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Zhang H, Li Z, Li W. M2 Macrophages Serve as Critical Executor of Innate Immunity in Chronic Allograft Rejection. Front Immunol 2021; 12:648539. [PMID: 33815407 PMCID: PMC8010191 DOI: 10.3389/fimmu.2021.648539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/10/2021] [Indexed: 12/19/2022] Open
Abstract
Allograft functional failure due to acute or chronic rejection has long been a major concern in the area of solid organ transplantation for decades. As critical component of innate immune system, the macrophages are unlikely to be exclusive for driving acute or chronic sterile inflammation against allografts. Traditionally, macrophages are classified into two types, M1 and M2 like macrophages, based on their functions. M1 macrophages are involved in acute rejection for triggering sterile inflammation thus lead to tissue damage and poor allograft survival, while M2 macrophages represent contradictory features, playing pivotal roles in both anti-inflammation and development of graft fibrosis and resulting in chronic rejection. Macrophages also contribute to allograft vasculopathy, but the phenotypes remain to be identified. Moreover, increasing evidences are challenging traditional identification and classification of macrophage in various diseases. Better understanding the role of macrophage in chronic rejection is fundamental to developing innovative strategies for preventing late graft loss. In this review, we will update the recent progress in our understanding of diversity of macrophage-dominated innate immune response, and reveal the roles of M2 macrophages in chronic allograft rejection as well.
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Affiliation(s)
- Hanwen Zhang
- Department of Hepatobiliary-Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zhuonan Li
- Plastic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Wei Li
- Department of Hepatobiliary-Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
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Coelho S, Monteiro M, Santos J, Correia F, Rodrigues P, Rito M, Freitas P. Impact of sterile leukocyturia on outcome of critically ill patients with severe acute kidney injury. J Crit Care 2021; 64:1-6. [PMID: 33721608 DOI: 10.1016/j.jcrc.2021.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The role of immunological mechanisms on renal regeneration and functional recovery after an episode of Acute Kidney Injury (AKI) is still understudied. We aim to evaluate the impact of sterile leukocyturia on outcomes of critically-ill AKI patients. METHODS A retrospective analysis of critically-ill patients with stage ≥2 AKI by KDIGO was performed. Patients with urinary tract infection, previous renal replacement therapy, chronic kidney disease stage >3 and kidney, urinary tract or prostatic cancer were excluded. Sterile leukocyturia was defined as a positive leukocyte esterase value. RESULTS 108 patients with stage ≥2 AKI were included, 39.8% of which had sterile leukocyturia. AKI patients with sterile leukocyturia were older, had more cardiovascular disease and a lower baseline renal function (p < 0.05). They had a higher serum creatinine and leukocytosis at admission, were more frequently septic (p < 0.05) and had more persistent AKI by both KDIGO criteria at multivariable analysis (OR 6.130, 95% CI 2.007-18.747). CONCLUSION Sterile leukocyturia was associated with different patient baseline and AKI characteristics and more persistent AKI by both KDIGO criteria. Sterile leukocyturia may represent a surrogate marker of renal inflammation during AKI.
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Affiliation(s)
- Sílvia Coelho
- Intensive Care Department, Hospital Fernando Fonseca EPE, Amadora, Portugal; CEDOC- Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, Portugal.
| | - Margarida Monteiro
- Internal Medicine Department, Hospital Fernando Fonseca EPE, Amadora, Portugal
| | - Joana Santos
- Nephrology Department, Hospital Espírito Santo, Évora, Portugal
| | | | | | - Matilde Rito
- NOVA Medical School, NOVA University of Lisbon, Portugal
| | - Paulo Freitas
- Intensive Care Department, Hospital Fernando Fonseca EPE, Amadora, Portugal
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Gerber L, Gaspert A, Braghetti A, Zwahlen H, Wüthrich R, Zbinden R, Mueller N, Fehr T. Ureaplasma and Mycoplasma in kidney allograft recipients-A case series and review of the literature. Transpl Infect Dis 2018; 20:e12937. [PMID: 29856498 DOI: 10.1111/tid.12937] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 04/10/2018] [Accepted: 04/28/2018] [Indexed: 11/28/2022]
Abstract
Ureaplasma urealyticum and Mycoplasma hominis are common inhabitants of the human genital tract. Increasingly, serious and sometimes fatal infections in immunocompromised hosts have been reported, highlighting their pathogenic potential. We reviewed the clinical impact of positive Ureaplasma spp. and Mycoplasma spp. urine cultures in 10 renal allograft recipients who presented with sterile leukocyturia. Five recipients remained asymptomatic. Five patients were symptomatic with dysuria or pain at the graft site. Three patients developed biopsy-proven acute graft pyelonephritis with graft dysfunction. One of these patients additionally showed a renal abscess as demonstrated by magnetic resonance imaging (MRI). All were successfully treated. A literature search revealed a substantial number of case reports with severe and sometimes fatal Ureaplasma spp. or Mycoplasma spp. infections in immunocompromised patients. Colonization rate is high in renal transplant patients. A subset of patients is at risk for invasive disease.
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Affiliation(s)
- Lukas Gerber
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.,Division of Nephrology, Kantonsspital Aarau, Aarau, Switzerland
| | - Ariana Gaspert
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Antonio Braghetti
- Department of Radiology, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Hugo Zwahlen
- Division of Nephrology, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Rudolf Wüthrich
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Nicolas Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Thomas Fehr
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.,Department of Internal Medicine, Cantonal Hospital Graubuenden, Chur, Switzerland
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Knops N, van den Heuvel LP, Masereeuw R, Bongaers I, de Loor H, Levtchenko E, Kuypers D. The Functional Implications of Common Genetic Variation in CYP3A5 and ABCB1 in Human Proximal Tubule Cells. Mol Pharm 2015; 12:758-68. [DOI: 10.1021/mp500590s] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Noël Knops
- Department of Pediatric Nephrology and Solid Organ Transplantation and ‡Department of Nephrology
and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium
- Laboratory for Pediatrics, Department of Development & Regeneration and ⊥Laboratory of Nephrology, KU Leuven, 3000 Leuven, Belgium
- Laboratory for Genetic, Endocrine, and Metabolic Disorders and ∥Department of Pharmacology
and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Lambertus P. van den Heuvel
- Department of Pediatric Nephrology and Solid Organ Transplantation and ‡Department of Nephrology
and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium
- Laboratory for Pediatrics, Department of Development & Regeneration and ⊥Laboratory of Nephrology, KU Leuven, 3000 Leuven, Belgium
- Laboratory for Genetic, Endocrine, and Metabolic Disorders and ∥Department of Pharmacology
and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Rosalinde Masereeuw
- Department of Pediatric Nephrology and Solid Organ Transplantation and ‡Department of Nephrology
and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium
- Laboratory for Pediatrics, Department of Development & Regeneration and ⊥Laboratory of Nephrology, KU Leuven, 3000 Leuven, Belgium
- Laboratory for Genetic, Endocrine, and Metabolic Disorders and ∥Department of Pharmacology
and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Inge Bongaers
- Department of Pediatric Nephrology and Solid Organ Transplantation and ‡Department of Nephrology
and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium
- Laboratory for Pediatrics, Department of Development & Regeneration and ⊥Laboratory of Nephrology, KU Leuven, 3000 Leuven, Belgium
- Laboratory for Genetic, Endocrine, and Metabolic Disorders and ∥Department of Pharmacology
and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Henriëtte de Loor
- Department of Pediatric Nephrology and Solid Organ Transplantation and ‡Department of Nephrology
and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium
- Laboratory for Pediatrics, Department of Development & Regeneration and ⊥Laboratory of Nephrology, KU Leuven, 3000 Leuven, Belgium
- Laboratory for Genetic, Endocrine, and Metabolic Disorders and ∥Department of Pharmacology
and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Elena Levtchenko
- Department of Pediatric Nephrology and Solid Organ Transplantation and ‡Department of Nephrology
and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium
- Laboratory for Pediatrics, Department of Development & Regeneration and ⊥Laboratory of Nephrology, KU Leuven, 3000 Leuven, Belgium
- Laboratory for Genetic, Endocrine, and Metabolic Disorders and ∥Department of Pharmacology
and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Dirk Kuypers
- Department of Pediatric Nephrology and Solid Organ Transplantation and ‡Department of Nephrology
and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium
- Laboratory for Pediatrics, Department of Development & Regeneration and ⊥Laboratory of Nephrology, KU Leuven, 3000 Leuven, Belgium
- Laboratory for Genetic, Endocrine, and Metabolic Disorders and ∥Department of Pharmacology
and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
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