Böhmig GA, Halloran PF, Feucht HE. On a Long and Winding Road: Alloantibodies in Organ Transplantation. Transplantation. 2023 May 1;107(5):1027-1041. [PubMed link]
The authors discuss key findings that critically contributed to our understanding of transplant immunology but sometimes developed with delay and in a roundabout way, as was the case with antibody-mediated rejection- a main focus of this article.
Filippone EJ, Farber JL. The Histological Spectrum and Clinical Significance of T Cell-mediated Rejection of Kidney Allografts. Transplantation. 2023 May 1;107(5):1042-1055. [PubMed link]
Genest DS, Patriquin CJ, Licht C, John R, Reich HN. Renal Thrombotic Microangiopathy: A Review. Am J Kidney Dis. 2023 May;81(5):591-605. [PubMed link]
This article review the clinical presentation and pathologic hallmarks of TMA involving the kidney, and the disease-specific mechanisms that contribute to the endothelial injury that characterizes TMA lesions.
Yoshikawa T, Lee YH, Sato Y, Yanagita M. Tertiary lymphoid tissues in kidney diseases: a perspective for the pediatric nephrologist. Pediatr Nephrol. 2023 May;38(5):1399-1409. [PubMed link]
Tertiary lymphoid tissues (TLTs) are ectopic lymphoid structures that develop in non-lymphoid organs under chronic inflammation caused by pathological conditions, including infections, autoimmune diseases, and cancers. In this review, the authors describe the novel findings on TLTs in the kidney obtained mainly from the analysis of age-dependent TLTs and discuss the clinical relevance of TLTs in kidney diseases.
Buxeda A, Llinàs-Mallol L, Gimeno J, Redondo-Pachón D, Arias-Cabrales C, Burballa C, Puche A, López-Botet M, Yélamos J, Vilches C, Naesens M, Pérez-Sáez MJ, Pascual J, Crespo M. Microvascular inflammation in the absence of human leukocyte antigen-donor-specific antibody and C4d: An orphan category in Banff classification with cytotoxic T and natural killer cell infiltration. Am J Transplant. 2023 Apr;23(4):464-474. [PubMed link]
Isolated microvascular inflammation (iMVI) without HLA donor-specific antibodies or C4d deposition in peritubular capillaries remains an enigmatic phenotype that cannot be categorized as antibody-mediated rejection (ABMR) in recent Banff classifications. iMVI displayed decreased circulating T and NK cells mirrored by T cell and NK cell infiltration in the renal allograft, similar to ABMR. However, the lesser plasma cell infiltration in iMVI may suggest an antibody-independent underlying stimulus.
Mehta S, Lightle A, Judson MA. Renal sarcoidosis. Nephrol Dial Transplant. 2023 Apr;38(4):826–833. [PubMed link]
Renal sarcoidosis is a rare form of sarcoidosis that results in granulomatous inflammation of renal parenchyma. A review.
Zhou W, Wang H, Sun S, Shen Y, Liu X, Zhen J, Zhang H, Duan F, Pan Y, Dong L. Association between glomerular C4d deposition, proteinuria, and disease severity in children with IgA nephropathy. Pediatr Nephrol. 2023 Apr;38(4):1147-1157. [PubMed link]
C4d was found to be associated with proteinuria, segmental lesions, and immunosuppressant treatment. Activation of the lectin pathway may reflect the severity of clinical and pathological manifestations of IgA nephropathy in children.
Rodelo J, Aguirre L, Ortegón K, Ustáriz J, Calderon L, Taborda A, Arias LF, González LA. Predicting kidney outcomes among Latin American patients with lupus nephritis: The prognostic value of interstitial fibrosis and tubular atrophy and tubulointerstitial inflammation. Lupus. 2023 Mar;32(3):411-423. [PubMed link]
In this study from our centre, we found that patients with moderate-to-severe IFTA had worse kidney survival than those with none or mild IFTA. Worse kidney survival was also found among those with class IV LN and fibrous crescents.
Noris M, Daina E, Remuzzi G. Membranoproliferative glomerulonephritis: no longer the same disease and may need very different treatment. Nephrol Dial Transplant. 2023 Feb 13;38(2):283-290. [PubMed link]
Jagannathan G, Weins A, Daniel E, Crew RJ, Swanson SJ, Markowitz GS, D'Agati VD, Andeen NK, Rennke HG, Batal I. The pathologic spectrum of adenovirus nephritis in the kidney allograft. Kidney Int. 2022 Feb;103(2):378-390, [PubMed link]
The most common histologic manifestations included granulomas (82%), tubulocentric inflammation (73%), and tubular degenerative changes consistent with acute tubular necrosis (73%). During a median follow-up of 55 months after biopsy, three patients developed allograft failure from subsequent acute rejection. All seven patients with available follow-up PCR showed resolution of viremia at a median of 30 days after diagnosis.