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Published on: August 12, 2017
Expression of the decay-accelerating factor (CD55) in renal transplants--a possible prediction marker of allograft
Sergey V Brodsky1, Gyongyi M Nadasdy, Ronald Pelletier
1Department of Pathology, The Ohio State University, Columbus, OH 43210, USA.
Insights
Decay-accelerating factor (CD55) protects kidney allografts without C4d deposition. Higher CD55 expression correlates with better allograft survival and improved kidney function, suggesting its potential as a prognostic marker.
Area of Science:
- Nephrology
- Immunology
- Transplantation
Background:
- Decay-accelerating factor (CD55) regulates complement activation, a key factor in antibody-mediated rejection (AMR) of kidney allografts.
- C4d deposition in peritubular capillaries (PTC) is a marker for AMR, but the role of CD55 in this context requires further investigation.
- Understanding CD55's role is crucial for improving outcomes in renal transplantation.
Purpose of the Study:
- To investigate the expression of CD55 in renal allografts.
- To correlate CD55 expression with C4d deposition, serum creatinine (SC) levels, and allograft survival.
- To assess the potential of CD55 as a biomarker in renal allograft dysfunction.
Main Methods:
- Analysis of over 200 renal allograft biopsies from patients with allograft dysfunction.
- Assessment of peritubular capillary (PTC) C4d and CD55 expression using immunohistochemistry.
- Correlation of CD55 staining patterns with changes in serum creatinine and allograft survival rates.
Main Results:
- A significant correlation was observed between serum creatinine changes and PTC CD55 staining in patients without C4d deposition.
- In C4d-negative allografts, increasing CD55 staining (negative, focal, diffuse) showed a trend towards lower serum creatinine increases.
- Renal allograft survival was significantly better in the diffuse PTC CD55 staining subgroup compared to the negative staining subgroup.
Conclusions:
- CD55 expression demonstrates a protective effect in C4d-negative renal allografts.
- The pattern of PTC CD55 expression may serve as a predictive marker for renal allograft survival in the absence of AMR.
- Further research into CD55's role could lead to novel therapeutic strategies for preventing allograft rejection.
Background:
Decay-accelerating factor (CD55) accelerates the decay of C3 and C5 convertases, participating in classical and alternative complement activation pathways. Complement activation plays a major role in antibody-mediated rejection of allografts (AMR); C4d is used as a marker of AMR. Emerging evidence suggests an important role of CD55 in the pathogenesis of AMR. The aim of this study was to investigate the expression of CD55 in renal allografts and to correlate it with the expression of C4d, allograft survival, changes in serum creatinine (SC).
Methods:
More than 200 renal allograft biopsies, performed for allograft dysfunction, were assessed for peritubular capillary (PTC) C4d and CD55 expression.
Results:
We found significant correlation between changes in SC and PTC CD55 staining pattern in patients with no PTC C4d staining. In these patients, SC increased from baseline by 2.2+0.34, 1.7+0.36, and 0.93+0.24 mg/dL in negative, focal, and diffuse PTC CD55 staining subgroups, respectively. Survival of renal allografts was better in diffuse PTC CD55 staining subgroup than in negative PTC CD55 staining subgroup.
Conclusions:
These data suggest that CD55 expression has a protective effect on PTC C4d negative renal allografts, and the pattern of PTC CD55 expression may be used as a potential marker of renal allograft survival in patients with no evidence of AMR.
