Immunological cluster complexes in kidney transplantation

Laboratory tests are significant for the detection of immunopathological disorders in kidney transplantation. As a rule, the choice of tests is carried out individually and is based on the clinical characteristics and the presumptive diagnosis. Most often, in patients after kidney transplantation, atypical and not always standard changes in immunological parameters are observed, which is associated with a combination of many factors leading to different immune responses. All this served as the basis for typing immunological parameters in renal allograft recipients using one of the methods of system analysis – cluster analysis. Kidney transplantation was performed in 104 recipients. Immunological examination was performed on the 360^th day after the surgery. The following groups of recipients were identified: KTR1 – with primary graft function on the 7^th day and satisfactory graft function within a year, KTR2 – with renal graft dysfunction on the 7^th day and within a year. By means of cluster analysis, immunotypes of regulatory complexes were detected and characterized in various courses of the post-transplant period. To assess the immune response in allogeneic kidney transplantation, a set of immune cells with a phenotype should be determined: CD3⁺CD4⁺CD25^+highCD127^+low, CD3⁺CD4^-CD8^-, CD3⁺CD4⁺CD69⁺, CD3⁺CD16⁺CD56⁺, CD19⁺CD5⁺, LIN^-HLA-DR⁺CD11c^-CD123⁺, CD3⁺CD8⁺CD69⁺, CD3⁺CD4⁺CD8⁺, CD3⁺CD8⁺CD38⁺, CD19⁺CD86⁺, CD19⁺IgD⁺CD27^-, CD3^-CD16⁺CD56⁺, CD3⁺CD38⁺, CD14^+lowCD86⁺, LIN^-HLA-DR⁺CD11c⁺CD123^-. According to our data, the immunological cellular composition of the central point of clustering of the tolerogenic immunological complex is represented by regulatory CD3⁺CD4⁺CD25^+highCD127^+low and double-negative CD3⁺CD4^-CD8^-T lymphocytes. The composition of the central point of clustering of the hyperergic immunological complex is represented by the cooperation of CD3⁺CD8⁺CD69⁺ and CD3⁺CD4⁺CD8⁺ cells. The structure of the tolerogenic immune response in patients after kidney transplantation is based on intercellular interactions, which has a hierarchical system, the basis of which is represented by the cooperation of regulatory cells CD3⁺CD4⁺CD25^+highCD127^+low, CD3⁺CD4^-CD8^-, CD3⁺CD4⁺CD69⁺, CD3⁺CD16⁺CD56⁺, CD19⁺CD5⁺, LIN^-HLA-DR⁺CD11c^-CD123⁺. The hyperergic variant of the immune response in renal allograft transplantation is based on excessive activation of the following links of the immune response: CD3⁺CD8⁺CD38⁺, CD19⁺CD86⁺, CD3⁺CD38⁺, LIN^-HLADR⁺CD11c⁺CD123^-, CD19⁺IgD⁺CD27^-, CD3^-CD16⁺CD56⁺, CD3⁺CD8⁺CD69⁺ and CD14^+lowCD86⁺. The detected immunotypes will make it possible to implement a personalized approach to the diagnosis and treatment of patients with various types of immune response in kidney transplantation.

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