Author(s)

Paula Xavier Dias-Pinto¹, José Gerardo G. Oliveira^2,3*

¹Instituto Português do Sangue e da Transplantação, Área Transplantação, Porto, Portugal.
²GCCT, Centro Hospitalar Universitário São João, Porto, Portugal.
³CINTESIS (Centro de Investigação em Tecnologias e Serviços de Saúde) FMUP (Faculdade de Medicina da Universidade do Porto), Porto, Portugal.

Background: Ischemia-reperfusion injury of organ transplantation activates several mediators which may link the innate to the adaptive immune response. Down the cascade of TLRs, we selected to study the expression of Interferon Regulatory Factors (IRF)-3 and -7 inside human Kidney Transplanted (KTx) organs and the synthesis of IFNα, the main growth factor induced by them, in KTx aspiration biopsy cultures. Simultaneously, we tested their robustness in diagnosing Acute Rejection (AR). Methods: Fine-needle aspiration biopsies (F-nab) were performed either on day 7 or 14 post-KTx among stable patients or on the day of AR diagnosis. On Fnab cytopreparations, we studied IRF3 and IRF7 by the enzymatic avidin-biotin complex staining, and in a different group of cases we quantified IFNα by ELISA in 48 hours Fnab culture supernatants. Results: AR group showed a significantly up-regulated expression for IRF3 and IRF7, reaching Positive Predictive Values (PPV) of 0.824 and 0.8, respectively, as well as Negative Predictive Values (NPV) above 0.9 for both; IFNα presented a PPV = 1.0 and a NPV = 0.9. A variation in the results was noticed according to different immunosuppressive therapies. Conclusions: Our findings suggest that IRF3 and IRF7, and IFNα which they promote, may be very important players in the early days post-KTx, linking the innate with an adaptive response and triggering acute rejection. These differences were very clear-cut, lending consistency to our speculation. It would be important to scrutinize for other potential effects derived from these IRFs up-regulation which could be of clinical relevance.

Kidney Transplants, Aspiration Biopsies, Innate Immunity, IRF, IFN-α

Dias-Pinto, P. and Oliveira, J. (2021) Innate Immune Response in Human Kidney Transplantation: IRF3 and IRF7 Together with Interferon-Alpha Are Significantly Up-Regulated in Acute Rejection. Open Journal of Nephrology, 11, 379-396. doi: 10.4236/ojneph.2021.113031.