Skin and kidney histological changes in graft-versus-host disease (GVHD) after kidney transplantation

Abstract

Kidney transplantation (Ktx) is generally performed during end stage renal disease due to a loss of the kidneys' ability to filter wastes from the circulatory system. Acute graft-versus-host disease (GVHD) after Ktx is a life-threatening complication that progresses to organ failure, systemic complications, and death. The current study evaluated the significance of histologic findings of GVHD as obtained from skin biopsies following Ktx in swine. A swine model of Ktx with tacrolimus-based immunosuppression was used to assess possible correlations between acute-graft-cellular rejection and skin histological findings for prediction of GVHD. Animals were divided into a Ktx treatment group or a control group with no Ktx and skin and kidney biopsies were histologically assessed at postoperative days 0, 15, 30, 45 and 60. Skin samples were analyzed and classified from grade 1 to 4 of skin GVHD and the major histopathological changes of kidney acute cellular rejection were described using Banff's score system. We observed a significant linear correlation between the histological grading values of skin biopsy changes and the histological grading values of kidney biopsies (Kendall's tau_b=0.993) in the Ktx experimental group. No histological changes were observed in controls. Our findings demonstrate the diagnostic value of staging skin GVHD after Ktx and suggest it's future utility for monitoring long term Ktx-induced changes.

Analysis of Cdcs1 colitogenic effects in the hematopoietic compartment reveals distinct microbiome interaction and a new subcongenic interval active in T cells

“…35 However, cGvH reaction is characterized by apoptotic bodies, cytoid bodies, hyperkeratosis, subepidermal clefts and thickened dermis in the skin and the head. 36 Histological determination of abdominal skin and epidermal and mucosal surfaces on the head revealed no signs of cGvH in the present study. Therefore, a GvH reaction did not represent a likely cause of the intestinal inflammation in BM chimeras.…”

“…53,54 Skin and mucosal surfaces in the abdominal wall and head were investigated, especially for vacuolar degeneration on cells in the stratum basale and stratum spinosum, hyperkeratosis and thickened dermis. 36…”

Skin Architecture, Kidney Transplantation, and Their Relationship to Basal and Squamous Cell Carcinomas

“…Furthermore, a certain grade of low-grade chronic rejection is likely present in all KT patients. A report in 2011, based on a swine model of KT, showed a linear relation between kidney graft rejection (indexed by Banff scoring system) and histological changes (vacuolar alteration) in the epidermis (17). Unfortunately, the authors did not examine the histopathological changes in the subepithelial connective tissue.…”

Mesenchymal Stromal Cell (MSC)-Derived Combination of CXCL5 and Anti-CCL24 Is Synergistic and Superior to MSC and Cyclosporine for the Treatment of Graft-versus-Host Disease

“…At the experimental endpoint on day 30, histologic evaluation was performed on 1 representative mouse with a score closest to the group average on skin, small intestine, and kidney using hematoxylin and eosin staining. The key histologic parameters were evaluated according to accepted published criteria for acute GVHD in the different organ systems [28,29]. Basal vacuolar change, spongiosis, and lymphocytic satelittosis were graded for skin; crypt apoptosis, lymphocytic inflammation, and intraepithelial lymphocytosis were graded for small intestine; and interstitial inflammation, tubulitis, and arterial changes were graded for kidney.…”