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Clinical and Developmental ImmunologyVolume 2013 2013, Article ID 460316, 6 pages

Research Article

Research Institute of Nephrology, Jinling Hospital, Nanjing University Clinical School of Medicine, 305 East Zhongshan Road, Nanjing 210002, China

Department of Renal Transplantation, The Third Affiliated Hospital, Sun Yat-sen University, 2693 Kaichuang Avenue, Luogang District, Guangzhou 510530, China

Received 29 May 2013; Revised 19 September 2013; Accepted 19 September 2013

Academic Editor: Xian Li

Copyright © 2013 Xue Li et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Previous data showed that the predominance of intraglomerular T-bet or GATA3 is correlated with different mechanisms of rejection, suggesting that the ratio of T-bet-GATA3 might be used to distinguish antibody-mediated rejection ABMR and T-cell-mediated rejection TCMR. Methods. We compared the intraglomerular T-bet-GATA3 ratio in ABMR and TCMR. The intragraft expression of T-bet and GATA3 was studied via immunohistochemistry. The correlation of the diagnosis of AMR with the ratio of T-bet-GATA3 was examined. Results. Both intraglomerular T-bet- and GATA3-expressing cells were increased during acute rejection. T-bet-GATA3>1 was strongly correlated with ABMR 93.3% versus 18.2%. The incidence of positive HLA-I-II antibodies and glomerulitis is significantly higher in T-bet-GATA3>1 group , , resp

The scores of peritubular capillary inflammation and glomerulitis were also higher in T-bet-GATA3>1 group , , resp

Nevertheless, T-bet-GATA3>1 is also correlated with C4d-negative ABMR and resistance to steroid treatment. Compared with C4d deposition, T-bet-GATA3>1 had a slight lower 90% versus 100% specificity but a much higher 87.5% versus 68.8% sensitivity. Conclusion. Our data suggested that intraglomerular predominance of T-bet over GATA3 might be used as diagnosis maker of ABMR in addition to C4d, especially in C4d-negative cases.

Autor: Xue Li, Qiquan Sun, Mingchao Zhang, Jinsong Chen, and Zhihong Liu



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