• Media type: E-Article
  • Title: Spatially resolved immune exhaustion within the alloreactive microenvironment predicts liver transplant rejection
  • Contributor: Barbetta, Arianna; Rocque, Brittany; Bangerth, Sarah; Street, Kelly; Weaver, Carly; Chopra, Shefali; Kim, Janet; Sher, Linda; Gaudilliere, Brice; Akbari, Omid; Kohli, Rohit; Emamaullee, Juliet
  • imprint: American Association for the Advancement of Science (AAAS), 2024
  • Published in: Science Advances
  • Language: English
  • DOI: 10.1126/sciadv.adm8841
  • ISSN: 2375-2548
  • Origination:
  • Footnote:
  • Description: <jats:p> Allograft rejection is common following clinical organ transplantation, but defining specific immune subsets mediating alloimmunity has been elusive. Calcineurin inhibitor dose escalation, corticosteroids, and/or lymphocyte depleting antibodies have remained the primary options for treatment of clinical rejection episodes. Here, we developed a highly multiplexed imaging mass cytometry panel to study the immune response in archival biopsies from 79 liver transplant (LT) recipients with either no rejection (NR), acute T cell–mediated rejection (TCMR), or chronic rejection (CR). This approach generated a spatially resolved proteomic atlas of 461,816 cells (42 phenotypes) derived from 96 pathologist-selected regions of interest. Our analysis revealed that regulatory (HLADR <jats:sup>+</jats:sup> T <jats:sub>reg</jats:sub> ) and PD1 <jats:sup>+</jats:sup> T cell phenotypes (CD4 <jats:sup>+</jats:sup> and CD8 <jats:sup>+</jats:sup> subsets), combined with variations in M2 macrophage polarization, were a unique signature of active TCMR. These data provide insights into the alloimmune microenvironment in clinical LT, including identification of potential targets for focused immunotherapy during rejection episodes and suggestion of a substantial role for immune exhaustion in TCMR. </jats:p>
  • Access State: Open Access