful in distinguishing these biopsies. Perforin‐stained slides demonstrated fewer cytotoxic T cells in the biopsies with BK virus (average 2.4 ± 1.4 cells per 100 lymphocytes per field) compared with those samples with acute rejection (8.6 ± 5.7 cells per 100 lymphocytes, P < 0.0001). No significant difference in granzyme B staining was detected between ACR and BKVN.
Conclusion: Clustered B cells and granzyme B staining did not differentiate between ACR and BKVN. However, ACR cellular infiltrate was rich in perforin positive cells suggesting that perforin staining may be a useful marker to discriminate between these conditions.</description><identifier>ISSN: 1320-5358</identifier><identifier>EISSN: 1440-1797</identifier><identifier>DOI: 10.1111/j.1440-1797.2008.01050.x</identifier><identifier>PMID: 19143944</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Acute Disease ; Adult ; BK Virus ; Female ; Graft Rejection - immunology ; Humans ; Immunohistochemistry ; Immunophenotyping ; Kidney Diseases - immunology ; Kidney Diseases - pathology ; Kidney Transplantation - immunology ; Male ; Middle Aged ; Perforin - analysis ; Polyomavirus Infections - immunology ; renal allograft ; Transplantation, Homologous ; Tumor Virus Infections - immunology</subject><ispartof>Nephrology (Carlton, Vic.), 2009-02, Vol.14 (1), p.118-122</ispartof><rights>2009 The Authors. Journal compilation © 2009 Asian Pacific Society of Nephrology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4360-c33f3172c86da24926a692ed438571ee17bc91479b61b3bcd1e4d035963230373</citedby><cites>FETCH-LOGICAL-c4360-c33f3172c86da24926a692ed438571ee17bc91479b61b3bcd1e4d035963230373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1440-1797.2008.01050.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1440-1797.2008.01050.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19143944$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ROGERS, NATASHA M</creatorcontrib><creatorcontrib>RUSS, GRAEME R</creatorcontrib><creatorcontrib>COOPER, JOHN</creatorcontrib><creatorcontrib>COATES, P TOBY</creatorcontrib><title>Immunophenotyping of interstitial infiltrate does not distinguish between BK virus nephropathy and acute cellular rejection</title><title>Nephrology (Carlton, Vic.)</title><addtitle>Nephrology (Carlton)</addtitle><description>SUMMARY
Introduction: BK virus nephropathy (BKVN) is a significant cause of late renal allograft loss. It is characterized histologically by an interstitial nephritis that can be difficult to distinguish from acute cellular rejection (ACR). We investigated whether immunophenotyping of the infiltrate would aid this distinction.
Methods: Ten cases of biopsy‐proven BKVN, following renal transplantation, were identified from a single transplant centre. The infection was confirmed by renal biopsy and staining for SV‐40 T‐antigen. Biopsies from 20 consecutive patients with ACR were identified and used as controls. There was no evidence of BK infection serologically or histologically in these patients. Immunohistochemical staining with anti‐CD20, perforin and granzyme B was performed on remaining tissue samples.
Results: Clustered B cells were demonstrated in both BKVN and ACR. Hence, the CD20‐stained component within the interstitial infiltrate was not useful in distinguishing these biopsies. Perforin‐stained slides demonstrated fewer cytotoxic T cells in the biopsies with BK virus (average 2.4 ± 1.4 cells per 100 lymphocytes per field) compared with those samples with acute rejection (8.6 ± 5.7 cells per 100 lymphocytes, P < 0.0001). No significant difference in granzyme B staining was detected between ACR and BKVN.
Conclusion: Clustered B cells and granzyme B staining did not differentiate between ACR and BKVN. However, ACR cellular infiltrate was rich in perforin positive cells suggesting that perforin staining may be a useful marker to discriminate between these conditions.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>BK Virus</subject><subject>Female</subject><subject>Graft Rejection - immunology</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Immunophenotyping</subject><subject>Kidney Diseases - immunology</subject><subject>Kidney Diseases - pathology</subject><subject>Kidney Transplantation - immunology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Perforin - analysis</subject><subject>Polyomavirus Infections - immunology</subject><subject>renal allograft</subject><subject>Transplantation, Homologous</subject><subject>Tumor Virus Infections - immunology</subject><issn>1320-5358</issn><issn>1440-1797</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1v1DAQhiMEoh_wF5BP3BLGsR0nBw5QtdtCtXAA9Wg5yaTrJXGC7dBd9c_jsKtyBF9sa5537NGTJIRCRuN6t80o55BSWcksBygzoCAg2z1LTp8Kz-OZ5ZAKJsqT5Mz7LQCVeUFfJie0opxVnJ8mjzfDMNtx2qAdw34y9p6MHTE2oPPBBKP7eOlMH5wOSNoRPYkgaU2s2vvZ-A2pMTwgWvLxM_ll3BwBnDZunHTY7Im2LdHNHLMN9v3ca0ccbrEJZrSvkhed7j2-Pu7nyfery28X1-ntl9XNxYfbtOGsgLRhrGPx501ZtDrnVV7oosqx5awUkiJSWTdxHlnVBa1Z3bQUeQtMVAXLGTDJzpO3h76TG3_O6IMajF--oy2Os1eFpABSsH-COQhecKgiWB7Axo3eO-zU5Myg3V5RUIshtVWLCLWIUIsh9ceQ2sXom-Mbcz1g-zd4VBKB9wfgwfS4_-_Gan35dTnFfHrIR0W4e8pr9yMOyqRQd-uVWq_Fit_BJ3XNfgMDCLAV</recordid><startdate>200902</startdate><enddate>200902</enddate><creator>ROGERS, NATASHA M</creator><creator>RUSS, GRAEME R</creator><creator>COOPER, JOHN</creator><creator>COATES, P TOBY</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>200902</creationdate><title>Immunophenotyping of interstitial infiltrate does not distinguish between BK virus nephropathy and acute cellular rejection</title><author>ROGERS, NATASHA M ; RUSS, GRAEME R ; COOPER, JOHN ; COATES, P TOBY</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4360-c33f3172c86da24926a692ed438571ee17bc91479b61b3bcd1e4d035963230373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>BK Virus</topic><topic>Female</topic><topic>Graft Rejection - immunology</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Immunophenotyping</topic><topic>Kidney Diseases - immunology</topic><topic>Kidney Diseases - pathology</topic><topic>Kidney Transplantation - immunology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Perforin - analysis</topic><topic>Polyomavirus Infections - immunology</topic><topic>renal allograft</topic><topic>Transplantation, Homologous</topic><topic>Tumor Virus Infections - immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ROGERS, NATASHA M</creatorcontrib><creatorcontrib>RUSS, GRAEME R</creatorcontrib><creatorcontrib>COOPER, JOHN</creatorcontrib><creatorcontrib>COATES, P TOBY</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology (Carlton, Vic.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ROGERS, NATASHA M</au><au>RUSS, GRAEME R</au><au>COOPER, JOHN</au><au>COATES, P TOBY</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immunophenotyping of interstitial infiltrate does not distinguish between BK virus nephropathy and acute cellular rejection</atitle><jtitle>Nephrology (Carlton, Vic.)</jtitle><addtitle>Nephrology (Carlton)</addtitle><date>2009-02</date><risdate>2009</risdate><volume>14</volume><issue>1</issue><spage>118</spage><epage>122</epage><pages>118-122</pages><issn>1320-5358</issn><eissn>1440-1797</eissn><abstract>SUMMARY
Introduction: BK virus nephropathy (BKVN) is a significant cause of late renal allograft loss. It is characterized histologically by an interstitial nephritis that can be difficult to distinguish from acute cellular rejection (ACR). We investigated whether immunophenotyping of the infiltrate would aid this distinction.
Methods: Ten cases of biopsy‐proven BKVN, following renal transplantation, were identified from a single transplant centre. The infection was confirmed by renal biopsy and staining for SV‐40 T‐antigen. Biopsies from 20 consecutive patients with ACR were identified and used as controls. There was no evidence of BK infection serologically or histologically in these patients. Immunohistochemical staining with anti‐CD20, perforin and granzyme B was performed on remaining tissue samples.
Results: Clustered B cells were demonstrated in both BKVN and ACR. Hence, the CD20‐stained component within the interstitial infiltrate was not useful in distinguishing these biopsies. Perforin‐stained slides demonstrated fewer cytotoxic T cells in the biopsies with BK virus (average 2.4 ± 1.4 cells per 100 lymphocytes per field) compared with those samples with acute rejection (8.6 ± 5.7 cells per 100 lymphocytes, P < 0.0001). No significant difference in granzyme B staining was detected between ACR and BKVN.
Conclusion: Clustered B cells and granzyme B staining did not differentiate between ACR and BKVN. However, ACR cellular infiltrate was rich in perforin positive cells suggesting that perforin staining may be a useful marker to discriminate between these conditions.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>19143944</pmid><doi>10.1111/j.1440-1797.2008.01050.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Acute Disease Adult BK Virus Female Graft Rejection - immunology Humans Immunohistochemistry Immunophenotyping Kidney Diseases - immunology Kidney Diseases - pathology Kidney Transplantation - immunology Male Middle Aged Perforin - analysis Polyomavirus Infections - immunology renal allograft Transplantation, Homologous Tumor Virus Infections - immunology |
| title | Immunophenotyping of interstitial infiltrate does not distinguish between BK virus nephropathy and acute cellular rejection |
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