Profiles of B-cell subsets in immunologically stable renal allograft recipients and end-stage renal disease patients

Background: Post-transplantation pharmacotherapies typically employ combinations of immunosuppressive agents that have been designed for targeted inhibition of T-cells and T-cell subsets. Studies of acute and chronic effects of clinically employed immunosuppressive agents on-cells and-cell subsets are significantly fewer in number and warrant further investigation. Accordingly, the goal of the present cross-sectional study is to functionally evaluate differences of B-cell subsets in patients with end-stage renal disease (ESRD) and immunologically stable renal transplant patients. Patients and methods: Of 103 patients who underwent renal transplantation, 73 patients were immunologically stable without rejection or infection. Among them, 34 patients were one-year post-transplantation, and 39 patients were five-year post-transplantation. The study also included 35 ESRD patients and 36 healthy volunteers. Flow cytometry identified-cell subsets in the study groups. Results: Renal allograft recipients had reduced percentages of total B-cells (CD19 +) and regulatory-cells (B-reg) (CD38(high)CD27 + CD24 +) compared with healthy controls. The percentage of transitional-cells (IgM + CD38(high)CD24(high)) and marginal zone (MZ) B-cells (IgD-CD27 +) was reduced in transplant recipients compared with patients with ESRD and healthy volunteers. The highest percentage of plasma cells (PCs) (CD38(high)CD27 + CD24-) was in patients with ESRD. In five-year post-transplantation group, CD38(low)CD21-B-cells increased when compared with the other groups. Healthy volunteers and patients with ESRD had fewer unswitched memory (UM)-cells (IgM + IgD + CD38(low)CD27 +), and increased isotype switched memory (ISM)-cells (IgM-IgD-CD38(low)CD27 +). There was no difference in the percentage of naive B-cells (IgD + CD27-) among diverse groups. Conclusions: The percentages of the total, transitional, Bres, PCs, MZ, and UM-cell subsets in immunologically stable renal allograft recipients were significantly different from healthy controls. However, B-cell subsets in patients with ESRD were minimally different with immunologically stable renal allograft recipients.