A different perspective on how the immune system behaves in kidney transplantation
Better understanding of how the immune system responds to a donated kidney could help us keep transplant patients healthier for longer. Although much new research is underway, there is still a lot we do not know about how our immune system responds to a donated kidney. With support from Kidney Research UK, Dr Anne Pesenacker aims to add to our knowledge by investigating a type of immune cell that helps to control our immune response.
Towards a greater understanding of how the immune system behaves in kidney transplantation
Kidney transplantation is the best option for patients with end-stage kidney disease. However, when a patient receives a new kidney their body’s immune system can identify it as foreign and attack it in a process called rejection.
There is still a lot we do not know about how the immune system behaves and the specific immune cells that play a part in rejection.
What are regulatory T cells?
Regulatory T cells (Tregs) are a part of the immune system that circulates through blood and tissue. They oversee the immune system and stop the body’s immune cells attacking its own healthy tissues.
Previous studies have suggested that Tregs may be able to stop a donated kidney from being rejected. Patients who received a new kidney and had more Tregs were less likely to suffer from rejection. Now, Anne will look at these Tregs in more detail to better understand their function before, during and after kidney transplantation and how they interact with other cells inside the donated kidney.
Looking at immune cells in kidney transplant patients and donors
Certain laboratory techniques can assess ‘Treg fitness’, a term that describes how well they should be able to do their job. Anne and the team have previously found that Tregs have different markers on them which can be used to check their fitness. Importantly, she has also found that the Treg fitness profile is different in patients with rejection.
To investigate this further, they will look at Tregs in a large group of kidney transplant patients and individuals who have donated a kidney, through collaboration with Professor Reza Motallebzadeh from University College London.
They will study blood and biopsy samples from patients and live donors who have kindly donated their samples for research, comparing Treg profiles with healthy individuals.
Using laboratory technology that allows them to analyse cells, they will measure Treg fitness from blood samples at different timepoints following transplant surgery. They will then use an imaging technique to look at biopsy samples and assess how Tregs interact with other immune cells inside the donated kidney.
A future towards personalising immunosuppression
By understanding more about how the immune system behaves in kidney transplantation, with a special focus on Tregs, this study could help us to identify patients at risk of rejection and identify new treatment approaches.
Meet the researcher
Dr Anne Pesenacker from University College London (UCL) has received a Professor Michael Nicholson research project award of £250,000 from Kidney Research UK to look at how T regulatory cells behave to understand and predict rejection in kidney transplantation and identify potential new treatment targets.
“This will be the first research study looking at how Tregs behave both in the blood of kidney transplant patients and inside the donor kidney itself which allows us to learn more about rejection. Thanks to funding from Kidney Research UK, this added knowledge and the potential of uncovering new molecules and cell interactions, could lead to future studies that allow us to develop and utilise therapies to ultimately achieve longer graft function with less systemic immune-suppression.” Dr Anne Pesenacker.
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