Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation

Inhibitory killer cell immunoglobulin-like receptors (iKIRs) are randomly expressed by natural killer (NK) cell subsets and recognize motifs shared by HLA class-I (HLA-I) allotypes. Such interactions prevent NK cell autoreactivity while enhancing their response against cells lacking those HLA-I mole...

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Autores: Alari-Pahissa, Elisenda, Federico-Vega, Judith, Ataya Fernández, Michelle, 1993-, Buxeda, Anna, Bello-Rico, Víctor, Gimeno, Javier, Yélamos López, José, Altadill, Mireia, Sanz-Ureña, Sara, Riera, Marta, Burballa Tàrrega, Carla, 1988-, Chamoun, Betty Odette, Pérez-Sáez, María José, Redondo Pachón, María Dolores, Vilches, Carlos, Crespo Barrio, Marta, López-Botet, M. (Miguel)
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/70976
Acceso en línea:http://hdl.handle.net/10230/70976
http://dx.doi.org/10.1016/j.ajt.2025.04.024
Access Level:acceso abierto
Palabra clave:KIR-HLA-I mismatch
Antibody-mediated rejection
Killer cell immunoglobulin-like receptors
Microvascular inflammation
Natural killer cells
Renal transplant
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spelling Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammationAlari-Pahissa, ElisendaFederico-Vega, JudithAtaya Fernández, Michelle, 1993-Buxeda, AnnaBello-Rico, VíctorGimeno, JavierYélamos López, JoséAltadill, MireiaSanz-Ureña, SaraRiera, MartaBurballa Tàrrega, Carla, 1988-Chamoun, Betty OdettePérez-Sáez, María JoséRedondo Pachón, María DoloresVilches, CarlosCrespo Barrio, MartaLópez-Botet, M. (Miguel)KIR-HLA-I mismatchAntibody-mediated rejectionKiller cell immunoglobulin-like receptorsMicrovascular inflammationNatural killer cellsRenal transplantInhibitory killer cell immunoglobulin-like receptors (iKIRs) are randomly expressed by natural killer (NK) cell subsets and recognize motifs shared by HLA class-I (HLA-I) allotypes. Such interactions prevent NK cell autoreactivity while enhancing their response against cells lacking those HLA-I molecules (missing self), a situation defined in transplantation as iKIR-HLA-I mismatch (iKIR-MM), whose genotypic prediction has been associated with microvascular inflammation (MVI). Herein, we compared iKIR-MM in kidney transplant recipients with MVI ≥2 (n = 19) and controls with MVI ≤1 (n = 36). In parallel to genetic analysis of iKIR-MM, which was more frequent in MVI ≥2 patients, putative alloreactive iKIR-MM NK cells were defined by flow cytometry as NKG2A(-) cells bearing self-specific but lacking donor-specific iKIR. Although iKIR-MM NK cells were detected in both groups, their pretransplant numbers were higher in MVI ≥2 patients (median = 11.02, interquartile range = 0-58.31 vs median = 0, interquartile range = 0-9.46), especially in the presence of donor-specific antibodies or C4d, and correlated with MVI grade. Pretransplant, a subset of MVI ≥2 patients showed high proportions and numbers of oligoclonal iKIR-MM NK cells, which displayed an NKG2C(+) adaptive phenotype associated with cytomegalovirus infection. This pilot study provides a novel perspective on the contribution of iKIR-MM NK cells to MVI, with potential practical implications.J.F.V. had support from a grant awarded by the Catalan Transplantation Foundation. This study was supported by grants: “PI20/00090” and “PI23/00061”, funded by Instituto de Salud Carlos III (ISCIII) FIS and co-funded by the European Union (EU-FEDER); “PID2019-110609RB-C21” and “PID2019-110609RB-C22” (funded by Agencia Estatal de Investigación and cofunded by EU-FEDER; “P105/U/2018” (Fundació la Marató de TV3); “RD21/0005/0022” (National Network for Kidney Research RICORS2024, co-funded by Spanish Ministry of Health-ISCIIII and European Union-NextGenerationEU), Instituto de Salud Carlos III (ISCIII) RICORS program to RICORS 2040-Renal (RD24/0004/0003) funded by European Union – NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia (MRR), and a 2023 Nephrology Research grant (Spanish Society of Nephrology S.E.N).Elsevier202520252025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/70976http://dx.doi.org/10.1016/j.ajt.2025.04.024reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésAm J Transplant. 2025 Aug;25(8):1657-69info:eu-repo/grantAgreement/ES/2PE/PID2019-110609RB-C21info:eu-repo/grantAgreement/ES/2PE/PID2019-110609RB-C22© 2025 The Authors. Published by Elsevier Inc. on behalf of American Society of Transplantation & American Society of Transplant Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/709762026-06-12T07:21:37Z
dc.title.none.fl_str_mv Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation
title Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation
spellingShingle Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation
Alari-Pahissa, Elisenda
KIR-HLA-I mismatch
Antibody-mediated rejection
Killer cell immunoglobulin-like receptors
Microvascular inflammation
Natural killer cells
Renal transplant
title_short Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation
title_full Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation
title_fullStr Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation
title_full_unstemmed Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation
title_sort Alloreactive adaptive natural killer cells in renal transplantation: potential contribution to allograft microvascular inflammation
dc.creator.none.fl_str_mv Alari-Pahissa, Elisenda
Federico-Vega, Judith
Ataya Fernández, Michelle, 1993-
Buxeda, Anna
Bello-Rico, Víctor
Gimeno, Javier
Yélamos López, José
Altadill, Mireia
Sanz-Ureña, Sara
Riera, Marta
Burballa Tàrrega, Carla, 1988-
Chamoun, Betty Odette
Pérez-Sáez, María José
Redondo Pachón, María Dolores
Vilches, Carlos
Crespo Barrio, Marta
López-Botet, M. (Miguel)
author Alari-Pahissa, Elisenda
author_facet Alari-Pahissa, Elisenda
Federico-Vega, Judith
Ataya Fernández, Michelle, 1993-
Buxeda, Anna
Bello-Rico, Víctor
Gimeno, Javier
Yélamos López, José
Altadill, Mireia
Sanz-Ureña, Sara
Riera, Marta
Burballa Tàrrega, Carla, 1988-
Chamoun, Betty Odette
Pérez-Sáez, María José
Redondo Pachón, María Dolores
Vilches, Carlos
Crespo Barrio, Marta
López-Botet, M. (Miguel)
author_role author
author2 Federico-Vega, Judith
Ataya Fernández, Michelle, 1993-
Buxeda, Anna
Bello-Rico, Víctor
Gimeno, Javier
Yélamos López, José
Altadill, Mireia
Sanz-Ureña, Sara
Riera, Marta
Burballa Tàrrega, Carla, 1988-
Chamoun, Betty Odette
Pérez-Sáez, María José
Redondo Pachón, María Dolores
Vilches, Carlos
Crespo Barrio, Marta
López-Botet, M. (Miguel)
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv KIR-HLA-I mismatch
Antibody-mediated rejection
Killer cell immunoglobulin-like receptors
Microvascular inflammation
Natural killer cells
Renal transplant
topic KIR-HLA-I mismatch
Antibody-mediated rejection
Killer cell immunoglobulin-like receptors
Microvascular inflammation
Natural killer cells
Renal transplant
description Inhibitory killer cell immunoglobulin-like receptors (iKIRs) are randomly expressed by natural killer (NK) cell subsets and recognize motifs shared by HLA class-I (HLA-I) allotypes. Such interactions prevent NK cell autoreactivity while enhancing their response against cells lacking those HLA-I molecules (missing self), a situation defined in transplantation as iKIR-HLA-I mismatch (iKIR-MM), whose genotypic prediction has been associated with microvascular inflammation (MVI). Herein, we compared iKIR-MM in kidney transplant recipients with MVI ≥2 (n = 19) and controls with MVI ≤1 (n = 36). In parallel to genetic analysis of iKIR-MM, which was more frequent in MVI ≥2 patients, putative alloreactive iKIR-MM NK cells were defined by flow cytometry as NKG2A(-) cells bearing self-specific but lacking donor-specific iKIR. Although iKIR-MM NK cells were detected in both groups, their pretransplant numbers were higher in MVI ≥2 patients (median = 11.02, interquartile range = 0-58.31 vs median = 0, interquartile range = 0-9.46), especially in the presence of donor-specific antibodies or C4d, and correlated with MVI grade. Pretransplant, a subset of MVI ≥2 patients showed high proportions and numbers of oligoclonal iKIR-MM NK cells, which displayed an NKG2C(+) adaptive phenotype associated with cytomegalovirus infection. This pilot study provides a novel perspective on the contribution of iKIR-MM NK cells to MVI, with potential practical implications.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/70976
http://dx.doi.org/10.1016/j.ajt.2025.04.024
url http://hdl.handle.net/10230/70976
http://dx.doi.org/10.1016/j.ajt.2025.04.024
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Am J Transplant. 2025 Aug;25(8):1657-69
info:eu-repo/grantAgreement/ES/2PE/PID2019-110609RB-C21
info:eu-repo/grantAgreement/ES/2PE/PID2019-110609RB-C22
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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