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. 2013:2013:460316.
doi: 10.1155/2013/460316. Epub 2013 Oct 23.

The diagnostic value of transcription factors T-bet/GATA3 ratio in predicting antibody-mediated rejection

Xue Li  1 , Qiquan Sun, Mingchao Zhang, Jinsong Chen, Zhihong Liu
Affiliations

The diagnostic value of transcription factors T-bet/GATA3 ratio in predicting antibody-mediated rejection

Xue Li et al. Clin Dev Immunol. 2013.

Abstract

Background: Previous data showed that the predominance of intraglomerular T-bet or GATA3 is correlated with different mechanisms of rejection, suggesting that the ratio of T-bet/GATA3 might be used to distinguish antibody-mediated rejection (ABMR) and T-cell-mediated rejection (TCMR).

Methods: We compared the intraglomerular T-bet/GATA3 ratio in ABMR and TCMR. The intragraft expression of T-bet and GATA3 was studied via immunohistochemistry. The correlation of the diagnosis of AMR with the ratio of T-bet/GATA3 was examined.

Results: Both intraglomerular T-bet- and GATA3-expressing cells were increased during acute rejection. T-bet/GATA3>1 was strongly correlated with ABMR (93.3% versus 18.2%). The incidence of positive HLA-I/II antibodies and glomerulitis is significantly higher in T-bet/GATA3>1 group (P < 0.001, 0.013, resp.). The scores of peritubular capillary inflammation and glomerulitis were also higher in T-bet/GATA3>1 group (P = 0.052, P < 0.001, resp.). Nevertheless, T-bet/GATA3>1 is also correlated with C4d-negative ABMR and resistance to steroid treatment. Compared with C4d deposition, T-bet/GATA3>1 had a slight lower (90% versus 100%) specificity but a much higher (87.5% versus 68.8%) sensitivity.

Conclusion: Our data suggested that intraglomerular predominance of T-bet over GATA3 might be used as diagnosis maker of ABMR in addition to C4d, especially in C4d-negative cases.

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Figures

Figure 1
Figure 1
Immunohistological analysis of intraglomerular T-bet and GATA3. Positive staining is labeled in brown color. (a) Intraglomerular T-bet expression. (b) Intraglomerular GATA3 expression (magnification 400x).
See this image and copyright information in PMC

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