Natural killer cell function predicts severe infection in kidney transplant recipients

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Abstract

The aim of this study was to determine if natural killer cell number (CD3/CD16±/CD56±) and cytotoxic killing function predicts severity and frequency of infection in kidney transplant recipients. A cohort of 168 kidney transplant recipients with stable graft function underwent assessment of natural killer cell number and functional killing capacity immediately prior to entry into this prospective study. Participants were followed for 2 years for development of severe infection, defined as hospitalization for infection. Area under receiver operating characteristic (AUROC) curves were used to evaluate the accuracy of natural killer cell number and function for predicting severe infection. Adjusted odds ratios were determined by logistic regression. Fifty-nine kidney transplant recipients (35%) developed severe infection and 7 (4%) died. Natural killer cell function was a better predictor of severe infection than natural killer cell number: AUROC 0.84 and 0.75, respectively (P =.018). Logistic regression demonstrated that after adjustment for age, transplant function, transplant duration, mycophenolate use, and increasing natural killer function (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.74-0.90; P <.0001) but not natural killer number (OR 0.96, 95% CI 0.93-1.00; P =.051) remained significantly associated with a reduced likelihood of severe infection. Natural killer cell function predicts severe infection in kidney transplant recipients.

Original languageEnglish
Pages (from-to)166-177
Number of pages12
JournalAmerican Journal of Transplantation
Volume19
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • clinical research/practice
  • Cytomegalovirus (CMV)
  • immunosuppression/immune modulation
  • infection and infectious agents
  • infection and infectious agents – bacterial
  • infection and infectious agents – viral:
  • infectious disease
  • kidney (allograft) function/dysfunction
  • kidney transplantation/nephrology
  • natural killer (NK) cells/NK receptors
  • translational research/science

Cite this

@article{abda214eee92464983eddea6193dd79d,
title = "Natural killer cell function predicts severe infection in kidney transplant recipients",
abstract = "The aim of this study was to determine if natural killer cell number (CD3−/CD16±/CD56±) and cytotoxic killing function predicts severity and frequency of infection in kidney transplant recipients. A cohort of 168 kidney transplant recipients with stable graft function underwent assessment of natural killer cell number and functional killing capacity immediately prior to entry into this prospective study. Participants were followed for 2 years for development of severe infection, defined as hospitalization for infection. Area under receiver operating characteristic (AUROC) curves were used to evaluate the accuracy of natural killer cell number and function for predicting severe infection. Adjusted odds ratios were determined by logistic regression. Fifty-nine kidney transplant recipients (35{\%}) developed severe infection and 7 (4{\%}) died. Natural killer cell function was a better predictor of severe infection than natural killer cell number: AUROC 0.84 and 0.75, respectively (P =.018). Logistic regression demonstrated that after adjustment for age, transplant function, transplant duration, mycophenolate use, and increasing natural killer function (odds ratio [OR] 0.82, 95{\%} confidence interval [CI] 0.74-0.90; P <.0001) but not natural killer number (OR 0.96, 95{\%} CI 0.93-1.00; P =.051) remained significantly associated with a reduced likelihood of severe infection. Natural killer cell function predicts severe infection in kidney transplant recipients.",
keywords = "clinical research/practice, Cytomegalovirus (CMV), immunosuppression/immune modulation, infection and infectious agents, infection and infectious agents – bacterial, infection and infectious agents – viral:, infectious disease, kidney (allograft) function/dysfunction, kidney transplantation/nephrology, natural killer (NK) cells/NK receptors, translational research/science",
author = "Claire Dendle and Gan, {Poh Yi} and Polkinghorne, {Kevan R.} and James Ngui and Stuart, {Rhonda L.} and John Kanellis and Karin Thursky and Mulley, {William R.} and Stephen Holdsworth",
year = "2019",
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T1 - Natural killer cell function predicts severe infection in kidney transplant recipients

AU - Dendle, Claire

AU - Gan, Poh Yi

AU - Polkinghorne, Kevan R.

AU - Ngui, James

AU - Stuart, Rhonda L.

AU - Kanellis, John

AU - Thursky, Karin

AU - Mulley, William R.

AU - Holdsworth, Stephen

PY - 2019/1/1

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N2 - The aim of this study was to determine if natural killer cell number (CD3−/CD16±/CD56±) and cytotoxic killing function predicts severity and frequency of infection in kidney transplant recipients. A cohort of 168 kidney transplant recipients with stable graft function underwent assessment of natural killer cell number and functional killing capacity immediately prior to entry into this prospective study. Participants were followed for 2 years for development of severe infection, defined as hospitalization for infection. Area under receiver operating characteristic (AUROC) curves were used to evaluate the accuracy of natural killer cell number and function for predicting severe infection. Adjusted odds ratios were determined by logistic regression. Fifty-nine kidney transplant recipients (35%) developed severe infection and 7 (4%) died. Natural killer cell function was a better predictor of severe infection than natural killer cell number: AUROC 0.84 and 0.75, respectively (P =.018). Logistic regression demonstrated that after adjustment for age, transplant function, transplant duration, mycophenolate use, and increasing natural killer function (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.74-0.90; P <.0001) but not natural killer number (OR 0.96, 95% CI 0.93-1.00; P =.051) remained significantly associated with a reduced likelihood of severe infection. Natural killer cell function predicts severe infection in kidney transplant recipients.

AB - The aim of this study was to determine if natural killer cell number (CD3−/CD16±/CD56±) and cytotoxic killing function predicts severity and frequency of infection in kidney transplant recipients. A cohort of 168 kidney transplant recipients with stable graft function underwent assessment of natural killer cell number and functional killing capacity immediately prior to entry into this prospective study. Participants were followed for 2 years for development of severe infection, defined as hospitalization for infection. Area under receiver operating characteristic (AUROC) curves were used to evaluate the accuracy of natural killer cell number and function for predicting severe infection. Adjusted odds ratios were determined by logistic regression. Fifty-nine kidney transplant recipients (35%) developed severe infection and 7 (4%) died. Natural killer cell function was a better predictor of severe infection than natural killer cell number: AUROC 0.84 and 0.75, respectively (P =.018). Logistic regression demonstrated that after adjustment for age, transplant function, transplant duration, mycophenolate use, and increasing natural killer function (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.74-0.90; P <.0001) but not natural killer number (OR 0.96, 95% CI 0.93-1.00; P =.051) remained significantly associated with a reduced likelihood of severe infection. Natural killer cell function predicts severe infection in kidney transplant recipients.

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KW - immunosuppression/immune modulation

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KW - infection and infectious agents – viral:

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KW - kidney (allograft) function/dysfunction

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U2 - 10.1111/ajt.14900

DO - 10.1111/ajt.14900

M3 - Article

VL - 19

SP - 166

EP - 177

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

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ER -