A 2018 Reference Guide to the Banff Classification of Renal Allograft Pathology

Roufosse, Candice; Simmonds, Naomi; Groningen, Marian C. Clahsen-van; Haas, Mark; Henriksen, Kammi J.; Horsfield, Catherine; Loupy, Alexandre; Mengel, Michael; Perkowska‐Ptasińska, Agnieszka; Rabant, Marion; Racusen, Lorraine C.; Solez, Kim; Becker, Jan U.

doi:10.1097/tp.0000000000002366

Cited by 579 publications

(556 citation statements)

References 27 publications

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“…Taking together, ci and ct allowed to semi-quantitatively grade IF/TA according to Banff classification: grade I, mild (ci1 or ct1); grade II, moderate (ci2 or ct2); and grade III, severe (ci3 or ct3). 2 To improve accuracy of interstitial fibrosis evaluation, renal biopsy sections (3 µm) were stained with Sirius red. Sirius red specifically stains collagen fibres.…”

Section: Histopathological Analysis Of Renal Fibrosismentioning

confidence: 99%

The cannabinoid receptor 1 is involved in renal fibrosis during chronic allograft dysfunction: Proof of concept

Dao

Lecru

Vandermeersch

et al. 2019

J Cellular Molecular Medi

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Chronic allograft dysfunction (CAD), defined as the replacement of functional renal tissue by extracellular matrix proteins, remains the first cause of graft loss. The aim of our study was to explore the potential role of the cannabinoid receptor 1 (CB1) during CAD. We retrospectively quantified CB1 expression and correlated it with renal fibrosis in 26 kidney‐transplanted patients who underwent serial routine kidney biopsies. Whereas CB1 expression was low in normal kidney grafts, it was highly expressed during CAD, especially in tubular cells. CB1 expression significantly increased early on after transplantation, from day 0 (D0) to month 3 post‐transplant (M3) (22.5% ± 15.4% vs 33.4% ± 13.8%, P < .01), and it remained stable thereafter. CB1 expression correlated with renal fibrosis at M3 (P = .04). In an in vitro model of tacrolimus‐mediated fibrogenesis by tubular cells, we found that tacrolimus treatment significantly induced mRNA and protein expression of CB1 concomitantly to col3a1 and col4a3 up regulation. Administration of rimonabant, a CB1 antagonist, blunted collagen synthesis by tubular cells (P < .05). Overall, our study strongly suggests an involvement of the cannabinoid system in the progression of fibrosis during CAD and indicates the therapeutic potential of CB1 antagonists in this pathology.

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Section: Histopathological Analysis Of Renal Fibrosismentioning

confidence: 99%

The cannabinoid receptor 1 is involved in renal fibrosis during chronic allograft dysfunction: Proof of concept

Dao

Lecru

Vandermeersch

et al. 2019

J Cellular Molecular Medi

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“…Histologic findings remain the key element for the diagnosis of T cell–mediated rejection (TCMR) and antibody‐mediated rejection (ABMR) in kidney transplantation. According to the Banff classification, peritubular capillaritis (ptc), glomerulitis (g), interstitial inflammation (i), and tubulitis (t) constitute the main pathologic features of kidney allograft rejection and are characterized by the presence of “mononuclear cells” within peritubular capillaries, glomeruli, interstitium, and tubules respectively. Thus far, it is not recommended to specify the exact phenotype of these immune cells.…”

Section: Introductionmentioning

confidence: 99%

In situ multiplex immunofluorescence analysis of the inflammatory burden in kidney allograft rejection: A new tool to characterize the alloimmune response

Calvani

Terada

Lesaffre

et al. 2020

American Journal of Transplantation

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The exact composition of leukocyte infiltration during kidney allograft rejection is difficult to comprehend and visualize on the same biopsy slide. Using an innovative technology of multiplex immunofluorescence (mIF), we were able to detect simultaneously NK cells, macrophages, and T cells and to determine their intra‐ or extravascular localization using an endothelial marker. Twenty antibody‐mediated rejection (ABMR), 20 T cell–mediated rejection (TCMR), and five normal biopsies were labeled, with automatic leukocyte quantification and localization. This method was compared to a classic NKp46 immunohistochemistry (IHC) with manual quantification and to mRNA quantification. mIF automatic quantification was strongly correlated to IHC (r = .91, P < .001) and to mRNA expression levels (r > .46, P < .021). T cells and macrophages were the 2 predominant populations involved in rejection (48.0 ± 4.4% and 49.3 ± 4.4%, respectively, in ABMR; 51.8 ± 6.0% and 45.3 ± 5.8% in TCMR). NK cells constituted a rare population in both ABMR (2.7 ± 0.7%) and TCMR (2.9 ± 0.6%). The intravascular compartment was mainly composed of T cells, including during ABMR, in peritubular and glomerular capillaries. However, NK cell and macrophage densities were significantly higher during ABMR in glomerular and peritubular capillaries. To conclude, this study demonstrates the feasibility and utility of mIF imaging to study and better understand the kidney allograft rejection process.

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“…This is an important study question as subclinical inflammation because of its chronic low‐grade nature is not promptly diagnosed and can facilitate delayed allograft dysfunction. The authors recruited three patients who demonstrated such inflammation (Banff i‐ and t‐ < 2) on their 6 months post‐transplant biopsy. Patients were already on MMF, tacrolimus and prednisolone when they had their Treg cells acquired.…”

Section: Clinical Trials: Today and Tomorrowmentioning

confidence: 99%

Regulatory T cells in solid organ transplantation

et al. 2020

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The induction of graft tolerance remains the holy grail of transplantation. This is important as chronic allograft dysfunction and the side effects of immunosuppression regimens place a major burden on the lives of transplant patients and their healthcare systems. This has mandated the need to understand the immunobiology of graft rejection and identify novel therapeutics. Regulatory T (Treg) cells play an important role in modulating pro‐inflammatory microenvironments and maintaining tissue homeostasis. However, there are fundamental unanswered questions regarding Treg cell immunobiology. These cells are a heterogeneous entity with functionally diverse roles. Moreover, the adoption of novel deeper immunophenotyping and genomic sequencing technologies has identified this phenotype and function to be more complex than expected. Hence, a comprehensive understanding of Treg cell heterogeneity is needed to safely and effectively exploit their therapeutic potential. From a clinical perspective, the recent decade has seen different clinical teams commence and complete first‐in‐man clinical trials utilising Treg cells as an adoptive cellular therapy. In this review, we discuss these trials from a translational perspective with an important focus on safety. Finally, we identify crucial knowledge gaps for future study.

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A 2018 Reference Guide to the Banff Classification of Renal Allograft Pathology

Cited by 579 publications

References 27 publications

The cannabinoid receptor 1 is involved in renal fibrosis during chronic allograft dysfunction: Proof of concept

The cannabinoid receptor 1 is involved in renal fibrosis during chronic allograft dysfunction: Proof of concept

In situ multiplex immunofluorescence analysis of the inflammatory burden in kidney allograft rejection: A new tool to characterize the alloimmune response

Regulatory T cells in solid organ transplantation

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