T cell Activation Marker HLA-DR Reflects Tacrolimus-Associated Immunosuppressive Burden and BK Viremia Risk After Kidney Transplantation – An Observational Cohort Study

T cell Activation Marker HLA-DR Reflects Tacrolimus-Associated Immunosuppressive Burden and BK Viremia Risk After Kidney Transplantation – An Observational Cohort Study

Kidney transplantation (KT) is the current treatment of choice in patients with end-stage kidney disease. Immunosuppression is required to prevent acute rejection but is associated with a high incidence of adverse events. The immunosuppressive burden substantially differs between individuals, necess...

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Main Authors: Simon Aberger, Max Schuller, Agnes A. Mooslechner, Konstantin A. Klötzer, Barbara Prietl, Verena Pfeifer, Alexander H. Kirsch, Alexander R. Rosenkranz, Katharina Artinger, Kathrin Eller
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Transplant International
Subjects:
immune monitoring
immunosuppression
kidney transplantation
translational nephrology
personalized medicine
Online Access:https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14443/full
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Summary:Kidney transplantation (KT) is the current treatment of choice in patients with end-stage kidney disease. Immunosuppression is required to prevent acute rejection but is associated with a high incidence of adverse events. The immunosuppressive burden substantially differs between individuals, necessitating new immune monitoring strategies to achieve personalization of immunosuppression. To compare the evolution of T cell profiles in correlation with immunosuppression and clinical outcomes, 87 kidney transplant recipients were followed for 12 months after KT. Flow cytometry along with assessment of T cell activation markers and clinical data was performed before KT and during study visits 10 days, 2 months and 12 months after KT. Longitudinal T cell phenotyping revealed a significant decrease of T cell activation markers HLA-DR, FCRL3, and CD147 in CD4+ effector T cells after KT. The most pronounced reduction (75%) was found for the activation-proliferation marker HLA-DR, which persisted throughout the observational period. The decrease in HLA-DR expression reflected immunosuppressive burden through strong associations with tacrolimus trough-level exposure (coeff = −0.39, p < 0.01) and BK viremia incidence (coeff = −0.40, p < 0.01) in multivariable regression analysis. T cell activation marker HLA-DR emerges as a potential biomarker for tacrolimus-related immunosuppressive burden in association with BK viremia risk following KT.
ISSN:1432-2277

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