Time-dependent blood eosinophilia count increases the risk of kidney allograft rejection
Luc Colas, MD, PhD,
Linh Bui, MD,
Clarisse Kerleau,
Mohamed Lemdani, PhD,
Karine Autain-Renaudin, MD, PhD,
Antoine Magnan, MD,
Magali Giral, MD, PhD,
Sophie Brouard, VMD, PhD
Affiliations
Luc Colas, MD, PhD
INSERM, CHU Nantes, Nantes Université, Centre de Recherche en Transplantation et Immunologie UMR1064, Centre Hospitalier Universitaire de Nantes, ITUN 30 bd Jean Monnet, Nantes 44093, France
Linh Bui, MD
Centre Hospitalier de Mouscron, Belgique, Service de néphrologie, Belgium
Clarisse Kerleau
Service de Néphrologie-Immunologie Clinique, CHU Nantes, Nantes Université, Nantes, France
Mohamed Lemdani, PhD
Département of Biomathematiques, Faculté de Pharmacie and Biologie, Université de Lille, Lille, France
Karine Autain-Renaudin, MD, PhD
INSERM, CHU Nantes, Nantes Université, Centre de Recherche en Transplantation et Immunologie UMR1064, Centre Hospitalier Universitaire de Nantes, ITUN 30 bd Jean Monnet, Nantes 44093, France; Département d'anatomie et Cytologie Pathologique, CHU Nantes, Nantes Université, Nantes, France
Antoine Magnan, MD
Université de Versailles Saint-Quentin Paris-Saclay, Hôpital Foch, INRAe UMR 0892, Paris, Suresnes, France
Magali Giral, MD, PhD
INSERM, CHU Nantes, Nantes Université, Centre de Recherche en Transplantation et Immunologie UMR1064, Centre Hospitalier Universitaire de Nantes, ITUN 30 bd Jean Monnet, Nantes 44093, France; Service de Néphrologie-Immunologie Clinique, CHU Nantes, Nantes Université, Nantes, France; Labex IGO, F-44000 Nantes, France.; Centre d'Investigation Clinique en Biothérapie, Institut de Transplantation Urology and Nephrology (ITUN), Centre Hospitalier Universitaire de Nantes, 30 bd Jean Monnet, Nantes 44093, France; Corresponding author at: Service de néphrologie-Immunologie Clinique, CHU Nantes, Nantes Université, Nantes, France.
Sophie Brouard, VMD, PhD
INSERM, CHU Nantes, Nantes Université, Centre de Recherche en Transplantation et Immunologie UMR1064, Centre Hospitalier Universitaire de Nantes, ITUN 30 bd Jean Monnet, Nantes 44093, France; Labex IGO, F-44000 Nantes, France.; Centre d'Investigation Clinique en Biothérapie, Institut de Transplantation Urology and Nephrology (ITUN), Centre Hospitalier Universitaire de Nantes, 30 bd Jean Monnet, Nantes 44093, France; Corresponding author.
Background: Growing evidence suggest that type 2 immune effectors play a role in solid organ transplantation. The aim of this study was to evaluate the impact of blood count eosinophils (BCEo) on immunological outcomes in kidney transplant recipients with stable graft function after 3 months post-transplant. Method: We performed cause-specific Cox model considering BCEo, the use of calcineurin inhibitors and systemic corticoids as time-dependent explicative variables on a prospective cohort of 1013 kidney transplant patients who experienced kidney allograft rejection and/or the appearance of de novo donor specific antibodies after excluding common causes of increased BCEo.. Findings: BCEo ≥ 0.3 G/L was associated with a 3-fold increased risk of rejection independent of immunosuppressive regimen after 3 months post-transplant in patients without pre-transplant DSAs and with CNI-based immunosuppression. No association between BCEo either with donor specific antibodies or graft survival was noticed. Interpretation: These observations in this large cohort support the hypothesis of eosinophils in allo-immunity in human and claim for further mechanistic research. Funding: This study was supported by the French National Research Agency, The “Institut de Recherche en Santé Respiratoire des Pays de la Loire” and the University hospital of Nantes.
