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Clinical Significance of Macrophage Polarization in Antibody-Mediated Rejection of Renal Allograft

J Kim1, S-E Choi1, B J Lim1

  • 1Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

Transplantation Proceedings
|May 8, 2018
PubMed
Abstract

Insights

Macrophage polarization in kidney transplant rejection (ABMR) was studied. Glomerular M2 macrophages correlate with worse graft function but not survival.

Area of Science:

  • Nephrology
  • Immunology
  • Transplantation

Background:

  • Antibody-mediated rejection (ABMR) is a major cause of kidney transplant failure.
  • The roles of M1 (proinflammatory) and M2 (profibrotic) macrophages in ABMR are not well understood.

Purpose of the Study:

  • To investigate the significance of M1 and M2 macrophage polarization in kidney allografts experiencing ABMR.
  • To correlate macrophage polarization with clinical outcomes and histopathological findings.

Main Methods:

  • Analyzed 55 kidney transplant biopsy samples with ABMR.
  • Used immunohistochemistry to identify M1 (MRP 8/14) and M2 (CD163) macrophages.
  • Assessed M1:M2 ratios in glomeruli and tubulointerstitium, correlating with Banff scores, renal function, and graft survival.

Main Results:

  • Glomerular M2 polarization was linked to higher chronic glomerulopathy scores, elevated serum creatinine, and reduced estimated glomerular filtration rate (eGFR).
  • Tubulointerstitial M2 polarization showed lower scores for glomerulitis, arteritis, and capillaritis.
  • Macrophage polarization did not significantly impact long-term kidney graft survival.

Conclusions:

  • Glomerular M2 macrophage polarization in ABMR is associated with chronic glomerular injury and impaired graft function.
  • Macrophage polarization patterns do not predict long-term kidney transplant survival.

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